By Kay Lapp James
November 2, 2005
Wisconsin Dells
Being without health insurance can kill you, say Drs. Linda and Gene Farley, and access to medical care should be a right, not a privilege.
The two doctors spoke on the health care crisis and the need for a national health care plan at a meeting Thursday of the Dells Progressive Voices. About 20 people heard the Farleys describe with numbers and anecdotes the plight of the uninsured in America.
The two retired University of Wisconsin-Madison Medical School faculty members also were once family practice doctors and believe the country can afford to provide medical care to everyone.
Gene Farley asked anyone who does not believe health care is a right to say on whose doorstep the uninsured will die.
The uninsured die because they don’t have insurance, said Linda Farley. In 2002, 18,314 adults died because they did not have insurance and could not afford medical care.
U.S. taxpayers pay the health care bill for about 50 percent of the U.S. population through Medicare for seniors, veterans, Native Americans, Medicaid for the disabled, children and the poor elderly, and for public employees on the local, state and national level. Of the rest of the population, 45 million don’t have any insurance. Of those without insurance, 50 percent are employed and 25 percent are children.
While Americans may brag about the quality of care here, Linda Farley pointed to comparisons showing that the United States had poorer life outcomes than countries with national health care plans.
The U.S. had the highest infant mortality rate in 1999 (7.1 babies per 1,000 births)among a group of developed countries, that comprises Australia, Canada, Italy, Germany, France and Sweden.
In that same year and among those same countries, women lived fewer years in the United States. Here women can expect to live an average of 79 years, while in France they can live an average of about four more years.
“Every other industrialized nation (except the United States) has a healthcare system that assures medical care for all,” said Linda Farley.
Those countries also spend less than the United States does per person. Most spend less than half what the U.S. does, she said.
Besides the lower death rates, those countries also have more accountability for care and higher satisfaction with care, she said.
The way to cut costs and to insure everyone is to go with a one-payer health care system, the couple said. That eliminates the most costly feature of the U.S. health care system half the multiple payers: insurance companies, HMOs, PPOs and the government.
As an example of the savings that could be achieved, the Farleys compared the same size hospitals in the United States and in Canada. In the U.S., a patient bill must cover the costs of 356 people in the billing department, which adds about $372 to each bill. In Canada, the same size hospital needs just nine people in its billing department and billing adds $68 to a patient’s bill.
In addition to a more cumbersome billing process, hospitals and other medical facilities have been adding administrators. Since the 1970s, the number of administrators has grown by 2,500 percent while the number of registered nurses in hospitals has hardly grown. The growth of the clerical staff has spawned the increase in administration.
Linda Farley also pointed to the salaries of the CEOs of health insurance and managed care companies. The salaries start around $1 million and the highest, $5 million, goes to the CEO of Cigna, Wilson Taylor. Those salaries don’t include the stocks the CEOs also receive. Taylor also receives $64.2 million in stock.
The Farleys also cited drug manufacturers as contributing the high cost of health care. In a chart, they showed that drug companies spend 27 percent of their income on manufacturing, 35 percent on administration and marketing, 7 percent on taxes and only 13 percent on research and development. A drug manufacturer has profits of about 18 percent, Linda Farley said, which was much more than the average Fortune 500 company. It makes about 5 percent profit.
Doctors’ salaries are less of a problem, although some who have become partners in hospitals, clinics and insurance organizations have become millionaires. Gene Farley noted that when Medicare began in the 1960s, doctors’ incomes began to rise. Prior to that time, health care was considered a charity and doctors often weren’t paid for the care they provided. With Medicare, doctors could count on being paid.
“People say we can’t afford universal care, but we’re already paying for it,” Gene Farley said.
Bills to set up a universal or single-payer system in Wisconsin have been introduced in the state Legislature. Under such a system, the Farleys said the state could save money. In 2003, spending here for health administration totaled $7.72 billion. They say that a single-payer health insurance would have saved $5.52 billion or enough to provide $13,513 for each of the 409,000 uninsured people in the state.
Gene Farley said he does not understand why businesses here do not support a single-payer, universal health care system. Canadian businesses have cheaper operating costs because of the universal system there and support it. In Canada, every business has to pay into the system.
The United States or even Wisconsin won’t get a single-payer system unless people demand it, Gene Farley said. He urged people to be noisy and contact their legislators. He also urged everyone to vote, noting that poor people who pay the steepest price for health care (they get no discounts like the government and HMOs or PPOs get) don’t vote.
“It won’t get any better until people speak up,” said Gene Farley.