How to fix the healthcare system is the topic of a debate which has existed for decades in the U.S. There are many who favor a nationalized (another word for socialism) healthcare plan, out current president, Barack Obama, made a campaign promise to sign legislation, that would reform the healthcare system, before the end of his first term in office. Mr. Obama is, as this is being written, pushing hard to get this type of reform passed, in his first year in office.
Almost unbelievably, he has not read the details of this plan, not has anyone in congress, it is thousands of pages and they were being pressured to vote for it before it was even placed into their hands for examination.
I cannot comment in any detail on this plan, because, of course, I have not read it either.
What I can do, however, is examine some of the reason that people say show the need to reform the system, some of the general ideas how to, offer some observations and some criticisms, which I consider to be constructive, plus toss in some other ideas that do not get talked about much.
I am not an expert in medicine, economics, politics, or any fields related to this issue, but I have examined the topic over the years for over two decades. As you read this, please pay attention to the facts that I present, because facts are not opinions, however, also be aware, that though I am presenting facts here, the conclusions that I draw, are largely my opinion.
I have to say at the outset, that there is and can be, no perfect system. Any system settled upon with have it’s shortcomings, and there will always be those who will feel that something is inadequate or unfair.
The proponents of a nationalized healthcare system, often point to the fact that many countries (the United Kingdom and Canada are cited most often) already have a nationalized system in place which works, and the people in those countries pay less for their healthcare, than we in the United States do. Indeed, I have talked with people in those countries who like their system, and are amazed that the United States, is so far behind them in this respect. They will often say thinks like “It is almost a crime, that a modern and wealthy country like the United States, does not even provide basic healthcare for it’s citizens”. The also often refer to their system as providing free healthcare.
It is true that healthcare is expensive in the United States, we spend more on healthcare, per capita, than any country in the world. However, it is not true that the other countries provide free health care. It is true, that for some, the poorest of their citizens, that healthcare is free, but that is not true that it is free for everyone. They tell you that the healthcare is provided by the government, but conveniently do not notice that they are paying the taxes, which pay for the healthcare, so, it is in no way free. It is not provided by the government, it is only managed by the government.
There are many reasons why healthcare in the United States is expensive. One of them is the high premiums that healthcare providers must may for insurance to protect them from malpractice lawsuits. If we were to put in place some tort reform measures, limiting the size of awards or instituting loser pay systems, perhaps limiting the amount that the attorneys collect to a cost basis, instead of a percentage of the award, measures like these would lower insurance cost, and by extension, lower the costs passed on the the medical customer.
Another reason that healthcare is expensive in the United States, is that we spend lots of money on researching new medical procedures, new equipment development, and research into new medications. This progressive approach, costs a lot of money, and, it is also one reason why other countries get their medical care less expensively, because they benefit from the research done in the United States. The reason that so much research and advancement occurs here, far more than in other countries, is because our medical industry is based on private free enterprise. In free enterprise, companies compete against each other, to garner a larger share of profits to be had in this market. If we were to move more and more towared a less profitable model, we will see advancements in medicine, slow down.
Yet another reason for our expensive medical care, is medical insurance and government programs. Why would that be the case? Two reasons. One, whenever an insurance company or government entity is involved, there is a lot of paper work to be done. This paper work means that additional personel have to be hired to process the paperwork. This cost is reflected in the cost of care. Another problem that accompanies government and insurance provide care, is fraud. There are always those who will scheme to jack up the costs, or even bill for services that are never provided, sometimes for patients that do not even exist.
There is yet another reason that healthcare costs go up with a government or insurance system. When people feel that they will not be charged anything if the visit the physician, they are more likely to go to the physician, for minor maladies like the common cold.
As anecdotal evidence of how much money is saved when one pays for ones medical cost out of pocket at the time of need, I have recently had some medical expenses to deal with, as an uninsured and unemployed person who pays for his own expenses directly.
In the last year, my three daughters needed dental extraction of impacted wisdom teeth. Our usual local dentist recommended an oral surgeon. We called the office after he received the xrays, to discuss what these procedures would cost. The bill for the three girls, would be about $4500 dollars. That was a bit out of my price range. A few phone calls to lok for alternative solutions, and we ended up a a univeristy dental school, the bill there was $946 dollars, a savings of $3554, or almost 80%. If medical customers price shopped this way, medical intitutions would have to consider how to lower costs in order to attract business.
I went in for a checkup, and they were going to bill my insurance company $75, until I told them that I had no insurance, and I would pay cash, they lowered the bill to $37.
One of our daughters need to get a physical to go to a camp to volunteer, she shopped on the telephone, and found a clinic that gave her the physical fo $29.
What is the point? If Americans took more responsibility for their healthcare, instead of relying on work provided or government provided care, they would drive the overall cost of care down, through competition.
So, what else drives health care costs up? Quality of care does. Americans want a high standard of care, and they get it. While many may think that the quality of care is not good enough, the fact is that when you compare the outcome for specific maladies in the United States as compared with the rest of the world, we outperform other countries. Of people diagnosed with cancer, pneumonia, Aids, heart disease and others, the U.S. enjoys the longest survival after diagnoses of all countries. So, while we pay more here, we get more also.
If the U.S. adopts the sytems of other countries, and it ends up that our system works on a par with them, we will find, that we have to wait longer for appointments and treatments, sometimes months for life threating conditions. We will find our survivability rate lowered. There is a reason that patients for the U.K. and Canada come here for treatment, and that is because their own countries either deny it, or delay it dangerously. If the U.S. has such a system then, not only will our healt be in danger, but people in those other countries, will lose the option of having the safety of the backup system, that America now provides. These countries that many want us to copy, are living with the shortcomings of thier systems, and their newspapers have chronicled hundreds of hooro stories that result from their systems. Now, they are recognizing that they need to reform their systems, and work toward a more profit driven system.
People sometimes fail to consider, that the U.S. already has nationlized healthcare systems. Interview anyone who is stuck with the Vetarans Administration health care, or Medicare, or Medical, or the health care provided on Indian Reservations, and find out if they think the care is as good as outside the government system.
I have left a lot unsaid here, that is intentional. We can have healthcare reform, we can improve the system, without going to the nationalized system. We can be creative and make new models to help lower costs and improve quality, as well as make it more available, but we will have to get out of the idea that it is either the present system, or nationalize. The key to improvment, is more choices, competing, not limiting ourself to a government run system. Think about it, do you really want your healthcare controlled and decided by government beaurocrats, or are those decisions best left in the hands of the experts (healthcare professionals) and the patient (you)?
What do the people think?