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Posted on March 11, 2004

There's a single solution to problems in health system

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LAURA BILLINGS: There’s a single solution to problems in health system

A column last week about the health care costs that have been the sticking point in negotiations with striking Metro Transit bus drivers seems to have struck a chord with readers. Several dozen wrote in with their own concerns about the crisis in health care, which I thought I’d answer here, while we wait for our rides …

These bus drivers don’t know how good they have it. They should just be grateful they get health insurance at all — a lot of us don’t.

True. There are an estimated 41 million uninsured Americans, despite the fact we spend twice as much on health care as the average spent in other developed countries that provide universal coverage. Here in Minnesota, we have 394,580 uninsured — about 8 percent of the population.

Why is it a company’s responsibility to pay for any of the coverage? When my grandfather came to America from Germany in 1898 he never expected anyone to pay for his health care — and if you couldn’t afford something you didn’t get it.

Well, a lot of businesses believe that providing health coverage to employees should no longer be part of the social contract. A business group in California is trying to turn back a new law requiring large companies to pay for 80 percent of their workers’ health care benefits. The group already has collected more than 620,000 signatures to get on the ballot in November. Businesses in plenty of other places are eager to see how this turns out, since rising health care costs are cutting into profits.

As for your grandfather, his logic might have held up better a hundred years ago, when a trip to the doctor wouldn’t have bankrupted you. Have you checked out your own HMO statements lately? I went to the emergency room for stitches recently and got a bill for almost a thousand bucks. Why does it cost so much? In part, because those of us who do have insurance end up subsidizing those who don’t.

The biggest problem is that people use medical insurance way too much, and bug their doctors for the tiniest things instead of toughing it out.

I swear I needed those stitches. The blood was everywhere! It’s true that unnecessary medical costs are a contributing factor, but there are 41 million bigger problems.

It’s these doctors that are the problem. They want to keep us from having national health insurance because they’d lose money, and wouldn’t be able to pay the greens fees at their fancy golf courses.

Take your shots, but the truth is that physicians may be more fed up with the way our health care system works than almost anyone. According to a Harvard Medical School study published last month in the Archives of Internal Medicine, nearly two-thirds of the 904 Massachusetts doctors they surveyed were in favor of single-payer national health insurance. Some 57 percent said they’d be willing to work under a salary system, and 67 percent said they’d even take a reduction in fees for a reduction in paperwork. Physicians feel your pain.

There’s no way this country could afford to give health insurance to everyone who doesn’t have it. The expense would be mind-boggling.

Not really. According to a report from the Kaiser Commission on Medicaid and the Uninsured, providing coverage for all 41 million uninsured Americans would increase health spending’s share of the gross domestic product by less than one percentage point — $34 billion to $69 billion a year, depending on which approach you choose. As for mind-boggling, the uninsured already use about $99 billion in medical care each year.

You do a great job defining the problem — now come up with the solution to health costs.

Better minds than mine have already proposed one. In fact, more than 8,000 physicians (including two former surgeons general and the former editor of the New England Journal of Medicine) back a plan proposed last summer by Physicians for a National Health Plan. They suggest building and expanding on the foundation of the current Medicare program, providing access to people of all ages and covering prescription drugs and long-term care. They say such a single-payer system would save more than $200 billion a year in administrative, marketing and other private industry expenses — more than enough to pay for people who don’t have insurance.

Why haven’t you heard about this? Because the only politicians willing to say the words “national health insurance” in public are Ralph Nader and Dennis Kucinich. Even though health care has reached a crisis stage, expect November’s election to be decided on more important issues like who gets to marry whom and prayer in the classroom.

Every time I read your column I think my head is going to explode.

That sounds bad. You should see a doctor about that.
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Laura Billings can be reached at lbillings@pioneerpress.com or 651-228-5584.