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Health Care: The Problem

10/02/09 | by [mail] | Categories: culture/news

Much of the discussion our nation is having about health care is centered around the advantages and disadvantages of various proposed reforms. Maybe we need to give a little more attention to the problems themselves. I understand that conservatives have many legitimate concerns about a greater role for government in our health care system. Those concerns should play an important part in the national dialogue. But what I'm not seeing from conservatives is an acknowledgment of the problems with our current system.

A Harvard study (PDF) concluded that 44,000 Americans die each year because they lack health care coverage. That's 14 times the number of deaths from the terrorist attacks of September 11, 2001. Many Americans enthusiastically supported two costly wars because they felt this would prevent future attacks like 9/11. As tragic as those attacks were, their cost in human lives and in dollars pales in comparison to our health care crisis.

As I've pointed out before, in the United States we spend a greater share of our money on healthcare than any other nation in the world. Yet by many metrics, we are less healthy than the other developed nations (all of whom have some sort of universal coverage).

So before I advocate any specific reform, I would like to hear some reactions to the problems of American healthcare, especially from conservatives. What do you have to say to those who cannot get coverage because of pre-existing conditions? Setting aside specifics for a moment, can we all agree that it would be a good thing to have everyone covered? Or would you prefer that things go on basically as they are now?



If a person gets in a car wreck and has a punctured lung, what is the first thing that is done to try to fix their injuries? I would argue that you first fix the punctured lung and then sew up the outer wounds…

Suggesting that the health care system is being ruined by insurance companies is the same thing as fixing the flesh wound and leaving the punctured lung for another time. We have this nasty looking problem, but if we sew up the outer-most wound everyone will be happy. It is horrible that there are some people that are unable to get the care they need because of a preexisting condition. I don’t think that you can find one person who would argue that it is a good thing. But, as I said in my second post, the problem is not(entirely at least) the fault of the insurance companies. You are insane and naive to think that it is. But yet all that is talked about when reform is discussed is the big evil insurance companies.

And then to say that if there isn’t another idea, then ours is the best one is more insanity. I would say the causes of the high cost of care are fairly ingrained into the system…It might take time to figure them out, and come up with the solutions to the problems. You’re mad at Republicans in Congress because they say that the current “reforms"(quotes b/c they aren’t reforms) are bad. If the possibility of having a discussion existed then maybe the loud protests from that side would not be happening. At the present time there is not a possibility for a conversation, so if they think that the current ideas are bad then their job as our representatives is to make sure that any new systems, that implement the current ideas, do not make it through to become law. … Read More

Reforming the the health care insurance industry WILL NOT do as much to bring down the cost of care(the true problem) as a true effort to rid the health care industry of its current problems.

If all you want to do is concentrate on is the number of people that are dying from certain causes, then let’s make abortions, smoking and hot vegetable oil illegal; and make flu shots free on every corner. All three of those things, and the lack of the fourth, kill more people each year than lack of health care…They aren’t, however, the current big elephant in the room.

Kris [Visitor]  10/03/09 @ 11:07
[Member]  http://www.brendoman.com/10/04/09 @ 11:32

Wow! Kris’s response does seem so unmatched to your post that I almost wonder if Kris is a bot. Forgive me if you’re not Kris (and please, disprove me by saying something sentient in response so I can feel better about the world). I’d much rather believe that there isn’t some right wing bot trolling the blogosphere looking for health care posts…but when you, if there is a you, stick “Read More…” without a hyperlink in your comment you have to admit it gives one pause.

Doug [Visitor]10/04/09 @ 17:41
[Member]  http://www.brendoman.com/10/04/09 @ 18:15

Doug, There were several posts before the ones that you have seen. My comments were not a direct reply to what Danny said, because I don’t believe that the insurance industry is the biggest part of the problem. Danny’s questions were asking what I thought about the current insurance system. That is an overly-simplistic way to look at the current problems. That’s why I went off in the direction I did. BTW I am a real person, and have plenty of medical bills. I possibly could be helped by universal coverage. That doesn’t mean it’s the solution.

I think tort reform has to be part of it. Doctors, hospitals, malpractice insurance companies, etc are so susceptible to being sued for huge, outrageous sums of money, that it’s no wonder costs are going up so fast. On the other hand, patients also have to be reasonably protected from true cases of malpractice. Frankly, though, I’m not sure how to draw the line.

I think everyone will admit something has to change. In general, I’m socially liberal and financially conservative so I’d like the gov’t to stay out of the way most of the time. However, I think it may be necessary for them to get involved in this case. Whether it’s stronger regulation of the industry, or a public option – I don’t know. I do find it troubling that people/companies are able to profit off people being sick, though.

I wish conservatives would offer up a real, comprehensive plan instead of bashing the existing plans or appearing to be in the pockets of big healthcare corporations.

Josh [Visitor]10/05/09 @ 07:53

Some time ago I heard an interview with a health policy expert who suggested that the US should to what other countries do with malpractice and other civil suits: the loser pays all the court costs.

He said that in the US it’s too easy to sue for anything, because a lot of lawyers tell their clients that if they don’t win, they don’t have to pay anything (the lawyers recupe those costs in the cases they do win). But by requiring a losing plaintiff to pay the court fees, it makes people think twice about suing and helps ensure that people only bring a suit if they really have a case. If a losing plaintiff pays the court fees it also saves on some of the costs that the defending doctors otherwise have to pay.

According to the expert being interviewed, this is the way it is in England (if I remember correctly) and in a number of other European countries. It sound like a good idea to me, so of course Congress won’t do it.

Kyle [Visitor]http://www.brendoman.com/kyle10/05/09 @ 08:55

I wasn’t actually calling you insane and naive specifically…sorry if you took it that way. You and I both know that any possible solution to the health care system’s problems would be an extremely complex issue. Hopefully there are people working on the issue that are smarter than both of us(and anybody that either of us know).

I would say that paying physicians a yearly salary, as the cleveland clinic does, is one thing that could possibly help the problem. I’m not necessarily suggesting that doctor’s make too much money, but any time you get paid on a case by case basis there is an incentive there to perform unnecessary procedures. I think that we’ve all heard of instances where a person was admitted to a hospital, and a doctor who wasn’t there own dropped in for a few seconds then charged several hundred dollars for their time. How to figure out, on a nation-wide scale, what a sufficient salary is is something that would be very difficult to do. Sufficient is a subjective term in this situation too. Is it that a doctor comes out of school without the normal student loans, never has to worry about paying for continuing education and makes around $100,000(depending on location) for the rest of their lives(with inflation adjustments, of course). Or is that number entirely too small. I don’t even necessarily think that it is the solution for all doctor’s…maybe only family practice physicians. Maybe all doctor’s except for certain specialists.

I didn’t read this whole article, but only the part that says that the estimate is 2% of health care cost can be attributed to malpractice type expenses. That is a small piece of the pie, but it’s a huge pie! That 2% was before cost of defensive medicine, which they said would be difficult to track. My idea of malpractice reform isn’t necessarily to limit the amounts paid out to patients of actual malpractice, but to put a common sense/reality check on what is considered malpractice(same checks should be applied to the amounts) Several million dollars can probably be justified for true malpractice when the person who dies or is permanently harmed loses a whole life’s worth of earnings for them and their family. I don’t think that several hundred million is ever justified or deserved. The other part of the costs related to malpractice is defensive medicine. Apparently that number hasn’t/can’t be tracked.

Just 2 weeks ago I saw someone with tri-care(military insurance) have to wait almost an entire week to get their son’s broken finger in a cast, because of the referral process. I have seen govt employees wait a month to get a computer to begin work. Those two things alone are enough to make me think that the govt has no part to play in the insurance industry(especially the instance specifically related to insurance). Maybe the government has a role as a regulator, but they’ve proven not to be so good at that either. Refer to Bernie Madoff.

Another option could be to create a large system like what is provided to federal government employees. They really have it pretty good when it comes to health care. Even with a low deductible plan, the monthly cost is very low. Why can’t that system be replicated on a larger scale for the entire country?

If health care does become affordable and available to all American’s, then what do you do if a seemingly healthy 27 year old doesn’t buy in just to save a little money. If they come up with a life-threatening disease should they be excluded from buying in at that point?

My guess is that everyone in this country wants everyone to be able to get their health care needs met(except a lot of people probably don’t want illegal immigrants to get care), so when the argument is presented the way the reps from Florida and South Carolina did then nobody gets anywhere. I want everyone to get health care and coverage, but not at the expense of everyone else.

This whole argument is being presented in a bad way from both sides. The left uses, “scare tactics"(does the left use those, or was it only George Bush), and the right is essentially doing the same thing. The ultimate truth is that nobody with the power to solve the problem has any idea of how to do it. It, basically, sucks.

What ideas do you have for making everything better?

Kris [Visitor]10/06/09 @ 03:43
[Member]  http://www.brendoman.com/10/07/09 @ 09:36

Something I’ve been thinking about recently is how the coverage for pre-existing conditions should work. Currently I believe, at least in Missouri, if you change health insurance, but previously had coverage in the past 6 months, then the new insurance must cover pre-existing conditions. So, for people without any existing coverage, I can think of a couple scenarios:

1) Insurance must cover any and all pre-existing conditions and they don’t have to be disclosed. I think rates would go way up for everyone to compensate for people joining and then immediately incurring large medical expenses. Also, people could wait until they get really sick (cancer, organ transplant, etc) and then find insurance with the best coverage of their disease.

2) Insurance must cover only pre-existing conditions that are disclosed. For people with expensive conditions, the insurance company could quote sky-high rates making it impossible to afford. Or, as is sometimes the problem today, insurance companies can review past medical history to keep people honest, but then call a current condition pre-existing based on some completely un-related prior diagnosis.

Any ideas on how this would work?

Josh [Visitor]10/07/09 @ 13:07

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