By Susan Harper
In one way or another, all of us except the very rich (who are probably also the very well-insured) are grappling with the high cost of health care. And whether you like or loathe Obamacare, it has to be said that was such a compromise, it turned out to be kind of a camel — which (I’m told) is a horse put together by a committee.
People say, “What we really need is Medicare for everyone,” and I too think that Medicare for everyone might have been a better way to go — but then you will hear others say that the day is coming when we won’t have Medicare for anyone.
What’s going on here? As columnist Paul Krugman says, “The essential, undeniable fact about American health care is how incredibly expensive it is — twice as costly per capita as the French system, two-and-a-half times as expensive as the British system.” Wow. Can’t we do better than that? What happened to American know-how?
The thing is, we’re not getting better health care by spending way too much for it. As the Commonwealth Fund reported in June, the United States “underperforms relative to other countries on most dimensions of performance.” In other words, life expectancy is lower here, for example, and the mortality rate higher, than in the 10 other countries studied (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom). We rank last in terms of health outcomes, and “last or near last” in terms of access, efficiency, and equity. The United Kingdom, where health care is two-and-a-half times less costly than ours, came in first.
So something is definitely out of whack here. Krugman says “we suffer from an excess of money-driven medicine.” Yes, indeed — from the AMA limiting the number of medical schools and doctors here (to keep the supply low and the prices high), to hospitals becoming for-profit enterprises, in a position to benefit greatly from your misfortune, while you are in the awful position of not having a choice. Or so you think. Although you can’t help wondering sometimes: ‘Do I really need all these tests?’ And ‘Might they be cheaper somewhere else?’ That’s what money-driven medicine does.
If you’ve been following the news of the Ebola virus outbreak in Africa, you know that Ebola has been around since 1976, but none of the big pharmaceutical companies wanted to put time or money into developing a vaccine or a serum or anything that might have been helpful — because it would be such a gamble: unless there was a huge epidemic, they wouldn’t make a whole lot of money on it, and the stockholders would be upset. Can you imagine Louis Pasteur thinking that way? Or Jonas Salk?
I’ll tell you who does think that way, though: ballplayers. It’s all about the homeruns, these days, if you want a multi-million-dollar contract, so batters swing for the fences almost every time. Yet statistics have proven that it’s the teams with the most hits — not the most homeruns — that end up on top. Baseball, like our health-care “industry,” is working against itself, and we are paying the price every time we spend the fortune it takes to attend a simple ballgame. (If we can afford to go, that is.)
How do we get out of the money trap? How do we get pharmaceutical companies to stop making “portfolio decisions” to please their stockholders? How do we start caring for people again? I hope somebody knows the answer. If you think you have it figured out, speak up. America is ill over all this, and waiting for the solution.
Susan Harper is retired, lives in Commerce and volunteers with the Commerce Public Library and the Jackson County Literacy Program.