HEALTH CARE: Pulling the Plug on Grandma
According to the U.S. Census Bureau, 72.2% of the American population is left to fend for itself when it comes to health care. There are 202 million covered by private health insurance and about 47-50 million uninsured, roughly one in five of those not covered by the government.
Why are so many citizens left out in the cold? Very simple. An unholy alliance of insurance companies, doctors, lawyers has a enormous vested interest in keeping most of the health care system private: huge shareholder profits, outlandish compensation for top management and many doctors, gargantuan contingency fees for the plaintiffs’ bar in medical malpractice and reliable defense attorneys’ fees on the other side. To preserve their sinecures they bribe legislators (they call it “campaign contributions” but I defy you to explain the difference) to vote against measures that might provide universal coverage or in any way diminish their share of the health-care pie. Millions in “campaign contributions” yield billions in remuneration to the private healthcare system. Some have suggested that legislators wear patches, like NASCAR drivers, with the logos of the companies who underwrite their election campaigns. One of the fringe benefits of this cozy relationship is that the health care industry managed to wrangle an exemption from anti-trust laws (the McCarran-Ferguson Act of 1945), thereby allowing 2 companies – Wellpoint, Inc. and UnitedHealth Group -- to garner control of 36% of the industry mainly by acquiring competitors.
American corporations and other institutions constantly measure themselves against their competitors, seeking to adopt “best practices” within their industry in order to remain competitive. Yet when it comes to healthcare, they studiously avoid measuring themselves against the best practices in other countries, simply because such best practices involve more government control of the system and, if adopted, would diminish the generous remuneration the private health-care system now enjoys. Bought-and-paid-for legislators parrot the industry’s party line for “choice of doctors,” the presumed benefits of free-market competition and against the alleged delays and rationing of much-demonized “socialized medicine” (despite the fact that already half the annual health care expenditures already run through a ‘single-payer’ government system no one seems inclined to give up).
The private health-care industry, digging in to support the status quo, essentially shrugs its shoulders at the obvious shortcomings of the current system. For example:
In 2002, the Institute of Medicine (IOM) estimated that 18,000 Americans died in 2000 because they were uninsured, many simply because they had pre-existing conditions or lost their jobs. Since then, the number of uninsured has grown. Based on the IOM’s methodology and subsequent Census Bureau estimates of insurance coverage, 137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006. How’s that for “pulling the plug on Grandma?”
Because of the McCarran-Ferguson exemption from anti-trust legislation, many markets are dominated by relatively few health-insurance providers. According to the Center for American Progress (an organization with a declared progressive bias) “The result of this market concentration is that health insurance interests come before Americans’ health care needs. Where markets are dominated by only a few firms, health insurers revenues are growing faster than health inflation as insurers maximize rates they charge employers and families and create barriers to care. Employers are then unable to afford meaningful health insurance options for their employees or, in the case of small businesses, are unable to offer their employees insurance at all, while most Americans seeking health insurance in the individual market never purchase coverage.” (“Insurance Market Domination Leads to Fewer Choices by Ben Furnas, Rebecca Buckwalter-Poza June 16, 2009 http://www.americanprogress.org/issues/2009/06/health_competition_map.html) The American Medical Association agrees: “It is clear that patients—the ultimate consumers of health care—are not benefiting from these mergers. The AMA is concerned that the United States is heading toward a system dominated by a few publicly traded companies that operate in the interest of shareholders and not primarily in the interest of patients.
A clinical research study published in the American Journal of Medicine revealed the following results:
Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well-educated, owned homes, and had middle-class occupations. Three quarters had health insurance! Using identical definitions in 2001 and 2007, the share of bankruptcies attributable
to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001.
CONCLUSIONS: Illness and medical bills contribute to a large and increasing share of US bankruptcies. (“Medical Bankruptcy in the United States, 2007: Results of a National Study” by David U. Himmelstein, MD et al. http://pnhp.or/Bankrutcy-2009.pdf )
See the previous post for additional sobering statistics regarding the price Americans pay for allowing health insurers to underwrite Washington’s election campaigns.