Obamacare: A deeply flawed system

By Tom Walsh
The Ellsworth American (Maine), April 2, 2015

The big winners in the Affordable Care Act are not those newly enrolled, but the status quo players in the deeply flawed American health care delivery system: the health insurance industry, Big Pharma drug companies, for-profit hospitals, overpaid doctors and other co-conspirators in an American health care system that, by any objective standard, is a complete failure.

Unfortunately, the emphasis of this federal legislation (translates: Obamacare) is "affordable." To couch it in terms of "health care reform" is a rhetorical joke. The quality of health care in America is not being "reformed" in any way through a program that, bottom line, not only encourages, but now requires, Americans to buy into a health care system that remains deeply flawed. It's an approach that makes health care less expensive and more accessible, but not better in terms of quality of care.

In 2005, Paul and Gretchen Volenik moved from Hancock County to Nova Scotia to take advantage of Canada's common-sense, no-insurance-required approach to health care delivery. Between 1994 and 2002, Paul was a state representative in the Maine Legislature, where he was the point man advocate for a state-funded universal health care system that would provide medical care to every citizen of Maine. When that never happened, the Voleniks moved north.

"It's like a train," Paul says of the so-called health care reform. "The engineer is driving the health care train, and he stops at each stop and picks up a few more people, maybe children, or a group of low-income people. But he fails to notice that the train is on fire and that people are leaping off it in all directions, because the system is ridiculous. Until you get rid of the immense power of the drug companies, until you get rid of the inflated salaries of the hospital administrators, you will never have an effective health care system."

And we don't. In the world of health care statistics, "outcomes" means results. You know, little things like infant mortality and life expectancy. The outcome numbers, as they have for years, undercut the Big Lie that America has the "best health care system in the world." No. It doesn't. Not even close. Not when you look at those pesky outcome numbers.

"The United States health care system is the most expensive in the world," says a June 2014 analysis by the Commonwealth Fund. "The U.S. underperforms relative to other countries on most dimensions. Among the 11 nations studies in this report -- Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States -- the U.S. ranks last, as it did in 2010, 2007, 2006, and 2004. ... Most troubling, the U.S. fails to achieve better health outcomes than the other countries. ... The U.S. is last or near last on dimensions of access, efficiency, and equity. ... The U.S. ranks last overall with poor access scores on all three indicators of health lives -- mortality amenable to medical care, infant mortality, and health life expectancy at age 60."

There it is. Why bore you by drilling down into the stats? Suffice to say the numbers in terms of America's health care efficacy are not close to good. Among the world's industrialized countries, the American health care system, in terms of results, isn't within the top 20.

In 1974, while America's mindset was being distracted by Watergate and Richard Nixon's personal and political meltdown, there was a U.S. senator running around Capitol Hill, loudly preaching the gospel of what he termed "national health insurance." Too loudly, apparently, for the K Street lobbyists for Big Pharma drug companies, the American Medical Association and the American Hospital Association, who took note and collectively circled the wagons, making sure this potential drift away from the extremely lucrative status quo wouldn't come to be. To Sen. Ted Kennedy's dismay, it didn't. Nor has it, 40 years later. In the meantime, an estimated 210,000 Americans die each year from preventable medical errors, making such errors the third leading cause of death in the United States, after heart disease and cancer.

So jump aboard the train. Only now it's not an option, it's required. In the meantime, remember this: The only way to survive the American health care system is to stay out of it.

Good luck with that.

Tom Walsh of Gouldsboro is an award-winning medical and science writer.