Both parties protect health care industry

By James Fieseher, M.D.
Portsmouth (N.H.) Herald, Nov. 24, 2013

In the land where the Supreme Court recognizes corporations as "people," political contributions are seen as a "right of free speech," and multi-billion-dollar corporations are given taxpayer bailouts, it is little wonder that politicians are willing to shut down the government in an effort to support a bloated health care system that fails to cover more than 80 percent of Americans while charging us three times the cost of health care as in other industrialized nations.

There has been a great deal of political noise, but no constructive discussion when it comes to health care. Our health care "debate" has been reduced to an attack or defense of the Affordable Care Act, or ACA (a.k.a. "Obamacare"). Indeed, the implementation of "Obamacare" has uncovered some glaring flaws. Not the least of which was the president promising people they could "keep their health care plan" while simultaneously setting a standard for insurance companies to protect patients from substandard care. That promise would have worked if substandard health insurance didn't exist, but that was one of the reasons the ACA was passed in the first place.

Because of this oversight, we have Republican partisans demanding that health care reform be repealed, a Democratic president trying to regain credibility for a remark that in retrospect, never should have been made and self-insured Americans (approximately 10 percent of the population) trying to decide whether they should hold on to a substandard health insurance policy. It is this last group that feels like they're owners of a boat with a large hole in it. Their boat is fine as long as they don't need to put it in the water.

The ACA, promoted by Democrats, is faulty and complicated, but the Republicans' insistence on "free market" health care is worse. "Free market" is the same health care that we've been working with for the past 40 years and is available only if you're healthy and wealthy enough. Health care costs under a "free market" system are responsible for well over half of the personal bankruptcies in the Unites States each year. If you're a conscionable small business owner, a minimal health care plan for your employees constitutes about 25 percent of your business expense. There is nothing "free" in that free market. The Republicans' lack of a health care alternative makes the "party of business" more like the party only for big business.

Both Republicans and Democrats are careful to protect the health care industry. The Democrats do try to rein in some of the more egregious abuses of the health insurance industry, but the problems and abuses are so widespread that the ACA makes for easy pickings for its critics.

Is medical insurance too big to fail? Health insurance is one of the most profitable industries in the country, meaning we pay a lot into it and get much less out of it. Surely the reason that politicians from both sides of the aisle support the health insurance industry must go beyond fat political contributions. Medical insurance companies were not formed to promote health or health care; they are the one component of the health care industry that doesn't actually contribute to patient care. If you are lucky enough to hit the health insurance "lottery" and receive more money than you (and your employer) contributed, then you can be sure someone in the company is looking for a way to drop you from your plan.

To really fix health care, we need to look beyond the two "solutions" offered by the two major political parties that promote different ways of protecting our medical insurance industry. We need solutions that offer every American access to health care at a cost that neither bankrupts the individual nor the nation. That means a thoughtful, respectful discussion not manipulated by the fear mongers against big government or big business.

Winston Churchill once said: "Healthy citizens are the greatest asset any country can have." Our large corporations have received their bailouts, it's time we took care of our "other" citizens — the mere mortal ones.

James Fieseher, MD, FAAFP, practices in Portsmouth.