Here is an example of how one area of soaring healthcare costs can be contained: The Veterans’ Administration, which is the only government agency allowed to negotiate drug prices with pharmaceutical companies, pays 50 percent less than Medicare for the top-20 brand-name drugs sold to elders.
It’s not just brand-name drugs that can price non-VA patients out of treatment. A study from the Kaiser Family Foundation reports that while inflation rose 21 percent from 2000 to 2007, patient payments for generic drugs rose 38 percent in the same time period.
Medicare, by a provision of Part D, the prescription drug plan, is prevented from negotiating drug prices. How could one part of the government be disallowed from saving money while another part is allowed to do so? You might want to ask your Congressional representatives along with presidential candidates who all take big campaign bucks from the pharma lobbies of which there are more than 600 - 600-plus for one industry! - in Washington.
But it’s not just the pharmaceutical companies that are raking in profits on the backs of sick people and a sick economy. It’s every sector of the healthcare industry:
…”we must confront the fact that we pay more for virtually every pill, every artificial knee, and every screw than any other developed nation in the world - for absolutely no reason except that lobbyists have paid Congressmen to believe that if we don’t overpay, medical research will grind to a halt. The truth is that pharmaceutical companies spend much more on advertising than they do on research, and in recent years drug-makers and device-makers have been racking up double-digit profits - at the expense of the rest of the U.S. economy. Employers in Detroit simply cannot afford to keep the drug and device industry in the style to which it has become accustomed.”
- - TPM Café, 11 April 2008
Another practice that inflates healthcare costs is the mostly standard fee-for-service system in which providers, physicians and institutions are paid for each procedure, test and evaluation whether the patient needs it or not. At the Mayo Clinic and a few others, however, doctors are on salary, which keeps down costs.
All the Social Security scare stories are mostly hogwash; the system can be secured for decades to come with a few tweaks that won’t cause undue financial harm to anyone. Healthcare, including Medicare, on the other hand, is in deep financial trouble as is anyone trying to buy either coverage or treatment.
The only solution anyone in the world has invented that gives everyone access to healthcare is universal coverage, sometimes called a single-payer system, national healthcare, etc. (Anyone reading this who wants to shout, “But that’s – horrors! - socialized medicine”, please do it elsewhere. You are probably still weeping at Joe McCarthy’s grave.)
To succeed, a universal healthcare plan must be truly universal – that is, everyone participates. In that way, premiums are spread equally among the healthy and the sick. It is the essence of the idea of any kind of insurance: we pay because we’re betting that we may get sick one day with astronomical costs we could not otherwise afford. Some people pay without using much of the system. Others use much more than they pay. It is fair because every one of us is only a four-leaf clover away from needing the care.
In this volatile election year when something like 75 percent of the country is angry with the general status quo and only the wealthy are unconcerned with healthcare costs, we have an opportunity to change the healthcare system for the good of everyone by whom we vote for, and here’s what you need to know about that:
The minutiae of the two Democratic presidential candidates’ healthcare proposals are unimportant. Presidents don’t create legislation, although they can advise, consult and veto. That’s one of the reasons Hillary Clinton’s healthcare plan failed in the early 1990s. In operating out of the White House in secrecy, she ignored Congress, which does create legislation. (The senator may or may not have learned from that experience; it's hard to know.)
So what you want to look for as you choose your candidates for Congress, as well as president, is their commitment to true universal healthcare in general, and soon. By the time a plan works its way through Congress, the details will be chewed over, mangled, written and rewritten, and who knows? in the process, someone may come up with better ideas than Senator Clinton’s “mandates” and Senator Obama’s “children only” which still don't cover everyone and if implemented, would need to be redone in the near future with repeat cost to taxpayers in consultants, research and experts.
The bigger obstacles to a universal plan are those 600-plus pharma lobbies along with the insurance and healthcare provider lobbies.
Public momentum is with universal healthcare right now. And 59 percent of physicians nationwide support it. Medicare is a decent model; its administrative costs are about two percent compared to private coverage’s 15 to 20 percent. When I’ve written about universal coverage in the past, invariably several commenters wring their hands over all those poor employees of private insurers who will be out of work. Yes, and they’ll be immediately hired into the new system. Experience will be needed to run it.
As to Medicare and other countries' national healthcare horror stories, there are just as many, if not more, involving private coverage. No system is perfect, mistakes will be made, but you must ask yourself how well the current system is working when one-sixth of population has no coverage at all.
As we contemplate our votes this year, the Iraq war is important, the economy and housing are important along with corruption in high places, assaults on the Constitution and – well, you know the litany. But healthcare is equally, if not more, important.
When I was a kid, old people constantly repeated the phrase, “As long as you’ve got your health…” meaning that everything else is secondary. Even if your worst health problem has been only a bad flu, you know they are right. Nearly 50 million people can’t afford any kind of health coverage and have not seen a doctor in years. Due to recent increases in some co-pays from private insurers, some people are facing $4,000 and more for a month’s supply of needed drugs. No ordinary person can do that. Is the alternative to die even though a drug could save them?
The United States needs universal coverage. Keep that in mind as you choose your candidates this year and know where they stand on it before you vote.
[At The Elder Storytelling Place today, Norm Jenson penetrates an electronics problem we have all faced in The Beep.]