On the health insurance "reform" bills wending their way through Congress, the assessment of Dr. Steffie Woolhandler, professor of medicine at Harvard University, primary care physician in Cambridge, co-founder of Physicians for a National Health Program, should be a wake up call:
Well, I think we know—we now know the outlines of what they’re going to pass. It’s not an abstract something; it’s something real. And it’s quite bad. It’s $500 billion in new subsidies to the private health insurance, millions of mandatory new customers for private health insurance.
The Democracy Now --interview with Dr. Woolhandler, is practically a primer on not only what's wrong with the health insurance reform bills in Congress but also what's wrong with the US health care. Anyone that chooses not to read or listen to it forever waives the right to say that nobody could have known just how bad the great health insurance reform legislation would turn out.
A careful reading months ago of where this was heading was enough for some to see that the negatives were outweighing the positives because it was replicating the Massachusetts experiment that in less than three years is failing. From Dr. Woolhandler:
Much of the Massachusetts plan has been wildly expensive. According to the state’s report to its bondholders, it’s cost $1.3 billion this year. The state has opted to pay for that by stealing money from safety net clinics and hospitals, so that safety net providers that care for immigrants, the mentally ill, people with substance abuse, that provide primary care, they’ve seen their funds shrunken, so that money could be handed over to purchase insurance policies. Massachusetts now has the highest healthcare costs in the history of the world.
Stealing a buck from the public health safety net buys fifty cents worth of health care in the private medical sector. Or is that forty-five cents because inflation in the health care costs goes on and on. Why it looks like the supply is inadequate to meet the demand. Now exactly how is increasing the demand going to fix that?
Unfortunately, like all the other excellent critiques of US health care, Dr. Woolhandler writes the same prescription:
You have to compare that to what goes on internationally. With the average per capita cost of healthcare about half those in the United States, yet people in Canada and western Europe live about two years longer. They have complete free choice of doctor and hospital. They have lower infant mortality. People in other developed nations use some form of nonprofit national health insurance to get better care for less money. And that’s why our group supports the Medicare-for-all approach.
Waiting for Single-Payer.
There is no path to affordable Universal Health Care in the US as long as we persist in believing that insurance is the answer -- the only answer. Getting a third of the population into a federal public insurance pool wouldn't have worked because it left in place capitalist medicine. The cost of health care in the US is excessive in relationship to wages. Insurance has help mask that inconvenient truth. Price controls haven't worked for Medicare (the most expensive health insurance program anywhere on earth) or for health insurance companies. No reason to think that a new insurance agency would do any better.
Yet, it's neither difficult nor unaffordable to take giant steps towards UHC. The knowledge and infrastructure already exist. All that's lacking is the will and the vision.