The Health Reform We Need & Are Not Getting

[RedEarth]

Healthcare, Guaranteed: A Simple, Secure Solution for America
by Ezekiel J. Emanuel, with a foreword by Victor R. Fuchs
PublicAffairs, 219 pp., $14.95 (paper)

President Obama has placed health care reform high on his domestic agenda. He believes that a better health care system is essential for the nation’s economic recovery, so health reform “will not wait another year.” However, he has made only general proposals for reform, leaving Congress to work out the details of the legislation. The Democratic-led Congress has already passed some limited health legislation and its leaders say that they will put a comprehensive reform bill on the President’s desk before the end of this year.

Despite wide popular support for major reform, there will be powerful opposition. Most Republicans in Congress, allied with a small band of fiscally conservative “Blue Dog” Democrats, and most people in the for-profit health care industry will resist significant change. Many others with ideological objections to “big government” pay lip service to reform, but will balk at proposals that threaten private insurance. Compromises will be necessary, so it remains to be seen what legislation emerges and how effectively it addresses the basic problems of the US health system.<1>

The central problem is its expense. Health care in the US is about twice as expensive per capita as in other developed countries—nearly 17 percent of US GDP in 2008—and its costs are rising faster. High costs partly account for another huge health care problem—nearly 50 million people are uninsured, and the number is rapidly increasing. Economists say that the main reason for high costs is the ever-expanding use of expensive kinds of diagnosis and treatment, such as new drugs, diagnostic tests, imaging methods, and surgical procedures. Physicians in most other advanced countries have access to virtually the same resources, but use them less.

......

Neither my proposal, nor Emanuel’s, nor Conyers’s, nor any other plan that starts with the elimination of private employment-based insurance and depends largely on public funding stands much of a chance of being enacted now. It would be too great a change, and it would threaten insurance companies and other powerful vested interests that influence Congress. The same is true of any major reorganization of medical care that phases out fee-for-service practice in favor of nonprofit multispecialty groups of salaried physicians and dampens the commercial fire that has converted US medical care into an ever-expanding profit-seeking industry.

As bad as they already are, things will have to get still worse before major reform becomes politically possible. The legislation likely to emerge from this Congress will not control—and will probably even exacerbate—the inflation of costs. But sometime in the not-too- distant future, health expenditures will become intolerable and fundamental change will at last be accepted as the only way to avoid disaster. When that time arrives, the opportunity to enact real health reform will finally be at hand.

Physicians for a National Health Program
29 E Madison Suite 602, Chicago, IL 60602
Phone [phone] | Fax: [phone] | email: [e-mail]
© PNHP 2009
http://www.pnhp.org/news/2009/june/the_health_reform_we.php

[bertman]

1. So, what he/they are saying is that we have to wait for a disaster before we change course.

And all because the insurance industry has our elected representatives and senators by the short and curlies.

Disgusting.

Time to take to the streets.

[SharonAnn]

4. That's the way it usually works in the U.S. We don't act pre-emptively. We wait for disaster

As Winston Churchill said, "You can depend on Americans to do the right thing, after they've exhausted every other option."

[Stellabella]

2. I don't buy that the huge increases in cost are because of costs of

treatment and diagnosis. There is much better treatment and diagnosis in other countries for much less cost. I think it's the effing insurance companies, big pharma raking in the dough, and doctors who don't police themselves and others, driving up malpractice rates.

I wish that JUST ONCE we would be proactive about something, not wait until we're struck with a disaster and finally react to it. What is wrong with America, anyway?

[TankLV]

3. So the "high costs" are due to the cost of TREATMENT, DRUGS, & DIAGNOSIS - but not the OVER 30% we

pay for USELESS "INSURANCE"?!!!

Of course, if all we want is affordable health INSURANCE, instead of NO INSURANCE and only the health CARE, then they DON'T INCLUDE the cost of the INSURANCE in ALL their phony analyses...!!!