Tag Archive for profits

The myth of government dysfunction

By my friend and former colleague Matt Davies.

As a Supreme Court announcement on the Affordable Care Act nears, the volume on the rhetoric is rising almost to the pitch it was before President Obama signed the bill into law. House Speaker John Boehner is promising to eviscerate the law if it is upheld so that President Obama won’t be able to boast about success during the coming election season. GOP nominee Mitt Romney is denying he had anything to do with the Massachusetts plan on which the federal law is based. He now says he would work to repeal the ACA.

So, what about the good of the American people? Is our current “system” really worth defending? Are we really OK with more than 45,000 unnecessary deaths a year and hundreds of thousands of bankruptcies because of massive medical bills?

Big Insurance is fighting anything that will pinch its profits, and the GOP spin machine is talking about how the ACA will remove all control of their health care from people, and how the system will drown in an avalanche of paperwork.

But over here on the left with the ghost of Ted Kennedy, we’re talking about how to expand coverage, possibly to single-payer.

Here’s a little truth for you: Medicare spends 97 percent of its funds on direct services; health insurance companies are whining about having to spend 80 percent of the money they take in from customers on care. Why? Because of executive pay and bonuses, lobbying, advertising, marketing.

Here’s another uncomfortable fact for the right: Since 1970, the number of physicians has less than doubled, while administrators’ jobs have grown by about 3,200 percent, according to figures from the U.S. Bureau of Labor statistics. Those administrators work for insurance companies and for doctors’ offices, mainly because doctors need so much help coping with the different forms, codes and requirements of each insurance company. In the US, we spend more than $700 per person on health care administration than they do in Canada, which has a national system.

About 31 percent of everything we spend on health care goes to this administrative mess, and the worst of it comes from the private sector. Under an improved Medicaid-for-all system, bills would go to one place; forms and codes would be universal instead of having a different set for each of dozens of companies.

If everyone has the same coverage, there will be no tricks to deny people coverage, such as denying a claim for a colonoscopy because it was done in a doctor’s office instead of a free-standing clinic.

Doctors and patients can make decisions based on the needs of the patient, not on what the insurance company will or will not pay for. The bureaucrats who interfere with doctor-patient decisions work for the insurance companies, not the people.

A nurse complained to me a couple years ago that she was on the telephone with a Medicare representative for almost two hours as they tried to come up with a code that would pay for what the patient needed.

I told her a private insurance company would have denied the care and hung up, and she agreed that likely would have been the case. The bureaucrats in the government might be somewhat burned out, but they aren’t eligible for a bonus just for denying you care.

We could save somewhere between 45,000 and 101,000 lives every year because we all would have access to appropriate health care, not to mention the money saved by managing chronic illnesses so they don’t become crisis care.

Insurance companies are spending billions to avoid letting everyone have access to care because there’s no money in it for them.

We are the only one of the so-called wealthy nations that does not see health care as a basic human right.

No matter what the Supreme Court decides in June, we all need to demand a better solution — one that puts people before corporate profits.

 

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