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Health Care Reform’s Deeper Problems

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Congress’ health care reform debate has highlighted how American governance is broken and the difficulty of addressing our national problems.

Take, for example, whether health care is in crisis at all. Conservative commentators argue that America’s health system is fine, that our excellent care simply costs more than other countries’ poorer quality, and that most uninsureds can afford coverage. They ask why we should revamp a great system for the two or three percent of Americans who get less.

This misrepresents reality, though. Care and outcomes are often superior in other developed nations. In America, the ranks of the uninsured and under-insured have skyrocketed, from insurance costs that have grown four times general inflation for a decade. Health coverage is employers’ most unpredictable major cost, a threat to their businesses’ competitiveness, and they have increasingly offloaded costs onto employees. So while  the marginalized uninsured are an important problem, declining coverage for the mainstream is the greater worry. Most know that, even with insurance, any major health problem can spell financial ruin.

As businesses and individuals have been priced out of health coverage over the last four years, commercial health plan enrollment has plummeted by as much as 20 percent, or about 36 million people. The Kaiser Family Foundation reports that 40 percent who lose group health coverage probably become uninsured.

Fewer people buying coverage means less money to pay for health care products and services, so the industry is experiencing an unprecedented financial decline. With reforms looming, it has fiercely advocated for universal coverage, which would provide stable funding for a larger patient population. Meanwhile, the industry has opposed changing business mechanisms that encourage waste, even though experts agree that one-third or more of all health care cost is unnecessary or inappropriate. But this raises an important question. Why not spend less by recovering wasted dollars, and then improve access?

The industry has pressed its goals through lobbying, which lets special interests exchange campaign contributions for policy influence. The non-partisan Center for Responsive Politics reports that, between January and June, the industry gave Congress more than $260 million. One lobbyist commented, “A person can reach no other conclusion than this is a quid pro quo [this for that] activity.”

The funds have gone mostly to Democrats, the party in power now, and are producing their contributors’ desired results. The current proposals expand coverage, but do little to reduce cost, failing to heed any of health care’s management lessons from the last 25 years. For example, they won’t re-empower primary care, which other nations have found will maintain a healthy populace for half the cost of our specialist-dominated approach. They fail to make care quality and cost transparent, which would let health care finally work as a market, and help identify the best health care vendors. They continue to favor fee-for-service reimbursement, which rewards delivering more products and services rather than rewarding results. And they all but ignore our capricious medical malpractice system, which most doctors say encourages defensive practice.

These problems and their solutions are structural, and are well understood within the industry. If reform does not pursue these structural approaches, health care will continue to drag down the larger economy. Our current problems will remain and intensify, at enormous cost.

Out of this experience, the American people should become aware of a couple of harsh truths.

First, so long as Congress willingly exchanges money for influence, American policy will favor special interests rather than the public interest. We’ll be unable to meaningfully address our national problems: energy, the environment, education, and so on.

Second, so long as partisans distort the truth to discredit their opponents, rather than focusing on our very real problems, America’s future will continue to be compromised.

Which is to say that we have deeper problems than an inability to fix health care.

Brian Klepper, PhD is a health care analyst based in Atlantic Beach. David C. Kibbe MD MBA is a physician and Senior Advisor to the American Academy of Family Physicians.

David C. Kibbe MD MBA is a Family Physician and Senior Advisor to the American Academy of Family Physicians. Brian Klepper PhD is a health care analyst.

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Tubal ReversalSquamoussashaCynthiaCoralee Recent comment authors
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Tubal Reversal
Guest

Hy all over there….
Hope u all fine and dng well….
Here I wanna some information about a Medical term that is called Tubal reversal…. A tubal reversal, also known as tubal reanastomosis, is usually performed when a woman wants to try to achieve pregnancy after undergoing a tubal ligation. In many cases, surgery for tubal reversal is successful. However, a number of factors can affect the success of the procedure. Estimates vary, but health experts approximate somewhere between 50 to 75 percent of tubal reversals are successful in reopening the fallopian tubes. However, the success rate may be much lower.

Squamous
Guest

America cannot afford health care, so the natural next step is to redefine health care so that little health care exits, and the most useful privilege of design is end of life counseling so that the right to die because no health care exists works to unburden the system.

sasha
Guest

here is a blog about women health pregnancy and tubal reversal http://www.mybabydoc.com/blog

Cynthia
Guest

Denture creams such as Poligrip and Fixodent have been linked to neurological and other problems. This site has some good information and recourse options: http://www.denturecreamlawyer.com/

Coralee
Guest
Coralee

I have done my best to educate myself by reading all of the bills that I can get my hands on. My two major issues with the Senate Finance bill is that it does little to bring down the cost to consumers and it forces people to buy overpriced and bad products. Those in the lower income brackets, except the very poorest, will be penalized because they won’t be able to afford insurance. Of all of the bills out there, the Wyden-Bennett bill is the only one that is so straight forward, it would never pass muster for congressional standards… Read more »

diatplan
Guest

Providers are paid less than stewards. Doctors’ compensation per thing done has been reduced. Thus, more of each thing are done, quicker, and with less thought and quality. This transcends all types of physicians.

jenny
Guest
jenny

interesting, hopefully we dont get this type of care http://www.typobounty.com/Funny/Health_Care_Reform3.htm which more than likely we will.

EHS student
Guest
EHS student

Please take my health care survey for my AP Government class. Here is the link.
http://www.surveymonkey.com/s.aspx?sm=C0cJjk_2fBoRkfZUp1UrGRSQ_3d_3d
Thank You

AG, M.D., J.D.
Guest
AG, M.D., J.D.

“Arrogance, Avarice and Addiction (“AAA)” The Senate, the House and, yes, our President all suffer from AAA. So god forbid a legislative health care act does pass it will never work. The costs imposed, the bureacracy and, lets not forget, the physicians who retire or quit because of the nonsense. The health reform bill care bill will make the present health care system look like a walk in the park. Arrogance, Avarice and Addiction always results in failure. They will bring down the professional, the politition and the acts that follow in their path. So get ready. There will be… Read more »

Cynthia
Guest

Interesting blog. I’ve been looking at elder and senior care and keep coming across issues involving denture creams and neurological problems. It seems that some popular creams are involved and lawsuits are beginning to be filed. I found a site that is sponsored, I believe, by an attorney group, but that has some good health and legal information: http://www.denturecreamlawyer.com/ I hope this is of help to your readership.

Richard Quinn
Guest

I wish we were getting any kind of health care reform, but rather what we are getting is marginal insurance reform, Medicare reform and expanded coverage. People who have health insurance will get the short end of the stick. Here are the consequences as I see them,
http://quinnscommentary.com/category/healthcarehealthcare-reform/

Pat
Guest
Pat

Americans have brought the health care debate on themselves, and it is the natural companion to the job outsourcing that now leaves few companies to participate in health care financing programs. Without jobs, Americans cannot afford health care insurance, and that suits companies just fine because they are busy using overseas employees for whom they pay no health care costs. America cannot afford health care, so the natural next step is to redefine health care so that little health care exits, and the most useful privilege of design is end of life counseling so that the right to die because… Read more »

tubal reversal
Guest

Reversal of sterilization and microsurgery for the repair of damaged tubes secondary to pelvic adhesions and/or closure of the tubes in cases of previous pelvic disease are all becoming increasingly common and successful. With today’s micro-surgical techniques, a being who has had a previous tubal ligation has a 50-70 percent chance of becoming pregnant after a reversal of sterilization is done. A diagnostic laparoscopy is generally done first to confirm that tubal repair is possible. Subsequently, a two to three inch incision is made at the top of the pubic bone. This is sometimes known as a bikini incision. All… Read more »

Be Greatful
Guest
Be Greatful

The deeper problem with health care reform is whether or not illegal immigrants will have the right to purchas private health insurance. There is no way to provide subsities to illegal immigrants. Anyone not being able to show proof of being a US citizen should not be granted access to private insurance.

Alan
Guest

While we are waiting for the reform to come, I’m using the prescription discount card that I found at http://www.rxdrugcard.com. The membership fee is low. And they post drug prices online to check before you enroll. That’s transparent!