Tuesday, August 4, 2009

For the Medical Industry, It's Time for a Change

Anybody who thinks the medical industry in this country doesn’t need reforming either has bag loads of money or runs the medical industry. There are two obvious problems with our health care industry. First, the cost of insurance (and the ever increasing costs that insurance won’t pay – like annual checkups for children) is getting out of hand. For years, the cost of medical care in this country has been exceeding the rate of inflationgreatly exceeding the rate of inflation. The rate of increase is having an adverse affect on retirement systems across the country. In essence, the insurance companies, at the heart of the medical industry, have no competition and insignificant regulations to keep down their costs. They are running a protection racket that makes the Mafia jealous. The American Chamber of Commerce has recently argued that reforming the health care industry will put insurance companies out of business. This is like worrying the Mob might be put out of business. And since hospitals know that insurance companies have no incentive to hold down costs because they have a captive market, the hospitals keep raising their prices, outstripping inflation (think about the 10 dollar Tylenol).

The second problem is the high number of Americans who don’t have health insurance, thus often preventing them from getting proper medical care for them or their children. At least 46 million persons below the age of 65 don’t have health insurance, and, of these, over 8 million are children. We, as a nation, are simply letting over 46 million of our fellow Americans, our brothers and sisters, suffer because we can’t or won’t think of ways to help them.

The most common argument against reforming the system is the shibboleth of “socialized medicine” and the exaggerated claims that such national health care systems don’t work. The exaggerated failures in Canada, Britain (and here, and here), Sweden, etc. are the typical scare tactics used to frighten Americans. The argument boils down to, yes, our system isn’t perfect, but if you try to fix it, it will get worse. First, the use of the word “socialized” is simply a way to scare Americans. The typical American believes the mindless equation: socialism = communism. Secondly, in reality, we already have “socialized” medicine in this country. “Socialized” medicine is simply medical care paid for by the government. Medicare, Medicaid, and Veterans’ Affairs are examples of government-supported medical care. This is not to say that these services don’t need reforming as well. This does mean that the argument that reforming the medical system will lead to the horrors of “socialized medicine” is simply scare tactics. Call it what ever you want, we need to reform the medical system, and if you want to call it “socialized medicine,” “managed healthcare,” “single-payer universal care,” or some euphemism, it doesn’t matter as long as the obviously broken system gets fixed.

The high cost of a national health care system is trotted out as a reason not to even attempt to provide basic health care to all Americans. However, according to a report by the Organization for Economic Co-operation and Development (OECD), the US already spends more on health care than any other country. Thanks to the obscene profits across the medical industry, Americans enjoy paying 16.0 per cent of GDP on healthcare in 2007. In the same year, Canada spent 10.1 per cent, Sweden spent 9.1 per cent, and Britain spent 8.4 per cent (the average cost of health care in the countries surveyed in the OECD report was 8.9 per cent of GDP). Thus, we are paying more than any other industrialized nation, including those with the dreaded “socialized” medicine, for a system that is obviously broken .

Too often, the argument against reforming the medical system is that it’s too complicated to fix. However, just after World War II, Europeans said the quickest way to get something done is to tell an American it can’t be done. With that kind of attitude, we figured out the Marshall Plan and put a human on the moon. Now, unfortunately, when you tell an American something can’t be done, he shrugs his shoulders and watches what he has on the DVR.

We used to have the smartest people in the world. In 1960, President John F. Kennedy challenged Americans to put a man on the moon. Americans (and people from all over the world) worked together, without regard to political affiliations, for seven years and achieved a remarkable goal. If we assume that other countries haven’t figured out their version of national health care (and this is a major assumption based on a phenomenal amount of disinformation), that gives us something to learn from. The basic elements of the scientific method are to gather data and make experiments. We have numerous observations and experiments to draw from. Maybe it’s time, once again, to challenge Americans to solve a supposedly insoluble problem.

There is no fast, simple solution to the problem of the looming financial disaster facing Americans, even those currently with health insurance. There is no fast, simple solution to providing basic medical care for all Americans. Admittedly, the typical American is the guy standing impatiently in front of the microwave waiting with irritation for his instant coffee to get finished. Assuming we can fix the health care problems in this country by some arbitrary date a few months from now is a curious mixture of arrogance and idiocy. We need to take advantage of the best and the brightest (especially those in our universities – persons who get paid to think, not bureaucrats who get paid to spend money), examine what works in other countries, and adapt those solutions to our problems -- this will take a reasonable amount of time.

There are no simple fixes, no magic wands to wave. I offer only four observations. The notion that a national health care system will be low cost is nonsense. Therefore, a necessary first step to help keep down the cost of national health care is to control our borders (ht to politicalman for this argument; truth to be told, he doesn't agree with my entire argument). According to some estimates, there are over 11 million illegal immigrants living in this country. We must provide health care for all Americans, but, if we provide health care for illegal immigrants as well, the flood gates will be opened and we’ll be swamped as more illegals, understandably eager for both higher wages and higher medical care, come to this country. At this point, our country could not sustain such a high financial burden . Secondly, to help finance a national health care system, we should institute a national lottery (according to Thomas Jefferson, a lottery is “the tax … laid on the willing only”. Every year, the Powerball turns a profit of millions of dollars. A true national lottery to fund health care would significantly lower the overall costs to the taxpayers.

Thirdly, we should focus on preventative health care. A RAND study indicated the possibility of $81 billion in savings per year with preventative health care. For example, instead of waiting for somebody to become deathly ill with diabetes, it would be more cost effective to send the person at risk for diabetes to a dietician and a gym than to wait to treat the blindness, gangrene, and other issues that result from this disease.

Fourthly, Congress needs to cancel their own, separate medical insurance system . Their system creates a health care utopia for them and their families. With little cost to them and with low or no co-pays, they cannot understand the health care problems of the average American. Most significantly, they and their families cannot be denied coverage for pre-existing conditions. There is also no chance that their policy will be canceled by their company once they retire. If they want to lead, if they want Americans to take them seriously, they should have the same medical benefits at the same cost to them as the average American. Any solutions to the problem with the medical industry must be enjoyed or suffered by our leaders.

There is no quick fix to the problems with the medical industry in this country. However, we have the ability to solve the problem if we approach the situation both rationally and compassionately. As long as the Democratic leadership argues that we must solve the problem within a few months (before elections) and the Republican leadership argues that “socialized” medicine will bankrupt this country (or at least put a dent in the obscene profits of insurance companies and hospitals) the problem will never be solved. As long as the American taxpayers continue to harden their hearts against the suffering of their fellow Americans, we will not solve this problem. As long as we choose not to force the government to perform its basic function of protecting its citizens, we'll have no meaningful health care reform. It’s time that we start taking care of our brothers and sisters.