“We are approaching a perfect storm of problems that, if not addressed by our next President, will cause our health care system to implode.”
–Senator and Presidential Candidate John McCain, 2008
Forty-Seven million Americans have no health care. Another 20 percent of the population is estimated to have health insurance that is inadequate for their needs. This means that almost half of the country has no insurance or less than adequate insurance.
When Switzerland changed over from a for-profit health insurance system to a non-profit health-insurance system in 1994, it was because they were scandalized to discover than 5% of their population did not have health insurance. Five percent! What does that say about who we are and how we feel about our fellow citizens? Can it be true that Americans no longer care about their fellow citizens? It doesn’t square with the enormous outpourings of support for sick children or countries that have sudden catastrophes. We are known around the world as being a compassionate country. At least, we used to be.
The American people want universal health care. As recently as March 5, 2009, a CNN/Opinion Research poll indicated that 72% of Americans want government to step in and fix health care. They want unconditional coverage, lower costs and reliability. What does that mean? Here’s what it means in other countries, and it is bad news for the health insurance industry and for doctors.
In the roughly 36 countries ahead of the United States in world rankings of the best health care systems, it means that everyone is covered. That part is not a question for debate in these other countries. Either the government runs the program and pays for it from taxes…which, by the way, Americans who have been polled say that they are ready and willing to do. Or it means that private non-profit insurance companies offer truly competitive and universally accepted policies from which people can choose. In Germany, for example, there are over 200 policies from which to choose but they all have similar coverage and none are allowed to turn down an applicant if a person chooses that policy.
In other words, we have to kill the goose that is laying the golden eggs for health care executives in order to be able to offer universal health care to our citizens. There is no “part for-profit” and “part public” system. We need either a non-profit but private system or a totally public system. France, with the best system in the entire world (very wealthy people go from the United States to France for certain specialties) is government run. Germany and others have a private insurance system that is non-profit and very competitive. But in all advanced countries besides ours, the rules are set by the government and they are set not for the insurance companies, doctors or hospitals. They are set up to help the People.
The numbers are clear. The United States, with health care costs that are upwards of $6,000 per capita is double that of most of the developed world. Our administrative costs are about 25% of total whereas in other industrialized nations, administration averages around 3%. We know that medical associations and government figures in the U.S. bear that out. In the U.S., while some figures for private health care administration may go as low as 17%, Medicare is administered for a little more than 2%. It doesn’t take a genius to see what we have to do.
There are problems with some health care systems. Seldom is anything perfect and usually not permanently. In Canada, while the Conservatives have never even considered doing away with universal health care, they have tried underfunding it, which led to some long waiting times. And it is still true that elective procedures can take months. But the waiting time for someone diagnosed with cancer is less than six days. Fortunately, the Canadians have no huge lobbying organizations as we have here in the U.S., like the association of hospital plans or the AMA. When they have a problem, they elect a new government to fix it.
One argument from the Right Wing and their medical lobby sponsors is that it will cost too much for universal health care. The fact is that it will cost less and we will have a better system. You see, these other countries have more general practitioners than we, more doctors per capita than we, more health and wellness programs by far than we and they do it at most for 10% of GDP whereas we spend 16% of a much larger GDP to accomplish much, much less.
What about malpractice? In Europe, there is virtually no such thing as malpractice. And in Japan, which not only has a private, controlled health care delivery system, and where doctors and hospitals are not allowed to charge more than a certain amount, malpractice insurance runs something like $30 per month. Of course, in many of these other countries who do not see medicine as a private industry but as a public or privately run service to the people, medical school is free. When Taiwan was considering which kind of universal health care system to set up, they never even considered the United States health care system. Their determination was that it was not necessary because what we have in the United States is not a “health care delivery system at all.”
The problems and the solutions are clear from what other countries, not influenced by greedy doctors and greedy health insurance company lobbyists, have done.
1. Take the profit out of the delivery of health insurances. (If the option is non-profit private delivery.) It is not a business. It is a public service.
2. Bring everyone under the health care umbrella, either by mandating private health insurance or by substituting a government run system like kind of premium system run by France.
3. If private insurance is used as the delivery system it has to be totally competitive, non-profit, cover everyone and pay every claim.
4. Let everyone buy into Medicare. It will cut costs to the bone.
5. Make sure that all health care companies compete with one another, and that everyone must be eligible to buy any plan.
Let’s make sure that everyone understands that this is NOT the typical image that is portrayed by the health care companies as SOCIALIZED MEDICINE. This is individual health care delivered by non-profit insurance companies competing with a public, Medicare-style plan.
We will need to make some further improvements. At present, the American Medical Association sets the number of doctors. Right now, there are about 16,000 medical students graduating each year and a need for at least 22,000 doctors. We need to graduate 22,000 doctors and begin immediately to train them. Certain areas like Arizona have the teaching facilities and other facilities need to be expanded within the next year to meet this need. We need a 30% increase in chairs in medical schools and we need to subsidize our medical students to encourage them to become general practitioners in underserved areas for at least five but probably about 7 to 10 years in return.
Until these things are accomplished this year, we must put the pressure on our elected representatives to let them know that they may want to stay close to those in the medical lobbying community. They need to know that…for certain…if they vote against universal health care with a public option–as a minimum–they will be looking for jobs with the health care industry in 2010 because they will no longer be our representatives.