Posted 08\/11\/2009<\/p>\n\n\n\n
As the Washington battles over health care reform continue, these past weeks have left me seriously conflicted. My moods swing between glee at the thought of health care reform and gloom as it seems we\u2019ve once again capitulated our country\u2019s needs to corporate bottom lines. You\u2019d think that as a lifetime Chicagoan, I\u2019d be used to this by now.<\/p>\n\n\n\n
From the looks of it, if any health care reform gets passed, the costs will be enormous, with the overruns channeled into the giant private health insurance companies which, to quote a long-dead and once-jailed Illinois politician \u201ccan smell that meat a-cookin’.\u201d<\/p>\n\n\n\n
The result I\u2019m anticipating seems a far cry from a system that would give equal health care coverage for all.<\/p>\n\n\n\n
If you want a reasonable analogy to our current health care system, it might be helpful to compare it to cancer. Yes, that\u2019s right. The health care system has become America\u2019s cancer and unless its growth is stopped, it may ultimately destroy our nation.<\/p>\n\n\n\n
The first malignant cell appeared in 1973 when Congress passed the HMO bill (bipartisan, by the way, authored by Teddy Kennedy and signed by Richard Nixon), essentially encouraging health care for profit. In the ensuing 35 years, this cancer has metastasized throughout the entire health care system. Simple greed compels everyone to seek a piece of the action.<\/p>\n\n\n\n
\u2022 Health insurance companies rake in incredible profits. UnitedHealth Group\u2019s CEO Bill McGuire has earned $3 billion in salary and options–that\u2019s not a typo–while the people his company insures grovel for their benefits and doctors file lawsuits against United for reimbursement.<\/p>\n\n\n\n
\u2022 Pharmaceutical companies license drugs developed abroad before marketing them to the US public at prices many times the price the identical drug sells for in the country that developed it (Forest Labs CEO Howard Solomon\u2019s paycheck for this creativity was $36 million).<\/p>\n\n\n\n
\u2022 Hospitals bill patients and insurance companies as if someone\u2019s finger was stuck on the \u201c0\u201d button. My wife\u2019s recent four-day stay tabbed in at $95,000. My five-minute skin cancer removal $5,000.<\/p>\n\n\n\n
\u2022 Even relatively small players try to cash in. Medical equipment suppliers sell aluminum walkers for $250, when you can buy one in any resale shop for $5. Medical laboratories bill insurance companies (and patients) hundreds of dollars for blood tests that cost pennies to perform.<\/p>\n\n\n\n
\u2022 And, believe me, there\u2019s no national tag day in the works for most doctors, whose mantra for 30 years has been \u201cBill \u2018em high, bill \u2018em often.\u201d<\/p>\n\n\n\n
In the end, we spend mountains of dollars on pretty mediocre health care. Europe and Canada have far better health statistics than the US. When I last checked, we were not quite at third-world levels, but somewhere close to the Balkans. Those stalwarts who continue to believe America\u2019s health care system is so great remind me of the old joke about the restaurant where the food is awful but you keep going because the portions are huge.<\/p>\n\n\n\n
If the health care system continues unchecked like this, we\u2019ll be wiped out economically–both individually and as a nation. See? It\u2019s like cancer.<\/p>\n\n\n\n
But to carry the analogy one step further, there are, sadly, few magic bullet treatments for cancer. Although I myself would like to awaken one morning with universal single-payer health care a la Canada, I am realistic enough to know there are probably too many vested interests, too many lobbyists, too much money involved, and too much public confusion for this to occur in my lifetime.<\/p>\n\n\n\n
In reality, cancer is a chronic illness with setbacks and gains. These days more and more cancer patients live for decades, often dying of old age or illnesses utterly unrelated to their formerly-fatal diagnosis.<\/p>\n\n\n\n
It\u2019s going to be this way with health care, our 21st century \u201cchronic illness.\u201d We\u2019ll see a major gain when Obama\u2019s bill passes–at least there won\u2019t be 50 million uninsured Americans. The trade-off is that a lot of the people paying for it won\u2019t really see much of an improvement and the lion\u2019s share of tax dollars earmarked for health will continue to make the rich richer.<\/p>\n\n\n\n
For me, as a practicing physician of many decades, I do embrace Obama\u2019s broad outline of a plan. Every single work day as long as I can remember, I\u2019ve been compelled to make uncomfortable decisions about what diagnostic tests, treatments, and specialists any given patient can afford. I\u2019m disappointed that supporters of Obamacare had to relent on so many important points and feel a knot in my stomach when I see a photo in the news of an unemployed (and likely uninsured) single mom holding up a sign that reads \u201cFight Obamacare.\u201d Somebody paid her to hold that sign, likely so she could feed her kids.<\/p>\n\n\n\n
I urge you to click two articles. First, this New York Times editorial<\/a> entitled \u201cHealth Care Reform and You.\u201d It\u2019s a couple weeks old, so it\u2019s dated already. Nonetheless, the decisions Congress makes in the next few weeks will affect us all for decades to come.<\/p>\n\n\n\n