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The Left v. The Right
Hey, Sarah Palin ... let's talk about current "Death Panels" In the middle of one night during my training at a county hospital outside of Los Angeles, a 12-year-old boy arrived at the emergency room. He was having a seizure. From a brain scan, we made the terrible diagnosis: He had suffered a massive stroke. At best, he would be severely disabled for the rest of his life. When I sat down with his mother to tell her the bad news, she told me that he had been a happy, healthy child through most of grade school. But there had been one other trip to the hospital. When he was 7, he'd had a stroke from which he recovered quickly and completely. His mother had been instructed to take him to a specialist to find out what was wrong so he would not have another stroke. But she was the family's sole provider and simply could not afford the expensive out-of-pocket bills. At first I was shocked and angry to learn she ignored a physician's advice that could have prevented this tragedy. I quickly realized, though, that the true culprit was our broken healthcare system. Because this system denies millions of Americans access to care, my patient's mother was forced to take a gamble on her child's health. The result was a debilitating stroke that should have been prevented. Until the system changes, health catastrophes like this will continue to be commonplace in America. Until we reform the system, Americans will continue to be forced to choose between feeding their families and taking them to the doctor. source An individual's position on health care reform is highly associated with their views about government influence in our market economy. Libertarians push for a more privatized system while Liberals believe the federal government should have a hand in the game. The primary problem with this structured debate is that the U.S. does not have a "market-based" health care system at present - and, we never really did.
 Because of Uncle Barack's address to the nation (9.9.09), one Republican congressman has become the focus of the national spotlight. Rep. Addison Graves "Joe" Wilson Sr (SC) will be remembered infamously for shouting, "You lie ..." during our president's speech. While Mr. Wilson may have valid reasons to oppose health care reform, most Americans were shocked by his violation of civil etiquette and lack of respect for our nation's highest office.
I am highlighting Joe Wilson, not for this public faux pas, but because of his experience with America's working "single-payer" health care program, called TRICARE, and which covers 9.5 million active-duty servicemen and women, military retirees, and their dependents. Wilson, who is a retired Army National Guard colonel, and his four sons, who are also in the armed services, enjoy free military (government run) medical coverage, yet the congressman currently posts on his website in large letters, "JOE WILSON IS PASSIONATE ABOUT STOPPING GOVERNMENT RUN HEALTH CARE!" Adam Weinstein, on his Newsweek blog, writes, "Military beneficiaries like Wilson - who, as a retiree, is eligible for lifetime coverage - never have to worry about an eye exam, CT scan, prolonged labor or open-heart surgery. They have access not only to the military's 133,500 uniformed health professionals, but cooperating private doctors as well - whose fees are paid by the Department of Defense. It's high-quality care, too: surveys from 2007 and 2008 list TRICARE among 'the best health insurer(s) in the nation' by customer satisfaction. Yet Wilson, and his "educated" followers (above), insist government-run health care is a problem." [1] Does Wilson have a problem with TRICARE? This is what he had to say: "Currently, TRICARE provides world class health care to 9.4 million beneficiaries who currently serve or have served this nation. The number of individuals who choose to enroll in TRICARE continues to rise because TRICARE is a low cost, comprehensive health plan that is portable and available in some form world-wide. TRICARE has been steadily improving since it was implemented in 1996, promoted by my predecessor the late Armed Services Committee Chairman Floyd Spence. In fact, in 2008 TRICARE was rated the best health care insurer in the nation according to the Wilson Health Information survey of customer satisfaction.TRICARE is an example how we can reform our health care system. Uncle Bararck doesn't want to eliminate the private insurance companies. Instead he wants to introduce a public option that would compete with the private insurers. I provide a brief background of our current system and illustrate why a public option is necessary. Part I: HISTORICAL BACKGROUND Going back 160 years, the American Medical Association (AMA) began setting standards for doctors as well as limiting the number of doctors in society. The AMA's "socialism" keeps doctor salaries HIGH to ensure that our best and brightest further medical careers. If one wants a "free market," you must dissolve the AMA. The number of doctors would increase and stimulate competition. Market forces would regulate (and reduce) the price of services. The role of the AMA remains a critical reason why prices are soaring out of control. Part II: MANAGED CARE In the 70s we witnessed the evolution of managed care, which moved the U.S. further away from free market principles. Medical boards, including hospital directors, doctors, insurance CEOs and BIG PhRMA, met to create networks of care, set prices and outline services - all based on profit. The networks are not monopolistic, as there are generally more than one in a region, yet this isn't Adam Smith capitalism either: we do not have open and free competition. We have an oligopolistic system (a limited number of players) of managed health care providers. In the initials years of an oligopolistic market, we generally witness intense competition as players battle to establish market share and profit margins. Yet as the industry matures (5-10 years), competition decreases and "price creep" becomes the order of the day. In a mature market, the cost to increase one's market share is higher than accepting one's current market position and simply allowing all prices to rise. OPEC works this way as well. Part III: PUBLIC OPTION Since we do not have the foundation for a market-based system, Uncle Barack has proposed a government-sponsored insurance exchange or what is commonly referred to as the public option. This public option would function similarly as other networks of care, i.e., people would choose their doctors, hospitals and coverage terms, yet the public option would NOT be "for profit." Similar to the private networks, a medical board would set prices, plans and coverage terms, yet different from private sector operations, the public medical board would include citizen representatives and hold meetings in the public arena - eliminating much of the mystery behind pricing in today's system. The public option would have another advantage - efficiency. At present this is the overhead of our competing systems:
Part IV: PAYING THE COST Many people are rightly concerned about how to pay for such a plan. Nearly 50 million Americans do not currently have coverage. If these individuals are added to private or public insurance roles, how do we shoulder the additional financial burden? One source will come from the decreased cost to administer the public exchange. Moving from the 18-40% overhead range to the 2-6% mark will yield billions of dollars. Second, we provide medical care to all citizens today, including the estimated 50 million uninsured, at tremendous cost to Taxpayers. To our credit, Americans do not leave the sick dying by the roadside. We offer them Emergency Room care. Unfortunately this is the most inefficient and COSTLY of all service. And this CHAOS within the system drives prices up. By requiring all citizens to have coverage, we will begin to focus on preventive care. We will catch problems when they are small (cheaper) rather than waiting for the last minute when costs will be the highest. Unless we are willing to break the AMA veto on medical care competition, we cannot have a truly free market system. The public option offers a balance to the AMA intrusion. A*L*O*H*A! [1] http://blog.newsweek.com/blogs/thegaggle/archive/2009/09/10/joe-wilson-s-dirty-health-care-secret.aspx [2] http://www.joewilsonforcongress.com/home/2009/07/amendment-to-healthcare/ |
