CHARLESTON, W.Va. -- It's time to talk about how we provide and pay for health care. The medical profession can actually accomplish cures now, thanks to a difference brought by the 20th century. Our science and technology are light years ahead of 100 years ago. So the availability of medical care today is not a luxury, but rather a necessity for life.
Yet somehow we still act as though some of us can just do without adequate health care -- and so what? I think it is because we don't really know the truth about what a health-care system can be. We have been totally taken in by a string of apparently indestructible myths.
America has the best health-care system in the world. This is the biggest lie of all, and includes all that follows. It is only the best if you are healthy or wealthy. We ration care by ability to pay.
According to rankings on every area of quality health from infant mortality to longevity, our medical care is mediocre although we spend much more per-capita than any other developed country and our costs are rising faster. U.S. private insurance overhead (including profit) is at least 30 percent, whereas Medicare overhead is 3 to 4 percent.
Medicine is a business like any other.
First, while you can do without a lot of commodities and services, but lack of medical care can be life-threatening. There are very few willing to forego it at a time of need. Patients are, therefore, a captive audience.
Secondly, patients don't have the knowledge to be wise consumers of medical care. How can they make good choices? Regarding insurance, policies are not written to be clear. Individuals cannot possibly sort through the options in the fine print and make a decision that is not only right for them at the time, but for the future. All told, medicine cannot be a business like any other.
The free market works for medical care and profit is the best organizing principle.
Profit motivates medical corporations just like all other corporations. That's what they are supposed to do -- make profits for their shareholders. They develop more salable products, from drugs to radiological equipment to insurance, etc., whether they are good for patients or not, and then they charge what the market will bear. The issue for corporate medicine is money, money, money -- not how to help people.
There actually is a free market in medicine.
No. Insurance companies and providers do not sink or swim on their own efforts. The government is already a very big subsidizer of medical research and care costs. The U.S. government itself already pays more for medical care, much of it through private insurance, than total per-capita spending in any other developed nation. The Affordable Care Act will not diminish corporate control. Medical corporations are very good at lobbying the government into spending money where it will do the most good for the corporations.
The free market is best for doctors and hospitals.
Absolutely not. Individuals, group providers and hospitals carry much uncompensated care on their books. Furthermore, their administrative overhead is huge, for pre-approving, resubmitting, appealing, billing and collecting. Staffing is problematic because there has been a major increase in administrators, but not in physicians and nurses. So it is no surprise that most physicians want a single-payer national health plan. Primary care physicians overwhelmingly want that change.