Published on TheHill.com on May 12, 2009
When all of America’s top health insurers and providers met at the White House this week and pledged to save $2 trillion over the next decade in health costs, they were pledging to sabotage our medical care. The blunt truth, which everybody agreed to keep quiet, is that the only way to reduce these costs is to ration healthcare, thereby destroying our system.
Here’s why:
• Essential to any cost reduction is a cut in doctors’ fees. Congress is trying to cut Medicare fees by 21 percent. But cuts in fees and doctors’ incomes will just discourage people from entering the profession and those already in it from practicing. The limited number of doctors and nurses in the United States is the key constraint on the availability of healthcare. Our national inventory of 800,000 doctors is growing at only about 1 percent a year (18,000 med school graduates annually minus retirements), while the nurse population is stagnant at 1.4 million. To stretch these limited resources so that they can treat 50 million more people is possible only through the most severe kind of rationing.
• As in Canada, the best way to cut medical costs is to refrain from using the best drugs to treat cancer and other illnesses, thereby economizing at the expense of patients’ lives. Forty-four percent of the drugs approved by the Canadian health authorities for use in their country are not allowed by the healthcare system due to their high cost. As a result, death rates from cancer are 16 percent higher in Canada than in the United States. We will pay for the attempt to save $2 trillion with our lives. (And remember, one cannot opt out of the Canadian system and pay for the medications out of pocket.)
• The only real way to save money on the scale projected is to ration healthcare services. Optimists say that this can be achieved by increased use of preventive care. But the Canadian experience indicates that when government — or its satellite private insurance providers — ration healthcare, they cut preventive care first. In Canada, colonoscopies are so rationed that the colon cancer rate is 25 percent higher than in the U.S. (even though Canada has a much smaller proportion of poor people, whose frequently bad diets make them more prone to the disease).
Obama’s pretension that nobody will find changes in his or her current health insurance plans except for a magical reduction in their cost by $2,500 a year is a fool’s proposition. Private health insurers will be no more private than TARP-funded banks or government-subsidized car companies are in Obama’s America. They will be controlled by government healthcare planners who will approve treatments, limit drug use, hold down medical incomes and bring their cost-cutting programs to bear. Inevitably, their ax will fall on the oldest and the sickest among us, those least “deserving” of our newly limited and, under Obama’s program, diminishing healthcare resources.
The other radical changes Obama is bringing about in our nation can always be reversed. New taxes can be repealed or lowered. That which was nationalized can be privatized. Government which has grown can be cut. But once the healthcare system is extended to cover everyone, with no commensurate increase in the resources available, the change will be forever. The vicious cycle of cuts in medical resources and in the number of doctors and nurses will doom healthcare in this country. This wanton destruction will not be reversible by any bill or program. A crucial part of our quality of life — the best healthcare in the world — will be gone forever.
Politically, voters will feel the impact of these “reforms” very quickly. When they face rejection or limitation at the hands of the bureaucrats, they will quickly understand that the their options have become limited. Just as in the 1990s, when HMOs first became universal, the patient outrage will create a political force all its own and those who foisted this brave new world on the American people will be in their crosshairs.
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The American Health Care System is controlled by the Politicians, Lawyers and the Insurance Companies. What is needed is Tort Reform, when an error is made, the patient should be reimbursed, but not the lawyer roulett system now in place, where lawyers make millions and little is left to the injoyed patient. The politians must accept that initial care is far more important than waiting for a near-death case to develope. Insurance companies should be held accountable to support by initial care and pay more for precare than three or four times for specialty care. Insurance companies should have, as part of their annual audit, the amount of premiums received and the amount paid out to provider care.
We already have an example of government run nationalized health care; the VA Hospitals which is a travesty and a tragedy in this country. We should emphasize this to the American public.
I would submit that most of the rising costs are for tests that the doctor has to perform to cover himself from a malpractice lawsuit. In the 1950s if you went to the doctor with a headache, more than likely he would give you some aspirin and send you home. Today, he would order an MRI at a cost of $1,000 to protect himself on the outside chance (1%) that the patient may have a brain tumor. Emergency rooms that exceed capacity are used for minor medical problems and by illegal aliens as their primary health care which currently are a huge cost burden.
Personally I like what one hospital in my area is doing. They are remodeling existing buildings or abandoned buildings to create health networks scattered across the city run by physicians keeping health care at the local level. The network is tied to other specialists and the hospital to provide those services if the primary physician thinks it is warranted.
To make this system even more successful what needs to be done is remove the burdensome oversight which is nothing more than overhead from health care providers such as Blue Cross/Blue Shield and allow them only to manage the office (e.g., making appointments, entering data into computer, billing, etc.).
Using the above model and expanding it would include the Federal government to ensure competition (i.e., construction and health care provider contacts) for resources for modification and/or remodeling of buildings and to maintain and process information and data within the networks.
The Federal government should have a role in making sure there is access to generic drugs and in negotiating costs on non generic drugs.
Physician guidelines (for treatment) should be developed through a medical organization such as the NIH and a doctor following these guidelines should not be sued.
Auditing for compliance can be accomplished through the GAO. This way health care stays at the local level. People would have a choice for a provider.
The Federal government should not have a direct role - that would be a disaster.
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Dick:
I have to agree with the HaroldCutler and am surprised that there was no mention of the need for tort reform in your article.
Legal issues not only add to the cost of health care, they multiply it. It’s crazy that any negative result, or even not as positive result as was expected, can become the basis for a law suit. Not only are the caregivers sued, but so are the institutions, the medical products manufacturers, the suppliers to those manufacturers, and nearly any passers-by that might have had some peripheral association with the patient.
There are few disciplines where anyone would expect 100% positive performance all the time. Some times things just happen. Some times the decisions aren’t perfect. Some times people simply miss something or for that matter aren’t told. Do each of these merit multi-million dollar judgments again people who are just trying to do their job? In most cases no.
Gross negligence is one thing, but to sue everyone in sight for any less than perfect outcome is wrong and it’s a major factor in the cost of health care, the decisions for people to become caregivers, and the decisions to continue in practice.
Stop the lawsuits first, then we can talk about how to reduce costs further.
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[…] future if President Obama’s plans come to fruition. I recently read a chilling article titled Death Of U.S. Health Care by political analyst Dick Morris. It’s worth reading in full, but the bottom line is that […]