Written by Michael Kulla (pictured)
There’s broad consensus that health Care needs a makeover, in spite of an unrelenting barrage of disinformation characterizing present reforms as risky and unworkable – the moral equivalent of Stalinist collective farming. There can be no levity on this weighty issue while the (political) blitzkrieg goes on unabated.
At the beginning of the 21st century, America was unquestionably the most powerful, innovative and richest nation in the world, paradoxically though, not the healthiest compared to other developed countries. While we can boast the best-educated doctors and nurses, the best equipped hospitals and leaders in medical research, sadly we have squandered our treasure. The basic shortcomings of our health system cover a wide spectrum – coverage, quality and cost.
Our Health Care System is a Failure …
A former patient of mine contracted diabetes, a disease that modern medicine can manage. If she lived in Canada, France, Italy, Germany, Britain, Japan, Sweden, etc. she would have been given the standard treatment for diabetes and she could have lived a normal life span. Once sick, her health insurance coverage was dropped, and she lacked the resources to pay for doctors and drugs to treat her. She died at 31. She didn’t die from diabetes per se, but from lack of access to health care.
On Sept. 11, 2001 some 3,000 innocent people were attacked and killed. We’ve spent staggering sums of money tom prevent this from happening again. But the same year, and every year since, more than 22,000 Americans (and numbers growing each year) die from lack of health coverage and hundreds of thousands more go bankrupt from treatment they cannot pay for. There are 46 million with no healthcare and another 40 million have only minimum coverage. Never does this scenario occur in any other developed country.
… Costly, Inefficient …
American health care is unhealthy. Costs are rising three times the rate of inflation. The U.S. spends $8,500 per person on health care; Britain under $3,500. Administrative costs in the U.S. are 20 to 30 percent of the total cost and just 5 percent in Canada and Britain.
Our health-care system suffers even more from inefficiency than from lack of funds. Gobs of money is wasted on bureaucracy, unnecessary tests, overpriced prescription drugs, fraudulent billing from vendors, etc. U.S. companies are increasingly less able to afford health coverage for employees.
Every developed country but the U.S. provides care to anyone who gets sick, pre-existing conditions notwithstanding, and most provide longer life expectancy, lower infant mortality and better recovery rates from major diseases than we do — and they spend far less on health care.
… And Morally Deficient
The landmark Affordable Health Care Act, misleadingly labeled as “Obamacare” was actually compromised legislation passed by both bodies of Congress. How can we have an honest conversation about the salutary features and ones that may warrant a makeover in the current adversarial climate?
Efforts to change the American system get derailed by sloganeering about “big government” – socialized medicine verses “free enterprise,” even though no one can quite define what it means. The essential moral question, should health care delivery be a sacred right, gets lost in the shuffle.
A Health Care System for the Benefit of Corporations …
Contrary to conventional belief, most developed countries manage health care without adopting “socialized medicine.” Other wealthy democracies could show us how to build a health system that fits our needs. A potpourri of options is available. Let’s face it, though, our health system is highly resistant to change. Vested interests – insurance and pharmaceutical companies, as well as hospital chains, have blocked attempts to restructure it for the benefit of care holders. Other industrialized nations with vested interests like Switzerland and Taiwan have overcome political hurdles and reformed their care systems.
… Supported by the Close-minded, Trite and Frivolous
Another barrier to reform is American Exceptionalism taken to extremes. Notice that presidents (and other politicians) take every opportunity to laud America as “the best.” To vacillate on this is “unpatriotic.” The real “patriot” evaluates the situation in toto (good, bad or whatever) and reacts with an open mind. The bogeyman isn’t that it is socialism per se, but that it is foreign.
Individual Care has Given Way to Medical Business Oligarchy
I have witnessed a profound change in my field — psychology. Its honed skills and art and science, in effect the accumulated expertise, has been pushed aside for time-limited robo-therapy. Adding insult to injury, patients pay more, doctors get less, paperwork is overflowing and insurance company telephone prompts are unending with often no human to talk with. The foregoing landscape results in poorer and more costly services in the long run. In contrast, insurance industry profits over the past few years are zooming. Most therapists try to maintain good practice standards in spite of this onslaught.
Medication prices would collapse in response to competitive pressures. Instead, prescription drug prices in America remain excruciatingly high, the result of Medicare Prescription Drug Act that forces Americans to subsidize overpriced drugs. The cost of the drug act was later (revised) to over $1 trillion, or three times greater than what Congress was led to believe. This act, written and lobbied through Congress by the drug industry nearly a decade ago, prohibits Medicare from using its enormous purchasing power to lower prices.
In Mexico, shelves are stocked with just about every popular American prescription drug but no prescription is required. Most prices are fractions of what they cost here. Certainly, there are medications that require close physician supervision and they should remain on prescription-only status, but affordability is essential.
Once a brand drug comes off patent generic equivalents emerge. They cost far more than they need to because of Federal Drug Administration regulations and drug company maneuvers. On average, Americans are paying substantially more at drug stores than ethical compounding pharmacies could sell them for.
Medicare is facing insolvency. A major reason is that too many older people are getting sick. Diseases of aging are preventable via a wide variety of lifestyle alterations. Government needs to be much more proactive in this area. One example is the needed promotion of vitamin D supplementation. Evidence supports the huge role that vitamin D plays in preventing almost every killer disease of aging.
A Dialogue about Morality, Rationality, Cost and Effectiveness
America’s health care anomalies are so numerous it’s not possible to fit them, as well as exciting new cost-saving initiatives, into one article. Americans deserve to be healthier and happier, and their needs must take top priority. For this to happen a rational dialogue without prejudice must ensue.
The primary issue for any health care system is a moral one. Should it be an essential safeguard of human life and dignity, an obligation for society to ensure it as we guarantee the right to prayer, education, voting, etc., or should we let Americans die for lack of access to health care? Settle this point and we can bring about fundamental change drawing from many systems in the world that are fairer, cheaper and more effective than ours.
About the Author
Michael Kulla is from Pleasant Valley, NY and is a New York State licensed psychologist.