Let's Minimize the Profit in Healthcare

Since the early 1990's, when the brave but naive Clintons dared to suggest health care reform, the idea that access to affordable health care in the United States should be a right and no longer a privilege has gained some traction. Perhaps the financial crisis that accelerated this past fall will convince more Americans that economic behavior in pursuit of mindless profit harms far more people than it helps.

On the other side, however, are the right-wing zealots who scare citizens into believing that any government-initiated remedy to our broken, needlessly expensive, and anti-democratic health care system would mean less access, less choice, and a lower standard of care.

Apparently, many people trust that their insurance company, the faceless financial behemoth that collects the premium money from them and their employers, will take better care of them than their government will.

Given the deregulation of the corporate and financial world over the past 30 years and the booms and busts that have left a wake of economic decay and demoralization for the majority of Americans, I don't think it's wise to entrust life and death decisions of health care to corporate boardrooms and Wall Street traders.  For example, when I learn from 60 minutes that health corporations grant bonuses for denials of service to patients who pay their hefty premiums on time, that is the clearest evidence that this system is beyond reform.  Such appalling corporate conduct is the best argument for removing private insurance companies from health care.

As deregulation has made the insurance giants indistinguishable from investment banks, is it no wonder that many have lost confidence in what was their core mission: provide the stability that individuals and families need in a complex financial world.  In the case of health insurance companies, of course, that has long included only those without 'preexisting conditions'.  This, in effect, excludes those who present a large financial burden to the industry, to be certain.  These are also the people who need the most help.

One of my good friends from high school was a star runner, captain of the school hockey team, and the smartest one of our crowd.  Fortunately for him, his employer, from whom he receives his health insurance, has stuck with him throughout a devastating bout of multiple sclerosis.  I witnessed his decline as a runner, when he couldn't explain why his times kept slipping compared to his training partner.  By the time of his wedding, he needed a cane to get down the aisle.  Shortly after, he accepted that he would need a wheel chair for independence, a larger computer monitor to make out text on the screen, and a more accessible place to live.

I wonder where Dan would be today if he had been dropped by his insurer.

Certainly he wouldn't have adopted two boys from Guatemala, wouldn't continue to serve the patients at UW Sports Medicine, and he wouldn't have won the Mike McKinney award for community service, all the while dealing with decreased function and, no doubt, the pain that comes with the loss of the life he had once imagined.

For most Americans, a devastating diagnosis of this magnitude quite often leads to the bankruptcy that results from the mounting debt of medical expenses and, for some, job loss.

So, first, get the profits of insurance companies, who add no value to medical services, out of health care.

Second, we need a national health plan to make sure that all Americans have affordable access to health care services and to those treatments that doctors deem necessary.  One of the causes of the spiraling cost of treating patients is the cost of pharmacuticals.  And yet, we have no regulation of prices and a shoddy FDA, which is not immune to the lobbying pressure from drug manufacturers.  Otherwise, how can we explain how a drug like Viiox was released to the public?The federal government could both negotiate better terms for consumers, or, better yet, place price controls on the amount of profit companies can make prolonging the life of those who face difficult decisions on whether or not to fill and consume their prescriptions.

A third rememdy I would offer is to change the salary structure of what specialists, such as surgeons make, compared to what their colleagues make in primary care and family medicine.  Unfortunately, the present billing structure of most health organizations rewards the work of specialists far more than it does those on the front lines of medical care.  What happened to the old addage, "An ounce of prevention is worth a pound of cure?"  In the model of most HMO's, however, the pound of cure, a procedure, is billed at an astronomically high rate.  But where does that leave those practicioners who are charged with keeping patients health enough to avoid expensive testing and costly surgery?  Perhaps in our question we see the answer: it is in the interest of HMO's to guide patients towards expensive procedures, where services are the most profitable.

It's obvious that the Obama administration and the Nation has its work cut out for it.