Commentary-Health Care Needn't Cost So Much
Health Care Neednât Cost So Much
By William A. Collins
Health care costs,
From greed and frill;
Itâs up to me,
To foot the bill.
You may have wondered why health care is so expensive. Or you may not have wondered, since the media pretty much scrupulously avoid pointing out how cheap it is abroad. Canadians pay about 60 percent of what we do. And why on earth should the media spill the beans? When you get big advertising bucks from drug companies and HMOs, itâs foolish to mention other, better, national systems where those fat cats are either tightly controlled or donât exist at all.
Thus, we citizens may snort about rapacious corporations, but we tend to accept that their existence must have been guaranteed somewhere in Genesis or Leviticus. Happily, thatâs not true. For those lucky folks who make it to age 65, itâs like reaching the Pearly Gates. Heaven is Medicare, where sins and HMOs are washed away, along with most health insurance bills. If my cousin, for example, age 64 years, six months, can last another six months, Medicare may lift her out of poverty. No more backbreaking HMO premiums.
But, cursedly, Medicare is actually socialized insurance, run by the hated government. Indeed, itâs what other lesser countries perniciously provide for all their citizens. To avoid the term âsocialism,â Americans now call it the âthe Single Payerâ system. That certainly clarifies everything. But even seniors ought not to get too accustomed to Medicareâs charms. The president is trying to tear off chunks of it and give them to private insurance companies.
So why is our HMO system more expensive than Medicare? Easyâ¦itâs waste. All those private insurers waste vast sums on advertising, conflicting accounting systems, and duplicative staffs, including doctors and nurses. If HMOs disappeared tomorrow, so would the nursing shortage. And then there are the big salaries, fancy buildings, and shareholders. Medicare uses only a tiny fraction of that sort of overhead. So yes, weâd be wise to rid ourselves of HMOs altogether.
Pharmaceutical companies are the health systemâs other main scourge. They spend more on advertising than they do on research. You may have noticed on your email that their prices are much lower in other countries â all other countries â than here. Thatâs because those dreaded socialized insurance agencies in foreign lands bargain hard for drugs for their whole nation. They wring the obscene profits out of life-saving medications. By contrast, in this country Congress recently prohibited Medicare and the Veterans Administration (VA) from muscling drug companies in the same way. As you might guess, those companies not only spend huge sums on advertising, but fund political campaigns as well. In the end, of course, itâs you and I who pay for all this hanky-panky.
But itâs not just the bad guys who make costs go up. Here in Connecticut the race is on among our sainted hospitals for permission to do cardiac surgery. Years ago the state limited that right to just a few places so as to hold down the cost of duplicative expensive facilities and staffs. But now everyone wants in. Cardiologists see profit and prestige from having a center in their own town, and hospitals are rubbing their hands over this potential new profit center.
Naturally, their newspaper ads donât mention profit. Our local hospital promotes instead the life-saving aspect of not having to fight the traffic on I-95 in an emergency. Almost all of this surgery, however, is elective. You drive yourself to Bridgeport for that angiogram. If you do have an emergency, the ambulance turns on its siren and drives up the shoulder of the road. Not surprisingly, the whole campaign is really about money.
There is, thus, a very good reason why all other advanced nations designate government, not corporations, to run their health insurance. Health is simply too important to leave to profiteers. And the solution here is simple enough â Medicare for everybody. Every worker would pony up a slightly higher payroll tax than Medicare charges now. So would every employer. That way Wal-Mart couldnât opt out. Congress would fill any gap. It would be fair, cheap, and secure.
No wonder it wonât pass.
(Columnist William A. Collins is a former state representative and a former mayor of Norwalk.)