Various states are trying to solve the healthcare crisis at what can only be considered the local level. New York is no exception. What follows below is an Op Ed/Letter in published in various papers in Northern New York concerning an inept state solution to healthcare expenditure that is being dictated by the insurance industry. The implications are clear at the national level. I would have so much wanted to be in the new majority to participate in bringing healthcare to every single American in my bid in the last congressional election. I only hope that the new majority can resist the Insurance and Pharmaceutical industries:
The “R” word is now out in the open. Healthcare has been rationed on the ability to pay for decades. It is an immoral abomination that has been tolerated for years because it was easy for the vast majority, who had access to healthcare, to look the other way. Now that majority, who found it so easy ignore the problem, is going find out what it is to be denied access to the very healthcare that they take for granted.
The Commission on Health Care Facilities is closing and downsizing hospitals. It will stand and become public policy because of the gutless way in which our lawmakers have arranged for its passage. Like that majority of Americans that have healthcare insurance, all they have to do is look the other way and on January 1st it becomes public policy. It does not require an affirmative vote. All this brought to you by five hospital CEOs, three health insurance executives (2 CEOs, 1 VP), three industry CEOs, three government administrators, a lawyer, a social worker, a technical university president, a banker and bishop and NOT one medical doctor and NOT one elected representative. Perish the thought of utilizing the expertise of physicians who intimately know the problems of a failing healthcare system or our elective representatives standing up and taking responsibility instead of cowering for political cover.
The solution of the Commission saves money in all the wrong places. It protects insurance companies and allows them to charge higher rates, cut benefits, make record profits and compensate their CEO’s with obscene salaries and perks. So emblematic of this unmitigated greed is the CEO of UnitedHealth, the second largest healthcare insurance company in the country and very active in New York, who was given $1.6 BILLION in compensation – 1/1000th of the entire healthcare expenditure of the United States.
Their solution eliminates thousands who actually provide hands on healthcare to the sick. The unspoken, but very predictable and forseeable, consequence is that the affected communities will loose their doctors. If a doctor does not have a hospital to admit and care for patients, they can’t practice. That is exactly what the Commission wants: just like Canada, eliminate doctors and limit – RATION – healthcare
We shouldn’t be surprised at their “solution”. One third of our healthcare dollar is squandered by administrative costs, another 10% by the inflated prices of drugs and yet, another 7% is by a liability system out of control. Forty five percent, nearly half, of our healthcare costs go to those who do not provide one jot of medical care – administrators and CEOs of hospitals and insurance companies, shareholders, lawyers – defense, plaintiff and corporate, office workers playing cat and mouse with the insurance companies, armies of middle management navigating the unnavigable – not nurses, doctors and patient care hospital and home workers. The insurance industry is clearly out to protect itself.
Healthcare is the single largest sector of our economy that devours 15% of our GDP: $1.6 Trillion. From the US Department of Commerce Bureau of Economic Analysis no other sector even comes close: durable goods (cars & parts, appliances, electronic equipment, home furnishings & fixtures, housewares, recreational & sporting goods, toys & games, etc) – 8.3%, food – 9.6%, gasoline, fuel oil and energy – 4.0%, national defense – 4.7%, transportation – 2.6%, housing – 6.2%. By its very dominance of our economy, solving the healthcare crisis that is killing us and killing our economy is the single most important economic issue before the nation. A successful solution will have the most profound salutary effects upon our economic and individual well being.
It is not fair that I so sharply criticize the offered solution without having one to offer. The bad news is that the healthcare crisis is not solvable at the state level. The good news is that it is solvable – at the national level. The principle of any insurance system is to spread the risk over the greatest population possible. Individual states cannot do this alone without making themselves uncompetitive with other states that choose not to solve their problem. We clearly need a national program of health insurance where everyone pays and everyone is covered. The cost is spread over all sectors of the economy: individuals, corporations, business, young, old, earned and unearned income. Combine this with controlling our drug prices and real liability reform and we save one third of our health care dollar – more than that spent on national defense.
The Health Care Facilities Commission estimates that its solution will save New York $807 million a year. Considering that New York’s 2005 GDP was $958 Billion and assuming that we spend the same 15% portion of our GDP on healthcare as does the rest of the nation (probably an underestimate), New York’s healthcare expenditure is $143 Billion per year. Enacting the healthcare solution above will save New York $47 Billion a year – money that stays in the pockets of New Yorkers. The Commission’s paltry solution with its rationing is a trivial 1.7% savings compared to the real solution to the problem.
The low hanging fruit to control our healthcare costs without rationing is there for the picking. It means an insurance program responsible to our elected representatives who, by law, will not be allowed to duck their responsibilities. It means elective representatives of courage and conviction whose reason for public service is not to maintain their jobs but rather seek real solutions for real problems. This means leaders with spine able to stand up to special interests. It also means a public able to discern courage and conviction from illusion and perception.
The Commission on Health Care Facilities is just a prelude of what’s to come in the next few years when the GMs (“What’s good for GM is good for America”) and the Wal-Marts (“Always the low price”) of the world along with the insurance industry redesign our healthcare system. The Health Care Facilities Commission report panders to those special interests and is far from the solution to our problem.
Bob Johnson, MD
Former Congressional Candidate 2006, NY23