Thursday, March 15, 2007
Handy Health Care Synopsis
At the link below you will find a handy synopsis of the complex issue of health care in the U.S.A. The synopsis focuses on two realities.
One - Our health care system is totally screwed up. 47 million Americans have no health insurance, and private insurance is prohibitively expensive for all but the affluent. Most of us depend on our employers to offer us health care benefits, at the same time that medical costs are rapidly increasing, causing the cost of health care insurance to rise at an even higher rate. This, in turn, causes corporations to offer health care benefits to fewer Americans, to avoid hiring older workers or those with health conditions, to downsize all classes of employees with greater alacrity, and to deny health care benefits to former employees on pensions. As a consequence, even though we pay twice as much for health care in the United States, we have a lower life expectancy than most advanced western nations, and "significantly higher infant mortality."
Two - Our leaders erroneously assume that "Americans would never accept socialized mediince", and that health care should be provided by commercial suppliers anyway because "markets will always outperform the dead hand of government."
According to the article at the link below, those who debate health care policy pay far more attention to the political reality, Number Two, than to the social reality, Number One. The article goes on to cite journalist Jonathan Cohn's new book about health care - Sick: The Untold Story of America's Health Care Crisis - And The People Who Paid The Price. Cohn says that the medical establishment started jacking up its prices beyond what most of us could pay almost as soon as they figured out how to cure more people than they killed. That happened approximately in the 1920's. When the Depression pushed the cost of medical care even further out of the reach of the average American, Baylor Hospital in Dallas started a system that we now know as Blue Cross. This, and organizations like it, were non-profit insurers that served communities and strove to keep costs low. The success of these organizations attracted into the marketplace other health care insurers whose motives revolved entirely around profit. Costs increased, and the average American again needed help to pay for health care. When wages were frozen during World War Two, corporations introduced health care benefits as an enticement to attract new hires. More corporations began to provide health care benefits to compete in the labor market, and the modern system was born.
As the cost of health care insurance rose higher and higher, HMOs stepped onto the stage, offering to control costs through "managed care". HMOs started as non-profit organizations, but were eventually replaced through the moral Gresham's Law of capitalism by HMOs seeking only to make a profit. These HMOs preferred to "manage care" the hilt, going so far as to deny treatments to those who needed them most.
The profit motive is a juggernaut, and costs continued to rise. Now we have a system whose mode of operation is the exact opposite of any authentic "service to society". It makes a profit on health care by providing it most willingly to the young and the healthy, and charging an arm and a leg from those for whom health care is most essential - the old and the sick. That is the social "bottom line" of health care, and it must change if we are to remain a civilized nation.
"A Short History of Health Care" from Slate