Why are Americans so agitated about reforms to health care? Statements such as “don’t touch my Medicare” or “everyone should have access to state of the art health care irrespective of cost” are, in my opinion, insufficient and unsubstantiated reactions that suggest a lack of understanding of our health system’s past, current and future resources and the funding issues that America faces going forward.
We all have questions about how the health system is now at what some call the crisis stage. Let’s try to remove some of the emotion from the discussion by taking a look at the process by which health care in this country emerged and how that has formed our perceptions and beliefs about health care. With that in mind, we can look at the advantages and disadvantages of the Obama administration’s health reform proposals and let’s consider the proposals put forth by the Republicans?
Access to the latest medical services is something we can agree would be a good option for our country. Experiencing a serious illness is one of the most difficult challenges in life and to face it without the resources to pay for it is positively frightening. But as we’ll discover after we have a better understanding of the facts, we will be able to see that reaching this aim will not be an easy task without our personal contribution.
These are the themes I’ll explore trying to make sense of what’s going on in American health care , and what steps we could take personally to help make it better.
- A recent history of American health care – what have caused the prices to be this high?
- The key elements of the Obama health care plan
- The Republican conception of healthcare – free market competition
- Access to universal access to state of the art health care is a noble goal but not easy to achieve
- What do we have to do?
In the beginning, let’s take an overview of the historical background of American health insurance. This is not meant to be a sloppy study of that past, however it will provide us with an appreciation of how the health system and our expectations for it developed. What drove costs higher and higher?
Let’s begin by turning toward how the American civil war. In that conflict, outdated methods and the devastation caused by modern-day weapons of the era combined to cause ghastly results. It is not widely known that most of the deaths on both sides of that war were not the result of actual battle but were due to the circumstances that occurred after a battlefield wound was caused. To begin with, healing of wounded soldiers was carried out in a slow manner and this caused severe delays in treating the wounded. Secondly Many wounds were put to wound care, related surgeries , and/or amputations to the affected limbs . This frequently resulted in the onset of a massive infection. This means that you could be able to be able to heal a wound in battle and then succumb at the hand of medical personnel even though they were well-intentioned the actions they performed were frequently extremely fatal. A high number of deaths can be explained by everyday ailments and diseases in a time that had no antibiotics. In total something like 600,000 people died from various reasons, more than two percent in that of U.S. population at the time!
Let’s go to the beginning of the second period to the beginning of the century for some perspective and to bring us to more recent times. After the civil war there were constant improvements in American medicine in both the treatment and understanding of specific ailments, the development of new surgical methods and techniques as well as in doctor education and training. For the most part, all doctors could provide to their patients was a “wait and see” approach. It was possible to treat fractures of bones and, increasingly, dangerous procedures (now generally performed in sterile surgical settings) but there was no medication yet in use to treat serious illnesses. The majority of deaths remained the result of untreatable conditions like pneumonia, tuberculosis, scarlet fever and measles and/or related complications. Doctors became more aware of heart and vascular conditions as well as cancer, but didn’t have the resources to treat these conditions.
This very basic review of American medical history helps to see that up until recently (around during the 1950’s) we had virtually no technologies with which to treat serious or even minor ailments. This is an important point to be aware of “nothing for you to deal with means that doctor visits were limited to emergencies and as such in the event of such an incident, costs were curtailed. The reality is that there was very little available that doctors could offer, and thus, virtually nothing was available to drive the cost of health care. Another factor that held cost down was the fact that medical procedures that were offered were paid out of pocket, which meant through the individual’s own funds. In the past, there wasn’t health insurance, and certainly not health insurance paid by employers. Other than the desperate who managed to be admitted to an institution for the poor and health costs were the responsibility of the individual.
What does health insurance have to say about health care expenses? The impact of health insurance on costs is, and continues to be until today, massive. As health insurance coverage for individuals and families became an opportunity for businesses to escape wage freezes and to keep and attract employees after World War II, almost instantly, an enormous pool of money was created to fund health care. The cash, in the form of the availability of billions of dollars in medical insurance companies, encouraged an innovative America to expand the research and development of medical professionals. More Americans gained coverage not only through private, employer sponsored health insurance, but also through the increase in federal funding, which led to the creation of Medicare and Medicaid (1965). Additionally, funding was made available to increase veterans’ health benefits. Finding a cure for nearly everything has been extremely lucrative. This is the primary reason for the variety of treatments available in the present.
I do not wish to convince you that medical advancements are bad. Consider the tens of millions of lives saved, extended, enriched and improved because of. However, as a funding source has that has grown to the current size (hundreds of billions of dollars per year) the pressure to increase healthcare costs is inevitable. Doctor’s advice and the majority people want access to the latest healthcare technology in form of pharmaceuticals, diagnostic tools, medical devices and surgical procedures. This means that there is more health care to spend our money on and up until a few years ago, most of us were covered and the cost was largely covered by a third-party (government and employers). Add an insatiable and unrealistic demands from the public for accessibility and treatments and you have what is known as the “perfect storm” for higher and higher health care costs. And by and large the problem is only getting worse.
At this point, let’s move on to the major issues that will lead us to a look and hopefully a greater comprehension of the health care reform plans that are being discussed in the media today. Is the current trajectory of U.S. health care spending viable? Is it possible for America maintain its world competitiveness with 16% of the money that accounts for 20 percent of our total national product is being spent on health care? What are other industrialized countries spending on health care , and are they even near those figures? If we add politics along with an election to the debate, information to help us answer these questions become critical. We must put in some time learning about health care and then deciding the way we view it. If we are well-equipped, we will be able to more wisely assess whether certain health care proposals might help or cause more harm to some of the problems. What can be done about the issues? What can we do to help in the resolution?