Health Care Solutions or Folly

By Joseph Geck

One of the most important debates occurring now is health care. Both Republicans and Democrats have fielded proposals.
 

There are three intertwined problems of our health care system: spiraling inflation; large numbers of uninsured, underinsured and insured whose insurance companies refuse to deliver promised benefits; and a quality problem that continues unaddressed.

We have the most expensive health care in the world with a per capita cost that is almost twice that of Canada or England, and a third higher than France, which has the best health care statistics in the world. This cost in the private sector is born largely by companies, which because of the increasing costs of health care are at a competitive disadvantage in the global economy. The cost inflation is driven by a number of factors and includes the way HMO’s and insurance companies operate. Because Canada, England and France all have single payer systems, they do not suffer the overhead of insurance companies and HMO’s.

Also, most developed countries finance health care through value added taxes and so companies are not burdened by health care costs.

The large population with inadequate insurance drives many not to seek care in a timely manner. They wait, which adds cost to the system when they finally seek help. Sometimes they die. Our high infant mortality rate is blamed on a number of factors including the fact that uninsured mothers do not get adequate health care, even though critics claim the care is available.

Whatever the issues are, our health care statistics are worse than any other developed country, in spite of having the best technology and the best-trained doctors.

Studies by Harvard have shown that even the poorest British are healthier than the richest Americans and studies by the AMA have shown that Canadians are also healthier. This flies in the face of the insurance company propaganda that brands Canadian and British systems as flawed.

As for quality we are killing around one hundred thousand people a year with hospital mistakes and another hundred thousand with errors in prescription drugs. The average car on the Ford assembly line is safer than the average Ford worker when he enters the hospital. The quality revolution that hit our car industry has yet to make a serious dent in our health care system.

None of the proposals being discussed really address the full scope of our health care mess.

The Republican proposals are extremely narrow, focusing on moving some of the cost burden off our companies and putting it into the hands of consumers. But without changing the fundamental operation of HMO’s, insurance companies or addressing the fee for service and conflict of interest issues would there really be a free market?

If union and large company bargaining power has not put a cap on the spiraling cost, putting the consumer in charge is like sending unarmed soldiers into combat.

The Democratic proposals are interesting but can a state really decrease the total cost by going single payer unilaterally? We know that cost containment if not successful would sink our already excessive tax burdened state. I would feel much more comfortable if instead of relying on computer models the plan would actually copy the strategies of countries with successful health care systems like France.

Voters need to become informed, put aside preconceived prejudices (e.g. single payer is communist) and force the politicians to act responsibly. This problem is costing many more lives than terrorism and we are a disgrace among Western economies.

Joseph Geck is a semi-retired international consultant.