Seize opportunity to fix health care system

by Bob Balhiser
Queen City News, Helena, Montana
Wednesday, December 17, 2008

Like the old saying, "Too many cooks spoil the broth", it can likewise be said that too many fingers in the till ruin a health care system. Dr. Putsch has recently done an excellent job of outlining just how much of our health care dollar is spent on administrative costs by citing studies that peg the range between 31 to 38 cents. I think everyone can agree that either amount is out of line and serves to explain why our health care costs have grown exponentially.

To reinforce Dr. Putsch's assertions, it may be instructive to enumerate just a few of the non-medical costs built into U.S. health care that could be significantly reduced or eliminated with a well-designed system to provide Medicare for all U.S. citizens. They are: 1) Insurance agent sales commissions; 2) Insurance company overhead costs five times those of Medicare; 3) Costs for doctors to deal with delays, denials, and complex rules of myriad private insurers and plans; 4) Unproductive costs of practicing defensive medicine; 5) Excessive costs of malpractice insurance; 6) Disproportionately high compensation of medical specialists; 6) Expensive advertising and "me, too" drug development costs incurred and passed on by pharmaceutical companies, and finally, 7) The obscene example Dr. Putsch used to illustrate the apparent necessity for "one billing clerk per bed" to sort out costs at Duke University Hospital.

Quoting a recent e-mail I received from Senator Baucus's office: "The U.S. spends twice as much per person on health care as any other nation in the world, but our spending does not translate into higher quality. The U.S. ranks 19th out of 19 countries in preventable deaths". I find it unimaginable Max can look at these statistics and not want to throw out the whole health care payer system and rebuild it from the ground up. Perhaps he would like to start over, but considers it politically impractical.

Similarly, a Montana reporter asked Barack Obama when he was in Butte why he didn't support a single-payer health care system despite the fact that a majority of voters support the idea. To paraphrase Obama, he said it would be too difficult and disruptive to deep-six most of the health insurance industry that employs three million people nationwide.

I supported Obama, but I must say he made a pretty lame argument in this instance! If these folks do not add value to our health care system, then they should find something useful to do. Many with claims-processing experience would likely find positions in a single-payer system, while many highly (over)compensated executives might be forced to discover their true worth in a real world job market.

I would not be at all surprised if an impartial, in-depth audit of our current health care system were to reveal that the portion of our health care dollar devoted to non-medical costs was actually as high as 50 percent. Considering all the "slippage" in our current health care system, I suggest that we should be able to root out the waste, provide basic health care for all U.S. citizens, and still have money left over.

We can fix our broken health care system, and with Max Baucus and Denny Rehberg in influential congressional seats, Montanans are uniquely positioned to get the ball rolling. Surely there are powerful lobbyists who will resist meaningful change, but just remember this: those of us who pay the bills far outnumber those with fingers in the tills. We could start by persuading Denny to promote a hearing on H.R. 676 to examine the merits of a single-payer national health insurance system in an open forum.

To fix our health care system, we need only embolden politicians to do the right thing, then support them when they do. We can bring about meaningful health care reform, but if we have become too lazy or complacent to seize this golden opportunity, then we deserve to live with a failed health care system that will ultimately bankrupt the country.

Bob Balhiser is a retired engineer who lives in Helena