National health insurance may be our only solution
Orange County Register
December 1, 2002
Commentary: National health insurance may be our only solution
by Michael T. Kennedy, MD, FACS
Don Hull's letter, "Universal coverage is anything but" [Nov 22], attacks the National Academy of Sciences for suggesting that the Bush administration should "test possible solutions, including universal insurance coverage." Hull equates universal health insurance, a single-payer system similar to the British National Health System, to the Soviet Union and Cuba, both communist dictatorships.
This is rhetorical hysteria.
The situation in California is at crisis level. Los Angeles County is planning to close major hospitals including Harbor General and Rancho Los Amigos, the latter the premier rehabilitation facility in the world.
Orange County hospitals are burdened with thousands of illegal, uninsured immigrants seeking care, but we can't turn them away from emergency rooms. They are getting treatment, and doctors and hospitals are paying for it out of the decreasing margins left over from managed care. The system for indigent care is overwhelmed. HMOs are "cherry-picking" healthy subscribers and providers (doctors and hospitals) are being squeezed to the point of insolvency. This can't go on much longer.
Free markets depend on information. The transaction has to be "transparent" so both the buyer and seller know the same facts. This is very difficult to accomplish in health care. Healthy subscribers like HMOs' lower premiums but when they get sick, it is too late to change. We have an aging population and Medicare is cutting back on reimbursement. No "fat" is left in the system. There is, however, an enormous amount of administrative spending in the current system. There are also many perverse incentives to "game the system" as shown in the Tenet Hospital scandal in northern California.
It may well be that a universal health plan, covering everyone regardless of ability to pay, could be funded out of the total current expenditure on the present system, which has so many distortions. Our own system is unstable and it will not be long before that is apparent even to Hull who probably believes himself to be safe.
Michael T. Kennedy Mission Viejo
Dr. Kennedy is past president the Orange County Medical Association and a past co-director of the Mission Hospital Trauma Center.
http://www2.ocregister.com/ocrweb/ocr/article.do?id=13884&year=2002&month=12&day=3
Comment: Noteworthy about this commentary is that Mike Kennedy, a personal friend, is predominantly a political conservative, and the Orange County Register is a libertarian newspaper. But an objective assessment of the factual status of our health care system, and an objective assessment of the application of health policy science will go a long way toward achieving mutual agreement on the desired model of health care reform. As Mike says, the situation in California is at a crisis level. It is time for all of us to work together on a solution.