Saturday, December 03, 2005

Health care: Our families deserve better

GM's recent decision to eliminate 30,000 jobs was blamed, in part on the cost of health insurance, which, GM says, is making the company uncompetitive with manufacturing elsewhere in the world. GM isn't the only one -- health care premiums are rising five times as fast as other payroll expenses, and the issue has been the biggest sticking point in labor-management negotiations around the country.

Our current health care system is clearly a drag on the economy. But it gets much more personal than that. As a parent, I know what it means to have a seriously ill child. I have been fortunate to have health insurance that covers my kids for most of their lives, but 9 million American children are not so lucky; a total of about 45 million Americans of all ages have no coverage, and even among those who do, many find needed health care unaffordable.

Now columnists from Los Angeles to New York are asking the obvious question. If the employer-provided health care system isn't working, why not do what most of the rest of the industrialized world does and try universal single-payer health care?

Some complain that the Canadian-style system requires people to wait for elective surgery. But Saul Friedman, in a column in Newsday, points out that an estimated 18,000 people die in the U.S. each year because they are uninsured, and children who enter the hospital without insurance are twice as likely to die as those who don't.

And the battle over who pays for each item on the health care bill adds tremendous cost to an already over-burdened system. Friedman cites economist Paul Krugman's estimate that 25 percent of health care costs can be attributed to administrative costs -- figuring who does and doesn't get what coverage, and profits. And we spend more per capita, and as a percent of our GDP, than does any other country; yet 41 countries do better than we do on infant mortality, 34 do better on life expectancy, and 45 million Americans have no coverage at all.

We are paying more and getting less.

The good news is that there are grassroots campaigns around the country making headway on universal coverage. The Universal Health Care Action Network lists organizations in 33 states working on health care reform. The American Medical Students Association website also is tracking health care reform -- it is not only patients that suffer; doctors and nurses are experiencing high rates of burn out from the current system. California especially stands out; a Canadian-style single-payer health care bill passed the State Senate and the State Assembly Health Committee, and will be taken up by the full Assembly in 2006.

Leadership, so lacking at the national level, is bubbling up from the grassroots. As more states enact policies that work, a sane national system is bound to follow. Businesses could breathe a sigh of relief as health care coverage would no longer be a rapidly inflating cost of doing business and the center of contention with employees. American families could be relieved of a major cause of bankruptcy (50 percent of those filing for bankruptcy did so at least partly because of medical expenses), and we would no longer have to fear being turned away at the clinic door. Is that too much for the citizens of one of the world's wealthiest countries to expect?


At 9:17 PM, Anonymous Blue Cross of California said...

It truly is unfortuante to hear 45 million have no health insurance coverage. Health coverage is important to many lives and I hope the health care system can be improved.

At 5:26 PM, Anonymous Anonymous said...

My parents are retirees of General Motors. They are success stories for the American dream - immigrating to this country from a much poorer one with no college education, no skills, and not knowing English - they worked their butts off at all kinds of menial jobs. And then their big break hit - Dad got a job at GM.

He stayed there for over forty-five years, and during that period Mom too got in. Our family was one of the lucky ones who got bumped up into the middle class via GM's living-wage union jobs. It was a slow transition made on the backs of hard labor. But it was part of the contract between America and working people. Work hard and you'll get your just desserts.

But that contract has been broken - people in my parent's situation today cannot find those jobs. And truth be told, people in better shape than they were can't find those jobs ... people like myself.

I am college educated, a school teacher - and I can't find a job besides substitute teaching, which holds no employer accountable to me. My income is determined by whether or not I get called in for an assignment. There is no paid time off like regular teachers, and of course no benefits. My maximum possible income is $18,000. My parents at my age under their circumstances were far better off economically than I can hope to be. And I don't have a dream of retiring with their pension plan or health care benefits, let alone a paid-off mortgage.

I will not be totally surprised if GM next tries to back out of paying the pension that my parents paid into all those years, or if they further reduce the health benefits that they have been promised. I get suspicious when I hear the term "legacy costs". I feel the media is conditioning us to blame GM's lack of success on retirees, and is not looking at other issues. Working on the line of an auto assembly plant or any other factory job was/is not pleasant and has/had many hidden life-robbing costs associated with it that one hardly reads about.

To wind down my story and make a point - we need options, and we need them quick!

We need living wage jobs!

We need health care!

We need a renewed contract that will restore people's trust that there is a reward available for hard work. Not hand outs, not free lunches - but a fair trade.

At 4:47 AM, Anonymous Anonymous said...

I am a Registered Nurse and Michigan taxpayer. Also a RETIRED GM (General Motors) salaried employee. Have proff of HUGE conspiracy related to OUTSOURCING of GM/Delphi Medical and Insurance. NO ONE WILL TELL THE TRUE STORY. Please call me @ 989-790-7623 if YOU have Integrity and will help. PRAY if you do nothing else. GOD is working in mysterious ways.

At 10:33 AM, Anonymous Anonymous said...

I am a PT with 23 years experience, in 4 countries, plus a grad diploma in international development. I look at the "health insurance" question from a pretty unique perspective: the systems analysis I learned in my grad diploma, my experience in 4 vastly differing systems, and that, as a rehab professional, we are on the "development"-like side of the Sickness Treating System. What I mean by that is we must make the most of every funded dollar, and there is never enough, while fat cat specialist MDs following their pay-per-procedure incentive and basic human greed/need, get payed thousands for diagnostic procedures which SO often seem more about billing and liability protection than a person's well-being.

There two major points I wish to make. First, the private, so-called health care insurance system is often not that, but more a system of extracting wealth from those with illness. Second, the universal coverage (the "Canadian" system), while certainly not without flaws, seems to me far superior.

I not wish to suggest that all Docs and other service providers are evil and greedy. But when the system is SO heavily laden to encourage a particular behaviour (fee per procedure, compared to the extreme, perhaps, of the old Chinese system where the physician was paid only if the person became well), it takes a super-human effort to go against the grain. And, despite the trained to be gods in which the Meds students seemed to be immersed during my training received, they are NOT demi- gods or superhumans, even with the frequent heroics so many acheive.

I remember a cardiologist joining the cardiac specialist nurses for a Friday social with drinks... he blythely commented on the system by describing a patient saying to him, "well, if YOU won't perform this (30-minute $700) test on me, I'll go to someone else". So he did the test, bought new golfclubs and payed for our drinks, many of the nurses fawning over his generosity.

A HUGE MYTH of the USA's Sickness care industry is that if the US opts for a universal coverage system, the government will be sticking it's nose into everyone's private health affairs. This in my experience could not be further from the truth. In Canada and Australia I have once, in about 10 years PT work witnessed goverment bureaucrats in a clinical facility. No one stressed, we carried on our very good quality care with no fears of reprisal or being denied payments. In "Skilled Nursing Facilities (SNFs) where perhaps 80%+ of the rehabilitation in the US is performed, we are obliged to spend (waste?) 25-30% of our time making sure our documentation contains only the correctly defined medicare/HMO wording and codes, and various other acts of corporate kiss-butt. What a waste!

Analysing 1986 data, the Canada spent 11.5% of it's GDP on Health/Sickness Care, and everyone was covered. The USA spent 14% of its GDP for about 75% coverage. Hmmm.

My estimation was that the 2.5% GDP difference, representing perhaps 2 million workers. Their jobs? Any number of clerical, legal or administrative services where records were rigorously reviewed for the purposes of payment acquisition or denial.

Imagine if all that brain power and
funding could be spent on education or provideing the other 25% of your population with coverage. And given the now-proven certainty that fear contributes hugely to poor health, how much less fear would the population live in, and how much healthier might The American People be in a system of Universal Coverage?

D McGregor, PT (1983 Grad)
Yet the private and clearly less efficient "Insurance" Corporations warn The American People of the evils of a Canadian-like system. Shame.


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