occupy
As much as we talk about the importance of changing healthcare policy on this website, there remains the underlying fact that healthcare is a highly volatile political issue that is often thrown around political circles with reckless abandon. While there are many reasons the “hot button” topic of healthcare gets brought up over and over again in politics, the primary reason is how expensive healthcare actually is in our country.
New budgets, proposed cuts and changes in programming always get our attention. It is Congressman Paul Ryan’s proposed budget that currently has many talking about what this means for healthcare. While not taking on these issues now, they are important to discuss and future posts may address what his proposed changes mean for healthcare.
A highly respected health policy leader once said – “You can make a long and distinguished career in Washington by believing and espousing things that are not true.”
So for now, let’s briefly examine some facts around healthcare to be better informed in our political discourse on the topic.
First, it important to point out that the healthcare system is in a crisis for reasons other than affordability. For example, consider that 45% of people get to health insurance through their employer does (and this does not mean employers are paying for all these healthcare costs). So we have an access to insurance issue (remember the number of individuals who are not insured?).
Second, in healthcare we have made two “errors” in our attempts to grow and change the field. First, we made an assumption that more specialization in healthcare will yield increased quality and health (not true); and second, we assumed that medicine will improve if treat it like a market place commodity (also not true).
Dr. Angell, former editor in chief for the New England Journal of Medicine said of healthcare being a commodity and being asked if we should toss healthcare out and start over:
“Yes, because it’s based on a false premise. Our health care system is based on the premise that health care is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. That’s not what health care should be. Health care is a need; it’s not a commodity, and it should be distributed according to need. If you’re very sick, you should have a lot of it. If you’re not sick, you shouldn’t have a lot of it. But this should be seen as a personal, individual need, not as a commodity to be distributed like other marketplace commodities. That is a fundamental mistake in the way this country, and only this country, looks at health care.”
Third, we must start to control healthcare costs while maintaining quality of care. One way to approach this is a very politically unpopular way, but likely to be the most successful way – replace the US “wHealthcare System” with a true US Healthcare System. There is plenty of money in healthcare to do what we need to do to create a truly “health” driven system. Just to give you a small idea of how much money is in the system, consider the graphic below (note: these are as 2006 and have increased).
|
Top Ten |
Estimated 2006 Annual GDP (PPP) |
| United States | $12,980,000,000,000 |
| China | $10,000,000,000,000 |
| Japan | $ 4,220,000,000,000 |
| India | $ 4,042,000,000,000 |
| Germany | $ 2,585,000,000,000 |
| “US Health Care” | $>2,000,000,000,000 |
| United Kingdom | $ 1,903,000,000,000 |
| France | $ 1,871,000,000,000 |
| Italy | $ 1,727,000,000,000 |
| Russia | $ 1,723,000,000,000 |
| Brazil | $ 1,616,000,000,000 |
So it appears that there is definitely enough money in the system to do something meaningful to advance and change healthcare. While this may require some to have new and innovative business plans, stating that there is not enough money in the healthcare system is not really accurate.
As long as we have the healthcare system and set up we currently have, there will always be new political battles to be fought. Regardless of the outcome of each of these fights, there remain some fundamental underlying issues that must be address and cannot be brushed under the carpet.
Make no mistake, these healthcare political issues are not going away any time soon. Let’s start to better organize our thoughts around what is true and what we really need to help change healthcare.