Diagnosis for health care reform not promising
Fred Jacobs, CEO of J-ad Graphics, says all the bluster and bragging from presidential candidates isn’t making me feel too healthy these days, especially the talk about one of the issues Americans say they are most worried about: Health care reform.
You can already tell we’re going to be hearing plenty about universal health care or what some call a single-payer system that looks like Medicare for All. It’s a system in which taxes cover the costs of essential health care services for all residents, effectively remaking what’s been a private health care structure into one run by the government.
For years, Americans have been looking to Washington to dig in and deal with some of the issues that have been driving health care costs to exorbitant levels, and both political parties – after all this time – have failed the American public in building a fair, just, and affordable alternative. Now we’re back to campaigning for next year’s election and bi candidates or current office holders appear to even be carrying a flashlight in the increasing health care darkness.
Even though our current system is flawed – and there does seem to be consensus on that point – dismantling a world-admired health care structure and summarily replacing with a government-controlled system like universal health care looks to me to be catastrophic.
Rising health care costs are not just an American problem. Other countries may spend less than the United States on health care, when compared as a percentage of gross domestic product or on a per-capita basis, but the same rising costs of health care in those countries impact their budget deficits, too. Like the United States, countries around the world are looking at tax increases and benefit reductions as a way to control costs.
If the government were to pay for and provide health care services, it becomes socialized medicine. For discussion purposes, that could be a realistic alternative, especially because socialized medicine systems do work well in some other countries. The United States, though, has already had some experience in socialized medicine and it has not played well on the marquee as most of us recall from the horror show that took place not too many years ago at Veterans Administration Homes, the Department of Veterans Affairs and in other parts of our armed forces.
Charged by the federal government with caring for men and women who defended our country, 26 veterans facilities from around the country were found in 2014 to have falsified data to cover up delays veterans endured while waiting for the care they needed. Allegations state that as many as 40 veterans may have died while waiting to see a doctor.
The futility of looking to Washington, D.C., to get anything done is now even more apparent as elected officials are back to work getting re-elected, which means any discussion on health care reform is framed by politics. The Pew Research Center reports that the public is taking a deeply pessimistic view of the prospects for partisan cooperation on anything in the coming year. About 7 in 10 (71 percent) say they think Republicans and Democrats in Washington, D.C., will continue to bicker and oppose one another more than usual this year, and since we’re heading into another election year, little if anything will get done until after the election. That is a sad commentary on elected officials who spend more time running for office than they do solving problems that impact our lives.
For several years now, the Kaiser Family Foundation has been tracking public opinions on the idea of a national universal health plan. Its polls show a modest increase in the support of the idea, especially for an expansion of the Medicare program through a Medicare or a Medicaid buy-in proposal. Yet, it’s unclear if the support continues, especially when people become aware of the details of a plan and how it works for users. Universal health care has a history of higher taxes, delays in medical tests and treatments and changes in the doctor/patient relationships. Plus, those who are presently covered by their employers’ insurance are concerned that a single-payer universal proposal will impact the level of service patients receive.
Even though Medicare for All is promoted as health-care reform, it’s not – because it fails to deal with any of the problems that drive up costs; it just transfers costs to a federally controlled system with politicians in charge. Medicare, Medicaid, the Affordable Care Act and Medicare for All are all government-financed plans sold under the guise of free health care for all. But it’s far from free.
Experts estimate it would cost tens of trillions of dollars over a decade. And several independent studies estimate that government spending on health care would increase as we move away from an independent program where companies fight to keep costs under control to a system controlled by politicians.
According to the Kaiser Foundation, a typical employer spends more than $16,666 per year on family coverage of which employers pay an average of 82 percent of the cost, plus $1,090 in Medicare taxes. According to the most recent census data, more than 158 million people get health insurance through their employers.
Giving the government more control over health care isn’t the answer. What we need is honest reform with a serious focus toward reducing costs.
I’ve been active in purchasing health insurance for my employees for more than 40 years and have seen prices and deductibles continue to rise while individual coverage has declined. Business and industry leaders have identified a number of issues that could reduce the cost of insurance, such as allowing insurance to be purchased across state lines, transparency in pricing, and reporting claims experience giving employers a better understanding of what’s driving the costs. Plus, the lack of competition and transparency in drug pricing has allowed drug-makers to take advantage of the marketplace, making patients, businesses, hospitals and doctors pay more.
Some of that edge comes from the part of insurance policies that benefit patients the most: Co-pays and deductibles. When consumers see only their co-pays or the deductibles assigned to a physician service, they don’t see – or care – about the ever-growing price increases. The insurance companies absorb the costs, so why shouldn’t a physician or drug company increase their costs? The patient with the full information is in no position to be concerned.
We need to empower individuals to shop for care-making personal decisions based on the cost of services. That would be transformational.
Even for the 28.1 percent of Americans who don’t have insurance or are underinsured, insurance companies collectively could offer an American plan with a selection of insurance offers. The payout to providers would be based on the average contracts they have in place from local insurance companies, which take into consideration where the policy owners live. And, those who just can’t afford any program – approximately 44 million –would continue to receive Medicaid until they can get a job where they have insurance included or can purchase one of the American plans. Either way, avoiding government-controlled insurance for all is a must.
Most people want the best care possible, but, when they pay the bill or understand the costs, generally, better decisions are made. Plus, none of the politicians are talking about who’s going to pay for it. Federal, state and local governments already spend more than $1.59 trillion per year on health care, some of which is paid with borrowed money. And few candidates running for office want to discuss the $1.92 trillion costs presently borne by the private sector.
I think most of us would agree that we don’t want health care costs to bankrupt families and the country or that we want a growing population to go without coverage. But moving into a universal system and throwing out the present system isn’t the answer.
You’ve probably heard the expression “you are what you eat.” Universal health care programs force healthy people to pay for others’ medical care. Chronic diseases, like diabetes and heart disease, make up more than 85 percent of health care costs. These diseases often can be prevented with lifestyle choices. Studies show that the sickest 5 percent of our population consumes more than 50 percent of total health care costs. The healthiest 50 percent of consumers spend only 3 percent of the nation’s health care costs.
A major concern with universal health care is the fact people may not be as careful with their health because a single-payer government program covers all costs. And with little or no financial incentive to do so, it could put even more pressure on health care providers. Many of the providers are independent or work for independent companies and would resist becoming government employees. Plus, doctors, as health care professionals, would be attracted to concierge medicine, where they only take people willing to pay for their services or need immediate attention.
Medicare for All without real health care reform might seem like a way to solve the problems. In the end, after all the dust settles, it would be nothing but another crisis.