Healthcare - The Real Facts by Dr. Copp

Not wanting to repeat what you’ve been seeing and hearing on 60 Minutes, Bill Moyers’ Journal and the evening TV news shows,... I’m going to try to give you my “big picture” approach to health care systems,... and try to debunk some of the myths and lies the heath care industry has been trying to sell you.

Please note that I refer to our delivery system as the HEATHCARE INDUSTRY. In a nutshell, I believe that is the real root of the problems we face. Uniquely,... healthcare in the United States is an INDUSTRY,... a for-profit business which is designed with the primary goal,... not of tending to your physical and mental welfare,... but of making money for its providers and investors. That’s a simple fact and should not come as a surprise! We live in a capitalistic society, and our political leaders long ago decided that healthcare is a commodity,... not a right of citizenship, like our public education, judicial system, fire protection, and other public services.

But that means any attempt to “reform” healthcare delivery and reduce the cost of healthcare will have a negative effect on the income and profits of pharmaceutical companies, hospitals, clinics, medical laboratories, and the manufacturers of medical equipment (such as expensive MRI machines, respirators, power wheelchairs, laser devices, pacemakers, etc.)

You should expect them to resist and fight back! Think about it,... for years, the drug companies have been spending millions trying to convince you that you need to take regular pills. They dream up curiously-named syndromes for common discomforts and get to sell you expensive remedies which could be treated by simpler, much less expensive means. These same pharmaceutical companies lobbied your congressional representatives to the absurd extent that recent reform legislation on prescription drugs specifically forbade the Medicare and Medicaid programs from negotiating with pharmaceutical companies for better prices on their drugs. Ridiculous,... but true!

Those same drug companies tell you that the reason your prescription drugs cost so much is that they have to spend enormous amounts of money on research to find new and better medications. In fact, most of the investment in developing and testing new drugs is shouldered by the federal government (as a tax-payer, that’s you), through the NSF, NIH and direct grants from HHS. The pharmaceutical companies spend three times as much on promotion,... detailing doctors, advertising on TV and in medical journals,... as they do on research.

The drug companies are not alone in these endeavors. Every part of the healthcare industry,... health insurance companies, hospital associations, nursing homes, health professionals and manufacturers of medical equipment,... provide your congressional representatives with generous contributions for their reelection coffers.

Let’s look at a few of them:

Over the last 6 years,...

Max Baucus, Chairman, Senate Finance Comm. has accepted over $2,350,000 from the healthcare industry as campaign contributions. Do you suppose he feels somewhat obligated to them? This year he’s earning it, as their defender against the massive popular demand to get a single-payer health insurance system. As chairman, he has outright refused to consider any single-payer proposals,... barring from the hearings any single-payer advocates despite vocal protests,... and he’s forging ahead with a plan that promises to discipline the industry,... but keeps them in charge.

His Republican counterpart on the committee, Charles Grassley, helping him write the reform legislation, has gotten nearly 25% of his campaign funding from the industry. He has accepted almost $1,500,000 from them.

Democrat Christopher Dodd has received almost as much as Senator Grassley to his campaign fund. A total of $1,444,522 from health insurance corporations alone.

John Boehner, Republican minority leader in the House, has received over a million dollars in the past 6 years. Which makes him a “piker” compared to John McCain, who received campaign contributions (including his run for the presidency) to the tune of well over $5 million, just from health professionals alone.

This is a high stakes game that’s being played and there seems to be no shame demonstrated by any of the participants. So far, in the absence of any serious consideration for a single-payer system (which would be the TRUE reform we need), the Obama Administration’s persistent efforts in the healthcare reform debates have managed to assure that we might get a “public option” for healthcare insurance in the final resolution of the bill. This is the very least we should settle for. And if there are no troublesome loopholes in the final bill, a federally supported “public option” should be sufficiently more efficient and less expensive, so that it would either drive the commercial health insurance plans out of business or force them to compete at a greatly reduced cost level.

If you’ve been hospitalized recently, you already know that present healthcare costs are completely unjustifiable. As you are undoubtedly aware, since the beginning of this century, just 10 years ago, the cost of healthcare has doubled.

Let’s consider why that’s the case. In the June 1st issue of the NEW YORKER magazine, there was an article by Atul Gawande, entitled “The Cost Conundrum.” You can pull it up from the internet on your computer. It’s definitely worth a thoughtful reading if you want to understand one of the reasons for skyrocketing healthcare costs. He analyzes, in considerable detail, the reasons why McAllen, Texas has one of the highest health expenditure rates in the nation. In 2006, Medicare spent $15,000 per enrollee here,... almost twice the national average. While in El Paso, with very similar demographics, Medicare spent only $7,504 per enrollee. The huge difference lies in how the local providers practice medicine.

Consider the fact that they’re probably treating elderly “snowbirds” who are virtually all covered by Medicare,... and not he local year-round population whose average income was about $12,000 a year. I asume that a few of you are eligible for Medicare and understand that when you see your personal physician for an annual visit, he or she is inclined to order a great many blood tests, an EKG, mammography, a chest Xray, perhaps some allergy tests, and maybe suggests seeing an orthopedic specialist for that low back pain or knee discomfort. Some of those things are ordered because, IF they missed something on your physical exam you might think your doctor was negligent in not detecting the cancer, or diabetes, or emphysema earlier. So, it’s a way for the doctor to minimize the chance of a malpractice suit.

You may have actually felt pretty fit, but all those additional tests and referrals serve to provide you with a level of assurance and comfort. As a result, instead of the routine visit and exam being, maybe $200,... it costs $500 or even $1,000. But It’s mostly being paid for by Medicare, TriCare or some other health insurance program, so that’s OK with you! Your insurance coverage separates you from the cost-benefit decision that you normally make in buying a car, household appliances or planning a vacation trip. I bet that many of you can’t tell me the total cost of your prescriptions per month, much less how much an MRI costs,... or what a battery of liver tests would run. Your providers can easily charge excessive prices because they’ve effectively separated the consumer from the paying of the bills. In addition, there are a few unscrupulous folks engaged in defrauding the programs, billing Medicare or Medicaid for services and supplies which were never provided.

What SHOULD we be paying for heathcare? How far out of line are we?

Other than the U.S., here are 9 of the highest spending nations per capita for healthcare in 2007, the latest year for which we have these figures...

France $3,040 Holland $3,092 Australia $3,123

Belgium 3,133 Germany 3,171 Canada 3,173

Iceland 3,294 Austria 3,418 Switzerland 4,011

These figures would be slightly higher now, but notice all but one fall between $3,000 and $3,500. The unchallenged champion spendthrift was the United States, with $6,096 per capita in 2007. That expenditure is currently approaching $8,000 per person, though the state of Hawaii has kept their health expenditures at about $5,000 per capita. Obviously, it can be done! It seems we could have a generous system with excellent care provided to everyone for much less than we are spending now. France has one of the highest rankings for their health care services and outcomes,... and spends half of what we do.

Let me summarize the myths you should discount,... and what it might take to set the system on the right path.

MYTHS:

The United States has the world’s best health care.

(This excerpt is from a recent study by U.S. physicians) - “Compared with five other nations—Australia, Canada, Germany, New Zealand, the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance.”

Don’t let a bureaucrat come between you and your physician.

If you have private health insurance, it is an insurance agency employee who gets between you and your physician, creating problems. If you’re on Medicare, a single-payer system, you know that problem does not arise. Maybe that’s why Medicare recipients are so satisfied with their care.

“Socialized” medicine is terrible. Canadians, Brits and the French hate it.

That is what the health industry folks want you to believe and have tried to convince you.

I encourage you to talk to one. Those recipients are really very pleased with their services.

Also they are enjoying better health outcomes and life expectancy than we are.

Government run health care will have to be rationed.

Health care is a limited resource and, as such, has always been rationed. In our current system, it is rationed by price,... what the individual can pay for, he gets. Under a public system, it would be rationed more equitably and fairly.

WHAT WE NEED TO DO:

• Preferably, adopt a universal single-payer system like France or Canada, (or like TriCare or Medicare) which covers everyone and is paid for through taxes. But our elected representatives are apparently lacking the political will to do that, so a “public option” coverage is absolutely necessary as a minimum.

• For that “public option” program, we must enable the administrators to negotiate with providers to assure top quality services and to obtain the best possible prices.

• Since everyone would be insured, insist that patients access their healthcare through a primary care provider and limit hospital ER access to genuine trauma and medical emergencies.

• Provide support for any qualified healthcare provider student to get their education in exchange for years of dedicated service after completion of their training.

• Set some clear limitations on reimbursable “end-of-life” health services and support individual hospice services at home, rather than in hospitals, during those final months of life.

---