Health care can't stand half-measures
By JOHNATHON ROSS
Toledo Blade
September 05, 2009
OUR health-care system costs too much and we get too little. Our costs per person are twice those of most of our economic competitors and those costs are added to every product we try to sell in the world marketplace.
It has been estimated that the cost of health care in each car we produce is more than the cost of the steel to make it. In terms of coverage, all of our economic competitors cover their citizens with a national health-insurance program. We are the only industrial democracy that fails to do so.
America leaves nearly 50 million with no coverage at all. More than 20,000 Americans die every year from lack of health insurance alone. Our poor quality of care results in an estimated 100,000 excess deaths from preventable and treatable causes every year.
For nearly 100 years the United States has been struggling to come to grips with health-care costs and coverage for all. Theodore Roosevelt, FDR, Truman, Kennedy, and Clinton all proposed some form of national health program, yet none was enacted.
The principal barrier to health care has been the opposition of special interest groups, especially the private health-insurance industry. So, here is an old idea: Pay them to go away.
We already have a uniquely American solution that works right under our nose that has proven itself durable and successful. It is our own Medicare program for seniors.
Multiple studies done by different health-economics experts consistently find that using an improved and expanded version of Medicare, we could cover all Americans with comprehensive benefits, allow patients to use the doctor and hospital of their choice with no restrictions, no co-pays, no deductibles, and no lifetime limits and still spend no more than we spend now with a sickness care nonsystem that fails to cover 50 million of us.
Private health-insurance premiums make up less than half of our total health-care spending of $2.4 trillion yearly. The rest is already publicly financed. The total profits of the private for-profit insurers only average about $20 billion yearly or about 1 percent of total health-care spending. Unfortunately, the administrative bureaucracy needed to advertise, sell, broker, collect premiums, process the bills, and pay shareholders a nice return wastes 15 percent to 20 percent of the money before a single patient receives care. Then the doctors and hospitals and other providers must deal with the complexity of a thousand insurers with tens of thousands of different insurance plans with different deductibles, co-pays, restrictions, rules, and regulations.
This has created an army of billing and insurance clerks in every doctor’s office and hospital. It is this waste, complexity, and administrative burden created by the need to service the private insurers that makes the U.S. health-care system the most complex, ineffective, expensive, and wasteful in the world. Almost every other civilized country covers all their citizens with a nonprofit national health-insurance program that costs about half as much per capita with equal or better health outcomes.
If we pay the private for-profit insurers $20 billion yearly to go way, multiple well-designed studies suggest that we can save at least $400 billion yearly by eliminating unnecessary administrative costs with an improved and expanded Medicare for all. We even have a bill in front of Congress to create this system, HR 676, the U.S. National Health Care Act. It will be debated and will receive a vote this fall. In addition, to the savings generated by the administrative simplicity of an improved Medicare for all, we can certainly improve care in ways that cut costs further. If we can lower costs by improving care delivery to equal those of the second most expensive health-care system in the world, Switzerland, it would yield $700 billion in savings each year. This is enough to pay for the cost of the big bank bailout, for the economic stimulus program, for covering all the uninsured and for improved coverage for the rest of us. An improved and expanded Medicare for all would save money and save lives. It is the fiscally conservative and ethically correct thing to do.
Congress should make this as an offer that cannot be refused in the best Godfather tradition. The insurance industry would be wise to take a generous bribe and go away. Maybe we should get rid of them anyway and keep the $20 billion yearly for improved education and environmental clean up that we need so badly. Is anyone else out there ready to put a horse head in the insurers bed? Please contact your legislators and let them know how serious you are.
People are dying every day from the grip these mobsters have on health care. They are unintentional serial killers. It is time to respond in the only language that they understand.
Johnathon S. Ross, M.D., M.P.H., is past president of Physicians for a National Health Program (pnhp.org) and a leader of the Single Payer Action Network in Ohio (spanohio.org).
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