I doubt that there is an American completely satisfied with our health care system. Even those of us fortunate to have good employer coverage are likely unhappy with the cost and seeing the employer chip away at the benefits because of those costs. Beyond insurance is the system itself. I for one fear entering the system even for a minor illness because I know once I do I will lose all control. I know that my doctor will not appreciate me asking questions or challenging his recommendations and may even resent it. I know that I may be subjected to tests driven mainly by an overly cautious provider rather than good medicine. I also know that if I do have some sort of a scan or procedure there is a good chance that my physician or some group of physicians has a financial stake in the facility. I have no confidence that I am getting the best or most appropriate care because I know there are wide variations across the Country. I have no way of knowing whether my doctor is the best at what he does or even if he is fully competent and frankly, that scares me. I do not understand why an initial office visit for a specialist cost $260 or looking in my ear cost $760 per.
I am aware that underwriting practices make obtaining health insurance impossible for many people and unaffordable for many more. However, I also know that doing away with those procedures will raise costs for all insured Americans. How quickly would Americans accept higher homeowner’s insurance premiums if the insurers were forced to cover people with already existing flood or other damage to their home?
I know that the health habits and life styles of Americans are a major contributing factor to current and future health care costs. Many, if not most large employers invest millions of dollars each year trying to correct this portion of the problem, but with minimal success to date because of the long term ROI.
I know that the entire administrative system supporting health care is broken, too complex and too expensive. There is far too little coordination and uniform processing of claims and other processes that physicians have to deal with; little or no coordination of medical care or records. The idea of negotiated fees and provider networks is out of date and merely shifts costs around.
What this all means of course is that America has a serious cost and quality problem with its health care system. This is no revelation to most people; we hear this all the time in the press, study upon study supports these observations.
Given what we all know, and here I have to include the members of Congress, I am dumbfounded that despite what we all know that Congress still focuses on expanding this broken system to more people while concurrently telling Americans the objective is to control health care costs, make it affordable if you will.
Do we yet know if we are trying to reform the health care delivery system or the health insurance system? The health insurance system may need a strong dose of administrative efficiency and coordination, but many of today’s perceived problems and costs are a reflection of the broken health care delivery system.
Most of the cost for the current health care reform effort goes toward expanding coverage and subsidizing the health insurance premiums for millions of Americans. Proposals require Americans to obtain health insurance. In other words we are forcing another fifty million people into a broken system thereby increasing the demand for services, eliminating cost control measures by insurance companies, expanding the scope of required coverage, creating a huge new bureaucracy and calling it “reform” and essential to controlling the federal deficit.
And we thought Bernie Madoff had chutzpah.