With swift determination President Obama killed an annoying fly during an on camera interview in the White House. If only he would show such mastery and swat the corruption in Congress that blocks necessary and genuine health care reform.
Ordinary Americans need affordable and comprehensive universal health care provided by a single payer government system. Every objective analysis supports doing this. Such a system would not affect how health care services are provided by doctors and hospitals, but it would remove the incredibly costly private insurance system. The only way to understand the resistance to this approach is to recognize the highly profitable private insurance system that uses its political clout in Congress to keep its stranglehold on our inefficient system. It is a system that does not provide quality health care to enough people. Consider these critical facts:
Over 18,000 Americans die every year from preventable illnesses because they do not get the medical care they need. Not surprising, because only 3 percent of health care spending is on prevention. Which also has something to do with 50 percent of spending going to just 5 percent of people.
The U.S. spends far more per capita on health care than any other nation, and health care costs continue to soar unsustainably, now at $2.4 trillion and 18 percent of our GDP. Our per capita spending is 40 percent more than the second most costly national system. The insanity is that we get poor value for what we spend. According to the World Health Organization, the U.S. ranks 37 th in terms of health system performance; we are far behind many other countries in terms of such important indices as infant mortality, life expectancy, and preventable deaths. Even the latest federal National Health Quality Report concluded: "health care quality in the U.S. is suboptimal; the health care system is not achieving the more substantial strides needed to close the gap or quality chasm' that persists."
While the wealthy get all the best medical care they want, medical problems contributed to 62 percent of all bankruptcies in 2007 and surely is worse today.
The current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. Its main function is not to provide quality health care for all people but to make huge profits for companies. Private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing. Thirty cents of every dollar is not going to doctors, nurses, medicine, medical personnel; it is going to bureaucracy and administration plus exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. More efficient public programs such as Medicare, Medicaid, and the VA are administered for far less money, less than 10 percent.
From 2003 to 2007, the combined profits of the nation's major health insurance companies increased by 170 percent. William McGuire, the former head of United Health, several years ago, accumulated stock options worth an estimated $1.6 billion; CIGNA CEO Edward Hanway made more than $120 million in the last 5 years. CEO compensation for the top seven health insurance companies now averages $14.2 million. Over the last three decades, the number of insurance administrative personnel has grown by 25 times the number of physicians.
As Senator Bernie Sanders said, health care "special interests have spent hundreds of millions of dollars on lobbying, campaign contributions, and advertising, and with unlimited resources they can make out a check as big as they need. They will continue to spend as much as they need in order to preserve this dysfunctional health care system from which they profit so much."
And the New York Times was correct when it editorialized that "A public plan would have lower administrative expenses than private plans, no need to generate big profits, and stronger bargaining power to obtain discounts from providers. That should enable it to charge lower premiums than many private plans."
All Americans need to understand that everything you hear and read that criticizes a government administered health insurance system providing universal health care are outright lies. Every time you hear someone say that the U.S. has the best health care in the world your immediate reaction must be "but only some people can afford and access it." Private health insurance is the culprit.
Yet corruption may prevail in Congress, despite the latest national poll results. A recent New York Times/CBS News poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector. In fact, 85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, nearly 60 percent said they would be willing to pay higher taxes to make sure that all were insured, and 72 percent supported a government-administered insurance plan - something like Medicare for those under 65 - that would compete for customers with private insurers, versus 20 percent that said they were opposed.
Cynicism I have, and so I have little hope that Congress and Obama will do what is right and necessary. Instead all we are likely to get is still more slick talk and self-congratulatory hot air when rather limited "reforms" are passed. How will you know? The health insurance industry will remain dominant and highly profitable. Also, beware of distractions like the new promise by the pharmaceutical industry to cut costs for some Medicare drugs.
This is the bottom line: The way to pay for universal health care is to reap the savings by offering a government plan far better than private health insurance. Over ten years $4 trillion can be saved, more than enough to provide good health insurance to absolutely everyone. Better to spend the money on providing more actual health care to millions more Americans than on enriching insurance companies and their executives. Some private insurers can still survive by selling products, as they do now with Medicare recipients, for supplemental and drug coverage.
If this window for health care reform closes with a farce, then many millions of Americans will suffer and die before another opportunity arises. I hope that Obama does not get reelected if this sad scenario comes to pass. That's assuming things are not manipulated to delay action until his second term.
Joel S. Hirschhorn has succeeded as: a full professor, University of Wisconsin, Madison; a senior staffer, U.S. Congress (Office of Technology Assessment); head of an environmental consulting company; Director of Environment, Energy and Natural Resources, National Governors Association; now an author and consultant. Recent books are: Sprawl Kills - How Blandburbs Steal Your Time, Health and Money, and Delusional Democracy - Fixing the Republic Without Overthrowing the Government. He has published hundreds of articles in newspapers, magazines, journals and on many web magazine sites. He has given hundreds of talks at a wide range of conferences worldwide. He focuses on American culture, politics and government, and health issues.
» left by Roy Ellis from Scrabble, Va. (130 days 18 hours ago.)
Another good article on healthcare Joel. Here are a few notes from yesterdays Wash Post. “53 indicted in Medicare Fraud Sting”. $50M in billing for unneeded services or for services that were not provided. I find that kind of special since healthcare fraud has been rampant through my lifetime and now that healthcare is on the front burner we get some enforcement action. How special! Yesterday the Senate Commerce Committee released a report stating that insurance companies have bilked consumers of billions that the insurance companies should have paid. Three healthcare specialist testified that insurers go to great lengths to avoid responsibility for sick people, use deliberately incomprehensible documents to confuse clients about their benefits and sell ‘junk’ policies that do not cover needed care. Well, this has been going on throughout my lifetime as well. Didn’t need a gov. committee to educate me on that one. Attny. Gen. Cuomo, NY, found that insurers under reimbursed consumers by as much as 28%. The insurance companies complained saying that paying whatever doctors charge is simply not economically tenable. A nice capitalists statement coming from a biz exec.
Let’see. What else is in the news that I already know. Ah, here’s one! Hospitals in the area are bracing for more cutbacks as they are experiencing soaring demand from uninsured patients (read illegal immigrants). Uninsured in this country stands at around 51M folks. The administration is pushing for free healthcare for illegals in their new public healthcare plan. Medical coverage for illlegal children was provided for in the recovery act for children to the age of 32. under the SCHIPS program.
Turns out that the Fed employees healthcare plan doesn’t provide the low drug price competition and market dominance they theoretically should bring 2, but that’s about to change according to the Fed. ‘Change’ will clear away the smoke and mirrors that surround the employee program. Ain’t that special! All these years we’ve heard about how great the Fed Emp healthcare program is and now they are talking of ‘change’ and smoke and mirrors. It was found that the OPM, which runs the program, pays substantially more for drugs as it does not regulate or negotiate on the price of drugs as other federal agencies such as Medicare, VA and Public Health Service in spite of the fact that the FED has the buying power of 8M members. It was found that Costco and drugstore ((dot)) com offer better drug prices than the FED program. Seems some pharmacy managers were receiving rebates of up to 50% that wasn’t being passed back to OPM. Who’d of thunk!? Can u believe it?
I saw something in the post today that knocked my socks off. Twice, the writer of one article referred to ‘reform’ of the healthcare system! When is the last time you heard the word reform from any gov related entity? I’m blown away! To wit; “White House officials said Obama opened the meeting with his pitch for reform, call the status quo unsustainable—“ and, “with cost estimates for health reform soaring beyond $1 trillion over the next decade- -“.
Attempts to reform any large program is useless with a corpocrisy government in place. Certain government reforms would be necessary before reform legislation on any major issue could be achieved. Reform of government would be incomplete without including the Congress as part of the effort. Congressional reform is needed to regain the proper representation a Representative or Senator should provide for his/her state. The goal would be to set a level playing field for all members so that the words ‘junior’ or ‘senior’ become superfluous. Thus, salaries of all members should be the same with no yearly pay increases and no retirement program. A new senator should have as much clout as a senator who has held office for several terms. The business model organization of tenure, pay and advancement to positions of power should be abolished. Organization and scheduling would still be done by appointed members but any perks associated with the position would be nil. The legislature is not a career oriented business and should not be operated as such.
Until government reform is achieved we cannot expect real reform of the healthcare industry.
Thank you, Joel, for writing such a comprehensive article about the healthcare reform and I also thank Roy Ellis for his comments. It truly is a challenging subject matter to wrap a mind around, and I will refer to your articles from time to time. I shall also try to think back over the documentary that took place this week on health-care reform ~ the only thing that truly sticks out vividly at the present is the comment made on how medical treatment could ever reach the masses if everyone were insured ~ there just aren't enough doctors in America and many are specialists earning high dollars because of their specialities. The GP pays a staggering $300,000 or more for an education and presently doesn't have much of an incentive to practice as such - mind boggling it is, but I get frequent information from the Obama Administration requesting support - we certainly do need more articles that enlighten and educate people. Thanks so much for the article. Suzy
I don't know guys. I work in the health care industry and I have seen the effects of the uninsured on these institutions but I have also been involved in public health care and would advise you to set up an appointment at your local health dept before supporting a health care system controlled by the government. Is that really how you want to see the er in America? Don’t you want control of your health coverage so no one can dictate what treatments you can have? If illegals are running up our health cost how about immigration reform as opposed to amnesty. Government has no business in my health care.
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