The midterm elections have come and gone, and there soon will be a lot of new voices reverberating through the halls of the Capitol -- which has to be great news for health care reformists. Who better to find a saner and fiscally more responsible way to deliver health care to our citizenry than those who have pledged to save us from wasteful spending and ineffective policies?
Welcome back, fiscal conservatives! We need you!
We need you because in 2009, US healthcare expenditures rose to 2.5 trillion dollars, representing almost 18% of the nations' spending that year, and marking the largest yearly increase in health care spending this nation has ever seen. We have witnessed your passion in all those campaign ads where you spoke about bringing runaway spending under control. Certainly, when our current way of operating the business end of health care is driving us both individually and as a nation towards bankruptcy, your consciences will not rest until you have made the kind of profound changes to our healthcare system that such wasteful spending calls for.
And we need you, fiscal conservatives, because if we can believe all your campaign ads -- and how could we not -- you have a proven track record of cutting through red tape and solving problems. The US has, by almost all measures, some of the poorest health on the planet despite the fact that our health care is also, by far, the most expensive. Now that's a problem. A big, embarrassing, shameful problem. If ever there was a time for tough, honest, no nonsense leaders who will fight for us in Washington, this would be it.
And talk about taxes! Transparent taxation is part of the bedrock of democracy. Yet most Americans have no idea of the hidden costs of our privately insured health care -- the approximately $1500 of a new car cost that covers autoworkers health benefits, for instance. Carry that same kind of calculation over to college tuition or any other typical big-ticket item, and we get a startling picture of just who it is that is not allowing us to hold on to our hard-earned money. It ain't big government. Compound that to the effect that employer-paid health insurance premiums have on our paycheck, our job security, and even our ability to change jobs, and we realize the toll our privately run system has taken not only on our pockets, but also on our individual liberty. We welcome your representation on this insidious taxation.
Now we may have the tiniest disagreement on the role of the free market in our society. We all understand that free market principles are part of the American DNA; in fact some of you folks talk about the free market the way you would talk about your sainted mother. But lets be honest. No matter how much we all love our mothers, there are some places we don't want to take her -- to college to be our roommate, for instance. There are some places where the free market needs to be kept at arm's length as well. It doesn't mean we don't love her.
At the hand of the free market, our healthcare system has devolved into a health-industrial complex where health policy is decided by executives in the boardrooms of insurance companies while pharmaceutical companies spend hundreds of millions of dollars annually to successfully market expensive drugs of questionable efficacy. To watch the commercials featured on the evening news, one would think that the biggest medical problem facing our nation is erections lasting more than four hours. Even many of the medical tests and procedures we undergo are driven primarily by the people who will make money if the tests are "positive." We don't need to be communists. We just need to be smarter. Healthcare for profit has not been good to us and we can't afford it.
We know you fiscal conservatives are a patriotic bunch -- to the point where you almost imply at times that the rest of us are unpatriotic, but I am willing to overlook that in a spirit of cooperation. Those of you who have served in the military, like I did for eight years as a medical officer in the US Navy, are quite familiar with a little concept we call single-payer, universal health coverage. So you see, it really was not invented by the Canadians, which means you can safely consider the medical and economic benefits of this system without feeling you are betraying the homeland.
So, new guys, you're smart, your patriotic and you know how to manage money and solve problems. Can you see why you are bringing hope (dare I say change?) to a liberal-leaning pediatrician who has seen, firsthand, the best that medicine has to offer in the form of our own military's universal single-payer health care system -- one whose policies were guided by medical science rather than profit? If you indeed mean what you have been saying about bringing spending under control, then profound, meaningful health care reform will be a top priority, and you really will be just what the doctor ordered.
Maggie Kozel, M.D. is the author of "The Color of Atmosphere: One Doctor's Journey In and Out of Medicine," forthcoming from Chelsea Green Publishing. Follow her blog at barkingdoc.com
Follow Maggie Kozel, M.D. on Twitter: www.twitter.com/barkingmd
David Katz, M.D.: Resisting the Tyranny of Medical Testing
Between no coverage and having a high deductible and co-pays if covered, all of us are vulnerable. Yet like in many situations, we are our own worst enemies. We all need to SAVE the burden of healthcare and SHARE its reduced cost. This is not rocket science, or something new that needs to be discovered. Here are suggestions:
1. Preventive Care - Stop smoking. Exercise and Prevent obesity and other illness with proper diet and life style. Regular medical check-ups.
2. Care for elderly parents, uncles and aunts; thus saving hospital and nursing home costs. End-of-life care, (last few months), account for 30% to 40% of costs.
3. Help relatives manage their chronic illness which accounts for 75% of costs and responsible for 70% of deaths.
4. Dissuade relatives, neighbors and friends from making hospitals' ER the first line of care - very expensive way to access healthcare.
5. Doctors and Hospitals have to end the 40% of over-treatment, under-treatment and in-appropriate treatment .... without further excuses of why it occurs.
6. Health industry - Insurers, Providers, Pharma, etc. need to half their overhead cost of 30+%.
We should stop blaming Govt.
Reward healthcare consumers and providers for approriate care and dis-incentivize inappropriate care.
Take-over at grass-roots by doing the right thing, even if inconvenient.
Look at the number of articles on healthcare written by self-described consultants on healthcare policy. I wonder who is paying their consultancy bills? Now perhaps Americans know why their healthcare bills is so high. It is estimated that less than half the healthcare dollar goes to needed care delivered by the care-givers.
The healthcare costs of 2.5 trillion dollars per year (your figure) is passed on as added cost of American 'goods and services' making us less competitive with foreign countries.
Dr. K.
Do you really want the government running our health care system? The VA has all the benefits of sponsorship and none of the hurdles. The VA does not develop, design, nor pay for breakthrough pharmaceuticals and treatments in medicine. They are not burdened with increasing malpractice insurance.
Americans realize the “hidden” costs of commodities and are doing something about it by sending a message to our representatives that business as usual will not be tolerated. Over taxation and regulation have placed an enormous burden on our grand children.
Don't we subsidize research and development of drugs for third world countries? Aren't there programs for those who cannot afford them here at home? I also take serious umbrage at your implication that four hour erections are not of vital national interest!
We have the best health care system on earth, proven out by foreigners trying to get treatments unavailable to them at home.
Are improvements needed? Always, but it’s a baby and bathwater scenario. You don’t have a similar situation between the VA and our overall health care system. Efficiencies can always be found, and forcing insurance companies to compete nationwide would go a long way in consolidating numerous and conflicting policies in the delivery of health care. Working within a system for positive change is always better than throwing one out.
I believe we can attack this issue without having the government run a 3 trillion dollar industry, and without disparaging my sainted mother.
All that insurance companies do is spread the risk of health expense over a large population of people. By providing this service they take a healthy profit. We have thousands of health plans with thousands of forms and procedures. It's estimated that at least 20% or more of health care expense is attributable to this redundency, add in the insurance companies profiting from the sickness of others and the savings could be huge.
So, instead of having hundreds of health insurance companies spreading the risk over hundreds of smaller groups, why not spread the risk over all 310 million Americans.
Big pharma would still be intact and untouched. Medical equipment mfgs would still be intact and untouched by "big government".
This canard that big government will damage the health care industry or the delivery of health care is unsubstantiated and, most times, promoted by the industries that just want to maintain their profits with little regard to the impact on all Americans.
It is well documented that we are woefully down the list of developed countries n the quality of our care in the US by many metrics from infant mortality to lifespan. And as for your comment that foreigners come here for care, ... it is true, ... while 50 million American Citizens go without insurance and the care it would pay for, or delay care until it becomes a disaster in the ER.
Medicare works incredibly efficiently, allows the selection of the provider, and should have been adopted as the model for a single payor, or at least a public option.
I hope your mother is well.
Keep the pressure and knowledge ON.