By Sandy Miller
Times-News writer
Sunday, March 11, 2007
Some would say the United States has the best health care system in the world.
But the numbers speak otherwise.
There are more than 46 million uninsured people in the United States and 218,000 of them live in Idaho. Millions more are underinsured. And despite the fact that the U.S. spends twice as much on health care than other industrialized nations – $7,129 per capita, according to the World Health Organization – it doesn’t seem to be getting much bang for its buck. Among other things, the U.S. is 27th on the list for life expectancy and a depressing 75th on the list for the number of children under age 2 immunized against measles.
People are calling out for change, and many of them are saying it’s time for a single-payer – or universal – health care system. And the voices being heard aren’t the voices of radical socialists, but the voices of mainstream, often conservative doctors, hospital administrators and other health care officials – people working within the system itself. Business owners are speaking out, too, by shifting more of the costs to employees and in some cases, dropping their employer-sponsored insurance policies altogether. Workers – the patients – are also saying enough is enough.
“When you can’t even afford your medical bills, something needs to be done,” said Roxy Carr of Twin Falls, who filed medical bankruptcy a few years ago when she found herself $45,000 in debt due to complications from diabetes.
The business of health care
Dr. Rod Kack, a local ear, nose and throat doctor, says the problems all started about three decades ago when medicine ceased being an art and became a business. The Centers for Medicare and Medicaid and other insurance companies replaced doctors as the decision makers.
“The third-party payers became the drivers in medicine,” Kack said.
And their motivations has little do with improving health care.
“Health insurance doesn’t have anything to do with health,” Kack said. “It has to do with business.”
Retired surgeon Dr. Harry Brumbach remembers back when doctors made the decisions. He remembers how back in the 1960s, two of his patients – a husband and wife died of cancer, leaving behind a teenage daughter. One day, the daughter’s high school principal called Brumbach and said if the girl had to pay off her parents’ medical debts, she wouldn’t be able to afford to go to college. Brumbach forgave the debt right then and there.
“I was in the golden era when we could make our own decisions – when we could treat people and forgive a bill without punity. Now, you’re punished by the feds.”
Kack said there’s a “health care pie” and everyone is competing for a piece of that pie.
“We have competition for resources,” Kack said. “There’s competition for dollars available. Thirty years ago, the bulk of the charges were for the doctor and what he did. Now, it’s direct hospital services.”
Another problem, Kack said, is overuse of expensive technology. Although he agrees state-of-the-art technology has its place, and can do some wonderful things, he believes it’s utilized too often.
“Money has been diverted into technology,” Kack said. “Medicine has changed from a profession that used to be hands-on. Now, it’s hands-off and technology driven.”
A single-payer system
Kack believes there needs to be a big change in health care, but he stops short of advocating a single-payer national health insurance system in which a single public or quasi-public agency organizes health financing, while delivery of care remains largely private.
“A single-payer system would be a nightmare because of the expectation of services,” Kack said. “They’re going to expect more than they get.”
But many others think a single-payer system is just the fix for America’s broken health care system. At the very least, a universal care system would provide basic health care to all. And that, said one hospital official, is not only the financially-responsible thing to do, but the moral thing to do.
“I think the basic health care system should be available to everyone,” said John Kee, chief executive officer at St. Luke’s Magic Valley Regional Medical Center. “What we are doing now isn’t right.”
Kee agrees that universal health care systems, such as the one in Canada, aren’t perfect.
“If you talked to Canadians, they’d say they have a great basic health care system, but you have to wait.”
Still, Kee said a single-payer system is the answer. And he’s not the only one.
Physicians jump on board
“Five years ago, if you mentioned national health care to a roomful of doctors, they would have booed,” said Bobbie Dennett, a disability hearing officer for the Idaho Department of Health and Welfare and the co-chair of the Outreach Committee of Idaho Health Care For All.
They’re not booing so much anymore. In fact, a number of physicians across the U.S. have banded together and formed Physicians for a National Health Program. According to the organization’s Web site, the reason the U.S. spends more and gets less on health care than other industrialized nations is because the U.S. has a “patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: Overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay.” In turn, doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. PNHP estimates that all this administration consumes a third of Americans’ health dollars.
PNHP believes single-payer financing is a way to recapture the wasted money. The potential savings on paperwork – more that $350 billion per year – alone is enough to provide comprehensive coverage to everyone without paying any more than we already do.
