Most Americans Oppose Healthcare Reform
From Professor Bainbridge:
"One of the real problems with the debate over health care reform is that the squeaky wheel gets the grease. The media and the politicians focus on people who have problems with health care issues, such as the uninsured, the underinsured, and those whose insurers deny coverage for significant health care problems. The trouble of course is that lots of people are satisfied with their healthcare."
In fact, most Americans are satisfied with their healthcare:
"Gallup's annual Healthcare survey, conducted Nov. 11-14, finds 57% of Americans saying they are satisfied with the total cost they pay for their healthcare, while 39% are dissatisfied."
An overwhelming majority of Americans say that the quality of healthcare they receive is either good or excellent (83%) and say the same about their own healthcare coverage (70%).
The good professor goes on to quote Jay Reding:
"Universal health care has a basic and fatal flaw, you can’t simultaneously reduce the cost of a service and increase access to it. If you have universal access, you have to find a way of paying for people to get that access, which raises costs. If you want to keep costs down you can only economize so far before you have to restrict access. Universal health care is a bit like a perpetual motion machine—it would be wonderful in theory, but it can’t actually exist in reality...
When confronted with a plan that forces people to change their coverage—and not necessarily for the better—it’s not surprising that the theoretical support for universal coverage ends up losing to the desire not to lose what people already have."
Read the whole thing.
"One of the real problems with the debate over health care reform is that the squeaky wheel gets the grease. The media and the politicians focus on people who have problems with health care issues, such as the uninsured, the underinsured, and those whose insurers deny coverage for significant health care problems. The trouble of course is that lots of people are satisfied with their healthcare."
In fact, most Americans are satisfied with their healthcare:
"Gallup's annual Healthcare survey, conducted Nov. 11-14, finds 57% of Americans saying they are satisfied with the total cost they pay for their healthcare, while 39% are dissatisfied."
An overwhelming majority of Americans say that the quality of healthcare they receive is either good or excellent (83%) and say the same about their own healthcare coverage (70%).
The good professor goes on to quote Jay Reding:
"Universal health care has a basic and fatal flaw, you can’t simultaneously reduce the cost of a service and increase access to it. If you have universal access, you have to find a way of paying for people to get that access, which raises costs. If you want to keep costs down you can only economize so far before you have to restrict access. Universal health care is a bit like a perpetual motion machine—it would be wonderful in theory, but it can’t actually exist in reality...
When confronted with a plan that forces people to change their coverage—and not necessarily for the better—it’s not surprising that the theoretical support for universal coverage ends up losing to the desire not to lose what people already have."
Read the whole thing.
Labels: health care crisis
posted by scalpel at 12:54 AM
2 Comments:
I think he's right that most people oppose change -- in everything in life. He's also right that a majority of Americans have health insurance and most don't currently have conditions that cause them to be dissatisfied with their health care. But that doesn't mean the system we have is the best we can do. Insisting that it is is like me insisting that because at the moment I'm reasonably healthy for my age, there's no reason for me to consider improving my diet, getting more exercise, or making an effort to get to bed before midnight at least a couple of nights a week.
While the US offers some of the best health care in the world, our health care SYSTEM is not the best in the world. It's far and away the most expensive, and the number of people who don't have access to good care because of that expense drives the infant mortality stats, the life expectancy stats and the other indicators that make us look bad against other industrialized nations.
Those who oppose health care reform always point to Britain and Canada as if those were the only models of alternative health care systems, warning us that we would have to accept terrible rationing of care that would cause long waits. (Since I am fortunate enought to belong to an HMO that already imposes rationing and long waits, I'm not as worried as they'd like me to be.) But there are other modern democracies that run their health care systems differently from the way we do -- less expense, better statistics, even higher user satisfaction. Last week, PBS produced a remarkable episode of "Frontline" -- titled "Sick Around the World" -- that looked at systems in Japan, Taiwan, Switzerland, and Germany, comparing their costs, constraints and achievements. Here's the link:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
One of the thngs that particularly struck me is that some of those systems use health insurance as their method of payment, but in all cases, the insurors are nonprofit and are not allowed to turn anyone down. America used to cover a substantial portion of its population under not-for-profit Blue Cross and Blue Shield plans, which, while not as good as nonprofit, were still less dedicated to sucking their share of money out of the system than today's for-profit Wellpoint plans. (Disclosure: I worked for the Blues many years ago in their not-for-profit incarnation.) Today, virtually all health insurance is for-profit, meaning health care dollars don't just go to you fine people who actually heal the sick -- doctors, nurses, paramedics, pharmacists, and other allied health professionals -- and to those who help you -- hospital administrators, office staff, etc. -- and to the health insurors themselves. Oh, no, those health care dollars also need to go to investors, stockholders who want to see a good ROI. Which means we are essentially paying for our health care with credit cards, financing it at a healthy (no pun intended) interest rate.
And unlike some of those who commented, I do know people who have gone without health care in America. For about 5 years in the late 80s and early 90s (pre HIPAA) I voluntered in the ER in our friendly neighborhood big-city public teaching hospital. My job was to talk to patients, try to ease their anxiety at being sick and in pain and parked for an indefinite length of time in a very stressful environment. I saw people who came in because of specific symptoms of cancer, for instance, who were treated for their immediate problem -- pain, maybe -- and then sent out with a referral. I don't argue with that; that's what an ER is supposed to do. But because I had already talked to those people and knew they felt they couldn't afford the surgery or the long course of treatment they needed, I knew the referral was nothing but scrap paper. They'd be coming back to the ER, probably several times, before their overal condition finally became serious enough to qualify them for admission. By that time, it would be too late.
Before that, in the early 80s, I volunteered in the same hospital's NICU and talked to a number of parents who were dealing with medical bankruptcy because of the costs of their babies' care. Many of them had done everything right in life; they just weren't lucky enough to work for an employer that provided adequate health insurance, nor did they make enough money to buy insurance on their own.
A 57% approval rating isn't very high. In school, that wouldn't be a passing grade. Although I have a good job at a large, stable company that provides health insurance for its employees and pays a large percentage of the premium, and I am happy with the HMO care I get, I know my situation could easily change. I am middle-aged with no relevant history other than hypertension, but if I lost my job in one of our periodic restructurings, I could not afford health insurance on my own. If I couldn't afford health insurance, I wouldn't be able to afford health care. It's one of my greatest fears, that I might lose my health insurance somewhere in the 12-year gap between now and Medicare. I know people with histories like spina bifida or CA that would keep them from ever being able to get health insurance on their own. I can't imagine the fear they must feel.
If we insist our health care system is the best in the world (despite all evidence), then we remain stuck with all its problems. If we step back and admit there's room for improvement, we can start talking about the equivalent of diet, exercise and adequate sleep -- thngs to make it even better.
As a disclaimer: I'm pretty libertarian and largely oppose government funding of health care on philosophical grounds. That said, this Jay Reading quote which is making its way around the medical blogosphere is absolutely ridiculous. Nonsense. Ridiculous.
If your metric is the number of people getting regular care then there is no doubt that reducing costs and increasing access would absolutely, positively be the end result of a system with the government as the single payer. Even here in America despite the absolutely bullsh*t claims that such could not work in this country because America is just so different. Get out of dodge like that.
The inefficiency, the profit margin in American health care tops the rest of the world by a wide margin. A single payer system with a global budget would absolutely cut both of those. And let us not pretend that all of pharma, all the device makers, all the providers are going to abandon the business under such a system. As long as a profit is to be made there will still be plenty of doctors to provide care, plenty of pharma doing the drug research. The profit might not be as big as it once was but that isn't an absolute discouragement.
I'm not going to attempt to speak to whether the American people do or do not support health care reform. Anyone can reasonably not support reform; I don't. But keep it within the realm of logic. There is absolutely no way you can imagine that reform couldn't work by pragmatic measures. Are people so brainwashed by the right as to truly believe that? Seriously? It's discouraging that American physicians refuse to use the actual data - the actual examples - and instead try to 'theorize' their way to why different systems of financing health care in America can't work. Just terribly disappointing to see physician-scientists doing that.
America has some unique characteristics but the fact is that health care systems across the world with an adequate, single source of funding (single payer and socialized systems) have universally improved utilitarian pragmatic end result health outcome measures. Such single payer systems have trade offs, all health care systems do but a single payer system could certainly improve those same measures in this country. Saying otherwise is essentially based on nothing. Absolutely no data, no examples...just the power of the prognosticators guessing ability, I guess.
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