Dinner at The White must be served on some pretty big plates because right now the man behind the Presidential Seal is working his way through a buffet that includes two foreign wars, an Asian nuclear threat, illegitimacy in the Iranian government, a Honduran coup, projected 10% unemployment, a backfiring auto industry bailout and a historical federal budget. Coming on the heels of Michael Jackson's death it is fair to say that President Obama has a full slate of tasks that require his attention. And we are now going to solve a riddle that has stumped America for a generation by completely revamping our current state of health care?
One can only hope he has left room for desert.
This is not a forum to bash our Commander in Chief or to pick our way through the politics of divisive thought. I wish only to lay out the facts so that a true measure of the challenge facing us can be weighed. And when it comes to health care reform in the United states the facts often get lost in the argument. Health care as we practice it in America is a broken machine with costs that far outweigh the returns. It's enormous, confusing and long overdue for a full body check up. And like many things in life it can best be explained by the money it costs to feed it.
Health Care. It means different things to different people but the dictionary definition sums it up nicely. Health is the soundness of body and mind and in this context care means 'to protect.' So health care can be translated as the protection of the soundness of body and mind. How do we accomplish this protection? Let's start with the government.
The government has two methods of providing health care. One is Medicare which is health care for those over the age of 65 and the other is Medicaid which cares for those from low income households. Together the government spends roughly 602 billion dollars annually to provide health care for the 87 million people protected by these systems. Neither is on the leading edge of exceptional service and they have spawned one of the better bumper sticker campaigns of the new administration, "If you think Health Care is expensive now just wait till it's free!"
Health care is not free, in fact it accounts for a thick 16% of the United States Gross Domestic Product. When combined with the private sector American health care cost us 2.4 Trillion dollars in 2008. That number is projected to grow to 3.1 Trillion by 2012 and to 4.3 Trillion by 2016 according to the National Coalition of Health Care (NCHC).
But where does the money go? How are we able to ring up a tab of that magnitude? In 2008 when we spent $2,400,000,000,000 on health care the NCHC claims that 480 billion of those dollars were spent on excess costs primarily due to administrative fees. Health care administrative costs is a loose brand that applies to the finances required operate the system we've built. There were 373,000 health care administrators in the U.S. in 2004 with a projected industry growth of 21-35% over the next decade. These are the office positions that file the insurance forms, schedule the patient visits and order the medical supplies. When 373,000 people have jobs which are said to cost 480 billion excess dollars per year one begins to realize that while health care reform sounds nice on the campaign platform it might pose a bit of a challenge if we are to accomplish it before the mid term elections.
But excess costs are not limited to office personnel. Ever had a stitch? Ever wonder what one of those little scissors used to snip the thread costs? Try a retail price of $453.00 according to an online medical supply site. Granted they are carbon bladed micro scissors but still, $453 to snip a thread?
So it is a big order if we are to fix health care in the United States. It's going to be a battle that will infiltrate every corner of the debate floor. Is it politically sustainable to tell 373,000 people that their jobs are part of the problem? Can we really tell manufacturers of medical supplies that they charge too much for their products? And remember we haven't even touched the topics of malpractice law or pharmaceutical profits.
So let's look at the plan. Obama came in with the promise that health care reform will happen in the first term and it will not raise taxes or be paid for with deficit spending. Sounded pretty good in August but last week White House Advisor, David Axelrod subtly mentioned the likelihood that taxes will be raised to cover this fight. Seems the tides of political rhetoric are being tested as the scope of this monster begins to reveal itself. If health care reform is to happen the very nature of its foundation ensures it will not come cheap.
The White House has a plan though and their website reveals it under the eight bullet points which they feel will best provide a solution. They vow to reduce costs for government and business, protect families from bankruptcy due to large medical bills, ensure choice of doctors, increase patient safety, maintain coverage for those currently insured, provide coverage for existing conditions, assure health care for everyone and then tucked quietly there in the back is a little heading for prevention.
Prevention. Now that's an idea. What would happen if we took a large chunk of this money and fed it into educating America on the risks of poor health? More physical education in the schools to stop obesity before it's too late? Educate the kids on how to read the labels on a box of food so they can teach their parents that while a Twinkie may be less expensive than an apple it actually costs far more in the long run. What could we save on treatments if we had a system that screened for cancer before we were faced with a full blown eruption of it? Perhaps then we wouldn't be faced with the task of plugging a crack in a bleeding levee.
There is a great discussion of how we could learn from the other industrialized countries who provide national health care for their citizens. In the United Kingdom everyone gets government provided health care. Great. The lines may be longer and you might not get the doctor you want but it does have an overwhelmingly high approval rating from those it serves. But there is a catch. There is no money provided for experimental drugs for the terminally ill. They will not spend money to extend life like we do here. If there isn't a cure involved there is no public funding. Is that something we could handle in America?
Because in America health care is a very large business and this business recognized long ago that there is no profit in the cure...
