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The average American spends more a year on health care than they do educating their children, building roads, and even feeding ourselves. It is estimated that we spent 2.6 trillion dollars in 2009, or $8,300.00 per person on health care. Forty five million Americans have no health insurance. Of course we all know that this is at the heart of the current debate on health care reform. There is a need to control costs while providing coverage for all.
John Lumpkin, MD, MPH, and director of the Health Care Group for the Robert Wood Johnson Foundation stated, "There is enough evidence that it is now time to do something and to do the right thing." There are many myths floating around regarding health care reform. There is a need to focus on the facts and to get rid of the myths. The myths are blocking our progress with regard to health care reform.
Here are a few of the myths:
Health care reform will not benefit me because I have insurance. Just because you have health insurance today, doesn't mean that you will have it tomorrow. According to the National Coalition on Health care, almost 266,000 companies dropped their employees' coverage from 2000 to 2005. "People with insurance have a stake because their insurance is at risk", says Judy Feder, a professor of public policy at Georgetown University. Judy is also a senior fellow at the Center for American Progress, a Washington, D. C. based think tank. In addition, in recent years the average employee health insurance premium rose nearly eight times faster than income. Stephanie Cathcart, spokesperson for the National Federation of Independent Business (NFIB), states "everyone is paying for health increases in some way, and it's unsustainable for everyone". "Reform will benefit everyone as long as it addresses costs."
Baby boomer's will bankrupt Medicare. This is another myth. If you want to blame the rise in health care costs on baby boomer's you need to look somewhere else. The growing ranks of the elderly only account for .4 percent of the future growth in health care costs, says Paul Ginsburn, president of the Center for Studying Health System Change. So why are costs in health care skyrocketing? Ginsburg and others point to all the fancy new technology. This is true. Someone has to pay for this new equipment that hospitals and doctors offices acquire. As with any business this cost is passed along to the consumer. We have MRI machines, CT scanning devices, new mammogram machines. As with any new technology when it first comes out it is expensive and then the cost goes down. Look at the computer. You can now purchase a brand new laptop for about $350.00. Years ago they ran about $2000.00. In addition, we have the fee for service payment system. This means that doctors are paid by the number of patients they see, and how many treatments they provide, rather than by the quality of care they provide. Some say this fee for service payment system encourages over treatment. This topic was discussed in the July-August 2008, edition of AARP the Magazine. You can view this article at aarpmagazine.org/health/health.care.costs.html.
Health care reform will cost us more. We have to think of health care reform as if it's an Energy Star appliance. It will cost more to replace your old energy guzzling refrigerator with a new one, but over time the savings will be substantial. The Commonwealth Fund, a New York City based foundation that supports research on health care practice and policy, estimates that health care reform will cost approximately 600 billion to implement, but by 2020 it could save us approximately 3 trillion.
My access to quality health care will decline. Just because you have access to lots of doctors that prescribe lots of treatments doesn't mean that you are getting quality care. Researchers at Dartmouth College found that patients who receive more care actually fare worse than those who receive less care. One example is heart attack patients. Heart attack patients in Los Angeles spent more days in the hospital and had more tests and procedures than heart attack patients in Salt Lake City, Utah. However, the patients in Los Angeles died at a higher rate than those in Salt Lake City. In addition, Medicare paid $30,000 for the Los Angeles patients, while they paid $23,000 for the Salt Lake City patients, who had better outcomes.
I won't be able to visit my favorite doctor. People worry that they will have fewer options when you start talking about health care reform. In our current system newer treatments are replacing older forms of treatment. It has been shown that the newer, more expensive treatments don't work any better than the older forms of treatment. One example of this is blood pressure medication. Doctors routinely prescribe new medications for treating blood pressure problems and the new medications are more expensive. Studies show that the older medications work just as well, if not better, and they are less expensive. New technology is a value, but in our current health care system there is no way to weigh whether these treatments work. There is currently comparative effectiveness research (CER) on which treatments work and which ones don't work. There are 18 organizations that support CER, including AARP, NFIB, Consumers Union, and Families USA. They believe that instead of limiting choices, health care reform will give doctors the information they need to practice better medicine. In our current system they are saying that expensive treatments replace less expensive ones for no reason.
The uninsured actually have access to good care in the emergency room. This is true. For five years while I was waiting to be approved by Social Security Disability, I had to use the emergency room and free clinics. You can get health care in this country if you are sick and in need of medical attention and you do not have to pay for it if you can not afford the bill. My quality of care was no less than it would have been if I had insurance, I always received excellent care. However, the emergency room alone does not help you get the right information to prevent a condition, or give you help in managing your condition, says Maria Ghazal, director of public policy for Business Roundtable, which is an association of Chief Executive Officers at major US companies. Forty one percent of the uninsured have no access to preventive care, so when they do go to the ER it is at a time when their illness has progressed and costs more to treat. According to Lumpkin Hospitals there is no way to recoup the costs of treating the uninsured, so they pass some of these costs on to the consumer that has insurance.
We can't afford to tackle this problem now. Although we are in the middle of a recession the most expensive thing we can do is nothing, according to Robert Zirkelbach, a spokesperson for America's Health Insurance Plans. If we do nothing the Congressional Budget Office projects that our annual health costs will rise to about $13,000 per person in 2017. In addition, the number of uninsured will rise to 54 million by 2019. More than half of Americans say they have cut back on health care in the past year due to cost concerns. Almost one in four of us have put off care that is needed, and one in five of us did not fill a prescription. The urgency for health care reform is greater now than it has ever been.
We will end up with socialized medicine. Some experts are in favor of a single payer system similar to Medicare or the health program offered to federal government employees. However, all of the proposals being offered now would build on our current system, which was an idea initiated by Hillary Clinton. Personally, I think this idea is the best and the most cost effective. Lumpkin Hospitals states, "there are many ways to solve our health care problem, but we will come up with a uniquely American solution, and that solution will be a mixed public and private solution."
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