Let's confront some tough facts in the health-care debate urges.
I met a friend of mine recently and went to shake hands. That’s when I saw her right hand. Red and swollen. At first I thought she burned it in a kitchen accident.
“No, I cut it,” she said.
I looked more closely. I’m not a doctor and I’ve never even auditioned to play one on TV. But the wound was nasty. Still bleeding after a couple of days. Hot to the touch.
I scrambled in my backpack and eventually found some disinfectant and a new bandage.
“You need to see the doctor,” I implored. “It’s infected.”
“I would go. But my health insurance stinks so bad. I’m afraid won’t be able to afford the co-pay.”
Only she didn’t us the word “stinks.”
Another friend lost a well paying job in the recession. He’s trying to get by as consultant. He lost his health insurance for himself and his family and can’t afford the COBRA payments anymore. If he weren’t in Massachusetts, he’d have no health insurance at all.
Another friend lost her job early in the downturn. Went to law school. Took a job at a firm and now has struck out on her own. If she didn’t live in Massachusetts, she’d have no health insurance either.
So, while the nation debates end-of-life consultation with a doctor, as if planning for the type and extent of medical intervention at the end of one’s life is equivalent to murder, what we really need to do is line up for a shot of courage.
We need to face the reality people like my friends face every day and face figures like:
· We spend $8,000 a year on health care per person. The next closest nation? Norway at $4,000.
Oh, and by the way, average life expectancy in Norway, which has government health insurance, is 79.78 years. Rank: 19th in the world. The U.S. average life expectancy is 79.06. Rank: 45th in the world. This according to that well known socialist organization, the Central Intelligence Agency’s 2008 world fact book.
· Forty cents of every dollar we spend on health care goes for overhead, not to deliver health care.
· An estimated 48 million Americans have no health care, up 18 million from 10 years ago.
· If we do nothing, the cost of health insurance will go up $1,800 a year over the next 10 years.
Congressman John Tierney, D-Salem, quoted those last few statistics, drawing on “a variety of sources including, but not limited to, America’s Affordable Health Choice Act (H.R. 3200), the three committees with jurisdiction over H.R. 3200 (Education and Labor, Energy and Commerce and Ways and Means), the non-partisan Congressional Budget Office (CBO) and non-partisan Joint Committee on Taxation,” said a staffer.
Republican candidate for Tierney’s Congressional seat, attorney Bill Hudak of Boxford, didn’t dispute the numbers of people without health insurance nor did he dispute the high overhead costs in the current system.
“I can’t comment on all the numbers,” said Hudak. “I’m not up on all the numbers and I know many have been disputed. You can make numbers say whatever you want.”
Hudak, who organized an anti-health-care reform rally in Peabody last week, suggested three steps to general insurance reform:
· More control at primary-care level
· Tort reform that considers the cost of over testing and over prescribing to avoid lawsuits
· Reducing administrative overhead in insurance companies by increasing competition among states to drive down prices and reduce administrative costs.
Perhaps there are some ideas worth pursuing here. Ensuring individual doctors can decide what’s best for their patients might reduce some of the anxiety about reform. Cutting lawsuit damage awards might save some money. Increasing interstate competition might help.
Hudak also suggested an employee tax similar to unemployment insurance to cover those who lose their jobs.
These are piecemeal approaches, which could be part of a larger reform. But piecemeal is exactly what Hudak wants. A problem-by-problem approach.
But they don’t add up to reform itself.
Putting a new tax on employers and employees for health-care coverage seems counter productive.
We need to be spreading the burden, not narrowing it. The insured already pay for the uninsured. It’s part of the reason our premiums go up and our benefits drop every year. It’s why health insurance in town budgets go up some 10 to 25 percent a year.
Health insurance costs are part of the reason the American car industry — and other industries — have trouble competing in the world market. Toyota. Bavarian Motor Works. Kia. They don’t have to build in the cost of health insurance into the cost of their cars. American manufacturers do.
This is to say nothing of the cost to small business and entrepreneurs who don’t open businesses because they can’t afford health insurance for themselves or their employees or fail to expand because of health-care concerns.
We’re all paying for the system we have now.
The questions we need to face concern how efficient our payment is, how efficient our health-care system is and how we can deliver health care in system that’s at least within shouting distance of being competitive with the rest of the world.
We all need a shot of courage to face these questions directly and see reform through.
Dan Mac Alpine is senior editor of the Ipswich Chronicle.