Right now in the U.S. there is a general agreement that the way people get health care in this country is in trouble. However, there is a large disagreement on what to do about it. At the moment I believe that a single-payer system would be best, but I am continuing to research the options as well as learning what other countries have done with their health care systems.
The U.S. spends about 15% of it’s GDP on health care. That’s more than any other country in the world. People on all sides of the issue use this fact to promote their point of view whether it’s that health care is too expensive in this country or whether it means that we have the best health care because we spend so much money. I’m of the opinion that both arguments have merit.
But what is the real problem with our health care system? From what I can gather there are a few distinct problems. The primarily cited problem is that about 15% of our population does not have health insurance. Another 15% are under insured. But is this the problem? I don’t think it is.
The problem is not insurance or lack thereof, the problem is the people cannot always get the health care they need. Even people who are insured are denied coverage to medical procedures that the insurance companies consider unnecessary. That brings up the question of who should be making these medical decisions, the doctor or the insurance company?
I understand the insurance companies’ point of view. They’re in business to make money. Part of that profit-motive means that they can’t just give away money. That means that they have to have controls in place to pay out only what they’ve agreed to.
On the other hand, when CEO’s of these companies are making 8-figure salaries there is certainly a question of ethics. And who really needs $10,000,000 a year to live on? I think most people would be happy making $100,000 a year. And $10MM would cover the insurance premiums for over 800 families.
But if we’re paying 15% of GDP for health care, why is it so hard for some to have access to it? Often cited is that about 30% of the money spent on health care goes toward administrative costs. There are over 3000 private health insurance companies in the U.S. Each has their own system of claims management. This means that the doctor has to hire someone just to handle the claims with all those different companies.
So if we could cut administrative costs to 10% of the overall cost of health care that would certainly help the situation. Costs would come down 20% which would mean that more people could afford it. It would also mean that we would spend less of our GDP on health care – only 12% instead of 15%.
So how do we cut administrative costs? If Henry Ford were looking at the problem he’d point out the inefficiencies of having 3,000 different ways of filing claims. Why not have just a few ways of filing? Maybe I’m looking at this simplistically, but it would seem to me that there are specific procedures performed and costs associated with those procedures and amounts that the insurance companies will pay for them.
There are already standard health diagnostic codes (ICD-9 codes) which I assume every insurance company uses. Surely someone could develop a system that the doctors could use to manage their patients’ medical records and as they add to those records as procedures are performed they could click on a button that would also file the claim with the patient’s insurer. Maybe that’s in the works already and I just don’t know it. (If not, and you’re in the medical industry, talk to me as I’d be willing to help develop such a system.)
The arguments for single-payer tout the efficiencies that would be gained from lowering administration costs, requiring everyone to pay in, and covering everyone.
Arguments against single-payer are that the government can’t run anything efficiently and often pays too much for goods and services. Requiring everyone to pay is an additional tax which would hurt the overall economy. And covering everyone would become simply too expensive – especially as people start to abuse the system.
Our Declaration of Independence says, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”
Does the right to Life include the right to health care to preserve and prolong that life? Or is health care a privilege reserved only for those who can afford it?
Ultimately this becomes a question of individual need vs. society’s needs. In order for our society to survive we sometimes need to make decisions that benefit a majority of individuals, but not everyone. So whose needs get sacrified on this issue?