In case you’ve been sleeping a lot lately, health care reform is in the news again. We’ve heard it all before; so, I’m not going to rehash it here. As always, though, we’re in the process of reducing the debate to the usual partisan political hissy fit.
Every U. S. President since Ronald Reagan has proposed reforms to the way this nation delivers and finances health care. Each, in turn, failed to motivate the movers and shakers to go beyond the cheap phase of change: TALK.
In the United States, social combatants have always managed to reduce the dispute to the level of a common street brawl between the proponents of a delivery system driven by free market forces and those who oppose it.
The former always accomplish their goal by characterizing the latter as raging socialists in an everlasting chase after a bogeyman called socialized medicine.
Free marketers usually proclaim that if the government controls things we’ll all die while awaiting some life-saving medical procedure. In addition, we’ll all experience monumental shortages in health care professionals: doctors, nurses, and technicians.
And, let’s not forget the most reliable scare of all, “Our taxes will skyrocket right into the stratosphere.”
The so-called “socialists” proclaim that if we leave everything to free market forces, all of the poor people will be dead in a month—children even sooner.
Worse, our middle class will go extinct within a matter a year or two; and the RICH, not the meek, will inherit the Earth, at least that part of it within the United States.
As always, simple minds effectively reduce the issue to the extremes of an either/or proposition. Either we select the free market delivery system in order to maintain our freedom to choose the best health care we can afford for our families and ourselves OR we opt for socialized medicine.
Essentially, claim its opponents, the latter would eliminate all our freedoms to CHOOSE the best doctors, hospitals, and state of the art medicines and procedures.
And, for the record, I agree with those opponents. However, I part company with them in their aggregate assertion that it MUST be either/or.
It doesn’t have to be. Nor—and this is important to understand—has the Obama Administration come within light-years of proposing socialized medicine.
And those who claim otherwise tend to be the same people who classify everything not associated with free market delivery as pure, unadulterated socialized medicine.
I’m going to approach this from a different perspective. But first, some facts compliments of the Congressional Record, AARP, and Pew Research, along with some of my own research.
In 1993, about 37 million Americans did not have health insurance. As of early 2009, that number had risen to about 46 million.
Likewise, in 1993, our aggregate spending on health care was around $913-billion. As of early 2009, that amount had leapt to around $2.5-TRILLION.
In per capital terms (national spending per person), we’ve gone from about $3,468 in 1993 to around $8,160 as of early 2009.
We spend a tad short of twice as much as the rest of the industrialized world combined does on health care delivery. And, what do we receive for all of this spending?
For starters, we have lower life expectancies and higher mortality rates for our children. Additionally, we continue to live with the myth that we who can afford health insurance have choices.
Additionally, we’re experiencing a critical shortage of nurses, medical technicians, and doctors (especially those of the primary care physician type).
I’m old enough to remember the pre-Health Maintenance Organization days (HMOs) of health insurance. In fact, as a child, I remember the days when employees had ONLY major medical coverage.
There were no such things as co-pays for doctor visits and prescriptions. Patients paid both their doctors and pharmacists in full.
I have always had health insurance for my family. Either I paid for it myself or an employer paid for it with some degree of contribution from me.
In those days, we had true choices in terms of physicians, specialists, and hospitals. And, medical doctors made treatment decisions based on medical need, not financial expediency.
As medical costs spiraled upward, HMOs were born. We liked the idea because they were cheaper for us. The trade off? The forfeiture of some of our choices.
But, the restrictions were not THAT prohibitive and the financial savings were substantial… AT FIRST.
As HMO influence grew, however, medical Camelot grew less charming, what with strangers and all telling us which doctors we could see, which medicines we could take, and which treatments we could have.
HMOs control the bulk of health care services today in America. As such, real choices do not exist.
Worse, non-medical types, in accordance with some pre-defined treatment or prescription tables, constantly scrutinize and often deny the treatments our medical doctors prescribe.
We now have to wait longer for appointments. The appointment times are shorter in duration. Both patients and physicians are so harried that there is hardly time to cover all the medical concerns.
Waiting times for patients to see specialists, for matters other than critical life and death circumstances, have increased from a week or so, to several months.
I’m on Medicare now with part D coverage from Blue Cross and Blue Shield. I don’t have to worry about PCPs. But, getting Medicare to pay for anything without some bureaucrat making it a federal case is a miracle.
Often, it’s just so much less hassle simply to die. And, you know what? More and more older patients have come to believe that the insurance companies and federal bureaucrats are on to something in this respect.
A friend of mine needs to see an ophthalmologist (MD eye doctor). He’s one-step removed from a dog and a cane. He’s on Medicare, too. The earliest appointment he can get is 4-MONTHS.
This got me to thinking and it’s always dangerous when I get to thinking. I’m a retired researcher. I know the right questions and how to ask them. Even more dangerous; I enjoy doing it!
I spend a lot of time on the road and in airplanes, ideal opportunities for asking people about their health insurance and what they think of it.
McMedicine seems to have a few flaws. (HMOs have tried being to health care delivery what McDonald's has been to fast food delivery.)
People are happy, but not HAPPY. The biggest complaints have been denials for prescribed treatments and wait times to see a doctor. Also, failure to obtain a referral from their PCPs almost always resulted in financial disaster.
So, not only does this nation spend scads more than necessary to deliver adequate health care via the free market, that same market faces, according to a growing bipartisan percentage of Congress, an unprecedented shortage of medical professionals: doctors, nurses, and technicians.
And, at an average of $1,200 per visit, hospital emergency waiting rooms nationwide are swamped with people with colds and no insurance.
Medical freedom of choice! Really? Prove it. It’s a long-standing con job and it’s time we all begin to understand what’s going on. What we’ve been doing is not working. We have to fix it. And we have to do it SOON.
But first, ALL of us have to decide how we’re going to view fundamental health care. Is it to be an absolute right that accrues as a function of our humanity and American citizenship?
Or, are we going to continue pretending it’s an absolute right all the while treating it as a relative right that accrues as a function of our individual abilities to afford it?
If it’s to be the latter, we need do nothing more except build temporary poor houses until only the rich remain. But, if we do this, who the hell’s going to cut the grass and clean the pools?
If it’s to be the former, though, we then have to come to understand that group health insurance, universal health insurance, public health insurance, individual health insurance, and single payer health insurance are NOT socialized medicine.
Aside from the Veterans Administration, socialized medicine does not exist in this country. Nor are any members of Congress trying to change it.
But, if we’re serious about changes, we have to realize that the best method is probably some combination of the other five types.
Former presidents have tried to begin reforms in this respect and Barack Obama has continued the trend. He’s allocated $640-billion in order to get Congress moving on the issue.
He’s not attempted to micro-manage “how.” He simply told Congress—both sides of the aisle—to work out the details. Wow! Like… that’s going to happen any time soon.
So far, the public blustering has amounted to nothing more than one side accusing the other side of bankrupting the country.
Back in the mid-‘80s, when personal computers were a novelty, the acronym, SS/DD, referred to floppy disk storage capacity and meant Single-Sided/Double Density.
We no longer need floppy disks, but that acronym is still a handy little device for matters political. We should keep it but change its meaning to “Same Sh*t/Different Day.
Oh well, at my age and with just a little luck, I won’t live long enough to make that trip to the poor house. How old are you, though?
Joe Walther is a freelance writer and publisher of The True Facts. You may comment on his column by clicking here.