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Home  At Length A Few More Thoughts On Health Care
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A Few More Thoughts On Health Care |
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Written by James Preston Allen
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Thursday, 02 July 2009 |
In this issue, we have taken on the medical insurance establishment, the pharmaceutical corporations, and political conservatives who scream “socialism” every time national health care is mentioned. These three sisters of the private health care industry are like the banking industry in that they would prefer to not be regulated, believing like the former chairman of the Federal Reserve, Alan Greenspan, that the free market will “self adjust” ––meaning that competition in the market place keeps prices in check. It would be great if the market worked like this, but as we’ve seen in the financial markets lately, they don’t.
Let’s use the drug industry (the legal kind) as an example. With the advent of the North American Free Trade Act, there has been expanded “free trade” with both Canada and Mexico. So why is it that in both of these countries, pharmaceutical drugs are far less expensive than in the USA? Well for one thing, both Mexico and Canada have some form of national health care, which regulates the price of prescription drugs. This should have a moderating affect on the price we pay here if we believe the free market model, but it doesn’t. Prices have been escalating to the point where just 14 tablets of a common antibiotic can cost over $100. I am told, by those who know, that this is cheap and we can expect to pay higher for more “exotic” drugs. Often, the price difference for exactly the same drug by the same manufacturer can vary as much as 70 percent between Canada and USA. And it’s not the fault of the pharmacists either, as their profit margins tend to be in the single digits.
For older Americans or those with debilitating diseases, the cost of drugs alone can be devastating—consuming as much a half their modest incomes—and when the insurance companies add on the co-payment to any medical treatment, up to the annual deduction or costs over the maximum of the policy, financial disaster can strike. It is reported that some 70 percent of all bankruptcies in this land-of-the-free market are at least partially attributable to a medical crisis and the cost of care. Currently there are some 46 million of us without health insurance who are at risk for this kind of medical/financial catastrophe—plus untold millions more whose insurance won’t fill the bill when it’s needed most—who will in the end, barring some other solution, end up at the county hospital emergency room paid for at public expense.
Emergency care is the most expensive form of medical care there is, and prevention is the least. What we have been doing these past decades is driving up the costs of hospitals––both public and private––driving many hospitals out of business. This puts even more stress on an already failing health care system that doesn’t even come close to providing full access to early treatment or prevention. So while Americans can claim to have the most sophisticated and expensive health care industry in the world, we also have a “system” that by comparison to the other industrialized nations has the highest rate of its population who can’t have it, unless they become indigent!
“Socialism! Socialism!! Universal health care is socialism!” they say. Yeah, and the boogieman is under my bed with the communists too. Let’s face it. National health care is no more socialist than say your local elementary school is socialist. Or for that matter no more socialist than our streets, highways, bridges, post offices, sewers or hydroelectric damns are socialist. Each of these for the most part have been paid for and/or maintained at public expense for the public benefit, which doesn’t prohibit anyone else from doing each of these things better for a profit, look at UPS or FedEx as examples of private competition against the US Postal Service. Yes I know that the USPS is now a semi-private affair but it was built with public money and wouldn’t have even been established except for the visionary leadership of that old Marxist Benjamin Franklin.
The deal is that a long time ago, in a far away place once known as America-the-beautiful, there were hospital districts, not unlike the community college districts of today. They were funded in much the same way we have supported public education, by property taxes or assessment districts. This was an era in which communities were bound together by common interests of local schools, local governance, local newspapers and, yes, a local hospital. And even still in this era, not everyone could afford health care and many were denied it, especially in rural areas or in the barrios and ghettos of our nation. Home births and lack of doctors was common. We’ve come a long way since those days. The question today is should we in all consciousness allow for there to be two categories of citizenship–those who can and those who can’t afford a doctor?
Furthermore, public opinion polls indicate that over 72 percent of the people in this country favor some kind of single payer health care option, but just what it looks like is anybody’s guess. Congressman Dennis Kucinich believes that if we took every dollar spent on health care today and put it into one pot, we could pay for coverage for everyone. Others believe that if we ended the war in Iraq and transferred the war budget into health care that this would pay for it. I have argued that if the federal government decriminalized marijuana and taxed it, we could pay for a national system. But this doesn’t address what exactly this system would be.
To start with, we should look at our history and see what has worked versus what hasn’t. And what has worked to the extent that we let it is the school system. Yes it’s not perfect, but there is a school in every community, usually several. And this doesn’t exclude families from paying more for a private school or a religious school or even starting their own charter schools. What it means though is that every child has access to an education—not just those who can afford it. We should expect no less from our health care system. We Should look upon it, not as a for profit industry, but like a public service utility with varying levels of service depending upon the population and the needs of the populations being served.
Perhaps President Obama should be thinking more about buying up the failing hospitals of America at bargain prices, rather than negotiate with the health industry as to what shape an insurance plan would take. He could convert the hospitals into public non-profit ownerships ran by local doctors and the communities they serve. This at least would be a down payment on a national health system that seems to be heading for its own sort of cataclysmic crash.
Be sure to read the rest of Random Lengths news and analysis of the health care debate including and editorial on congressional candidate Marcy Winograd, freelance writer Lionel Rolfe's piece, "Forget Trying To Make Nice With The Priests & Kings," and Channel RLn for video interview of Dr. Melford Wyman, a pioneering cardiologist who began practicing in San Pedro in 1959. He retired in 2002. Currently, Dr. Wyman is a member of Physicians for Social Responsibility and Physicians for a National Health Program and a tireless advocate for single-payer health coverage. |
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