Chris Graham | We’re smarter than that

Sure, we can argue numbers on health care, as we have been doing incessantly, at the behest of partisan Republicans who mask themselves as nonpartisan fiscal conservative patriots defending mom, apple pie and the American way of health insurance being provided the way it’s always been provided, by for-profit companies that we assume are more efficient than government-run health-care systems in Canada and Britain and every other industrialized nation on the planet, because, yep, we’re the only country in the First World still doing it the inefficient old-fashioned way.

Fifty million Americans uninsured, 25 million more underinsured, more than half of all bankruptcies resulting from medical issues that end up not being covered by health plans even among people who think they had the i’s dotted and t’s crossed. And then looked at another way – companies buried under the burden of having to pay for health coverage to compete domestically, multinationals wondering how they can keep jobs in the U.S. labor market considering they don’t have to pay what they pay for here in international markets, worker productivity down because workers even with health coverage can’t afford deductibles for basic preventitive care.

We can’t deny that the system isn’t working. It’s clearly not. We knew that 16 years ago when Hillary Clinton started and quickly lost control of the political fight to do something about injecting something in the way of a single-payer principle into the U.S. health-care system, and the main argument against the idea was that it was socialized medicine, which meant it was bad, because the word “socialized” was used as the modifier, and we all know how bad words that begin with “social-” are.

Truth is she wasn’t calling for anything akin to socialized medicine then, and neither is anybody with any real ability to effect real change today. The single-payer hybrids that are out there for discussion in 2009 are a mix of public and private that we can hope will meld the best parts of government-run health care and private health care for the betterment of all concerned.

The focus first and foremost is on the bottom line, and specifically how we can best reallocate the dollars that we spend (more per capita than any other country in the world) to ensure that people across the spectrum have the best chance at good health outcomes. Part and parcel to that is going to be reining in the private bureaucracy that takes 25 cents on every dollar that we spend on health care as administrative expenses. We have to find a way to get that figure down closer to the 4 to 5 percent that it costs the federal government to administer Medicare and Medicaid and the VA system and recommit the savings to the actual delivery of health services.

Two, we have to change the compensation structure for doctors who are currently paid for office visits and treatments and other widget-turning activities to a new structure that emphasizes the holistic wellness of the patients in their care. The idea here is basically to reward doctors for preventitive medicine and having healthy patients who otherwise in the current system don’t pay their doctors when they eat their apple a day to keep the doctor away.

Three, and in line with the holistic-wellness element of #2 above, we need to have a system that is more open to alternative forms of wellness that are outside the modern medical-care system. I’m not suggesting at all that anyone be forced to undergo treatments from other practices or philosophies that they don’t want or believe to be effective, but those who do want to go outside the mainstream should within some reason be able to do so without having to go it entirely on their own.

These are very basic principles, and I don’t claim to have a special divine power that would allow me to devise the right strategy for implementing a new system that would be guaranteed 100 percent to work. What I can say is that we’re never going to get anywhere but where we’ve been the past 16 years with our broke-and-not-fixing-it health-care system until we divorce the partisan politics from the discussion that has been hamstringing us for this time.

Figuring out a new delivery mechanism will be a heckuva lot easier than working through the politics, of course. Because an awful lot of people stand to lose an awful lot of money that they make off the system for the very reason that it is broken and not fixed and they think things are perfectly fine with the way things are not fixed. And those folks have proven awfully crafty with their messages of gloom and doom if the current broken system were to be fixed.

I’m being facetious when I say that. All they’re saying is that we’d have “socialized medicine.” Seriously, that’s what’s holding us back from joining the rest of the late 20th century? “Socialized medicine”?

I’d like to think that we’re smarter than that.

 

Column by Chris Graham


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