Dr. Daniel D. Bennett
Wednesday, July 23, 2008
If you did not already believe that our current health care financing system is rigged to benefit insurance companies over patients, then President Bush’s recent veto of legislation to halt Medicare cuts to physicians should have changed your mind.
The president and a few Republicans did their best to kill the bill because it took money from Medicare HMOs. Fortunately, they failed. Medicare HMOs were sold to the American public as a mechanism for allowing the private sector to save tax dollars by “managing” the care of enrolled senior citizens. Sadly, since the day there were started, they have cost us more per enrollee than traditional Medicare, and this is despite the fact that they care for a healthier population of seniors when compared with traditional Medicare. Why would politicians defend so-called Medicare Advantage? Money. These plans are profitable to the insurance companies, and insurance company profits translate to campaign donations. There is no better example of how the health care market is manipulated to make money for a few.
Most health insurance companies exist to make a profit for their shareholders. Profit motives are great when applied to commodities, but health care is not a commodity, and the health insurance market is not good for the health and well-being of Americans. Medicare was established as our taxpayer-supported health care financing system for senior citizens, and it has been a resounding success. The establishment of Medicare HMOs was a perfect experiment to test the hypothesis that the private market could do better. The results are clear: Medicare HMOs cost more and deliver less care than traditional Medicare. It is time to start expanding rather than assaulting Medicare.
Imagine our country without Medicare: Senior citizens are forced to obtain insurance coverage on the open market or through continued employment. A few wealthy seniors can pay out-of-pocket, but the majority find themselves unable to afford care.
This would be a catastrophe, and such a catastrophe is already occurring among tens of millions of uninsured Americans.
Now imagine that all of us have insurance similar to Medicare. Working parents no longer worry about the health of their families when they are “downsized.” Patients have a genuine choice of physicians and hospitals, rather than a choice of insurance providers. Small businesses can compete equally with large corporations for employees. Those with serious illness or injury get necessary care, even when they can no longer work. Everyone is covered everywhere, and coverage decisions are not based on profit.
Now stop imagining these things, and make them happen.
Some problems require the actions of a great nation. Would we have interstate highways connecting all corners of this country without the intervention and funding of the federal government? The same should be asked of the moon landings, the establishment of the National Institutes of Health, Social Security and the D-Day invasion. We are headed in the wrong direction, and there are many countries we can look to for inspiration and ideas. We are a great nation, and we can do better. We can do better than Canada, France, the United Kingdom and others whose health care systems are outperforming ours by most measures.
House Resolution 676, which has 90 co-sponsors, seeks to establish true universal health care by enhancing Medicare and expanding coverage to all Americans. The money we spend now on insurance premiums and other out-of-pocket costs will be more than enough to fund this proposal, especially once we eliminate the high administrative costs and excessive profits of the private health insurance industry. HR 676 deserves our support.
We have the physicians, nurses, hospitals, medical schools and the money. There is no excuse for the wealthiest nation in the world to have among the worst-performing health care systems. We can do better.
Bennett, who lives in Temple, practices dermatology and teaches medical students.