Health Care Video

Health Care Video

By

Leonard Zwelling

https://www.nytimes.com/2021/04/28/opinion/healthcare-us.html

One of the commonest fallacies perpetrated on the American people by the health care industrial complex (hospitals, doctors, pharmaceutical companies, device makers, insurers and the government) is that the American health care system is the best in the world. It’s not.

It might be true that in America you have the highest likelihood of receiving cutting edge experimental therapy for a rare cancer, but that’s not a metric of health care quality let alone cost and access.

In this video presented by The New York Times on April 28, eight English-speaking individuals from other westernized countries display their shock when they discover what most Americans already know. American health care is too complex, too pricey, and too unregulated.

Watch the video not for the facts presented but for the incredulity of the eight people when they learn how expensive American care is and how poor American life expectancy is when compared with that in other countries that spend far less per capita than we do. These people cannot conceive of living in a civilized system where 66% of the bankruptcies in the country are tied to health care costs draining all family resources. Many of them pay more for parking in the hospital lot than they pay for the care they receive in the hospital itself.

As I learned on Capitol Hill and during my year in Washington in 2009, the reason that American health care is a basket case is summed up best by Norman Ornstein’s definition of health care reform: “I pay less.” No one in the healthcare industrial complex wants to give up his or her revenue stream for the good of the American people.

The Republican leadership in the Senate and House did everything within its power to prevent the Affordable Care Act from passing. Since it passed in 2010, these same Republicans have tried to repeal it countless times with no success. And the ACA is neither a universal care system nor a single-payer system. In fact, it guarantees the preservation of the American insurance industry which is largely based on health coverage being attached to one’s work meaning when one loses a job and is in most need of help, he or she is least likely to be insured.

There are countless different systems around the civilized world that have been devised to provide health care for the citizens of the various countries. I am sure that we in America can come up with our own. But here’s what it has to do:

Cover everyone. No exceptions. Can you buy extra costly coverage if you want? Sure, but some baseline medical care is guaranteed to everyone. If the rich want concierge medicine, that should not be prevented, but it ought to be the exception. Eventually, if the universal system is working, concierge medicine may go away.

The cost of the care for the whole country needs to be borne by the whole country. Yes, this is socialism, but it stops victimizing the sick and rewarding the well. Sickness and wellness are often beyond the control of the individual. Americans should not be penalized because they came up short in the gene pool or were hit by a drunk driver while waiting for a light to change.

Quality should be measured and monitored and providers should be given feedback as to how they are doing and be held accountable.

None of this is the real issue. The real issue is how can the government of the United States move the entrenched health care industrial complex away from its stance against reform? Answer: it cannot. Thus, the clever politician would suggest an incremental way to get from where we are (no where) to where we need to be (everyone covered). That would be the initiation of the public option, an insurance system into which one pays and from which one receives coverage. It would work like Medicare, but would allow everyone over 26 to buy in. Premium cost could be need based and pricier for the more well to do who could forego it if they think they can do better in the open market. Insurance from employers needs to end. It makes no sense and never did once wage and price controls were lifted after World War II.

Don’t get me wrong. I understand why President Biden is going elsewhere for his initial legislative proposals. But sooner or later, we need to get back to this if the United States is going to keep up with the rest of the world. We are highest in healthcare spending and lowest in life expectancy among the countries surveyed for the video. Surely we can do better than that. At least, let’s start by expanding Medicaid throughout the country and creating a public option to compete with commercial carriers. My guess is that if the public option is even a little bit cheaper and just as good, economics will take over and we will get to universal health care soon enough. Maybe not for me, but for my grandkids.