Our country spends more on healthcare than any other industrialized country, with costs absorbing 16 percent of our GNP (gross national product). If current trends hold, that percentage is expected to increase to 25 percent by the year 2015.
Yet, in terms of access, quality, efficiency, equity and healthy lives, we ranked last when compared to five other developed nations (Australia, Canada, Germany, New Zealand and the United Kingdom), according to the American Academy of Family Physicians. In other words, we’re spending more money for poorer health outcomes for fewer people.
We keep tinkering around the edges, trying to fix the system by infusing more money. Our elected officials talk about the need to raise tobacco, beer and alcohol taxes and/or create new tax structures such as imposing a hospital, insurance or claims tax to provide coverage to the uninsured.
Virtually every political proposal being discussed in Salem and Washington DC talks about pumping more revenue into this broken system, not finding efficiencies. It’s as if our leaders think that the way to slim down our obese system is by feeding it a high calorie diet.
Meanwhile consumers are being asked to pay higher insurance premiums, while their co-pays and deductibles keep escalating and preventive services seem out of reach.
Lobbyists and special interest groups represent a very powerful industry which exerts an undue influence. And, we hear the words “transparency and accountability” bantered about as if they, in themselves, represent the answer to our rising costs, and access and quality problems.
As a society we like to assign blame – insisting that new technology, end-of-life care and malpractice lawsuits are responsible for rising costs, while never mentioning one of the true causes – the greed that’s infested the industry. Many non-profit insurance companies, hospitals, along with medical equipment companies, physician specialists and pharmaceutical companies continue to earn huge profits during these tough economic times.
And sadly our uninsurance ranks keep swelling as more people lose their jobs, while those fortunate enough to have private insurance or Medicare coverage often have difficulty gaining access to physicians because of the primary care shortage.
We confuse consumers using terminology that only the health policy wonks can understand such as medical-loss ratio, which, interpreted, means the percentage of the collected premiums that health insurers pay for medical care including physicians, hospitals and pharmaceuticals. Yet, until we have an all-claims, all-payer data base we’ll never know how that money is actually being spent.
Reformers are eager to make certain everyone has a medical home, a primary care provider, to oversee their healthcare. But, this perceived solution could result in even higher costs and access issues. Providers aren’t eager to take on more responsibility unless they’re given more money, and, with the looming shortage of primary care providers, access problems could increase.
In some circles, there’s talk about reducing insurance benefits as a way to control costs, but there’s little agreement by decision-makers on what should be covered. Consumers are further confused when having to pay extra charges if they see a physician outside of their insurers's provider network.
As shown by these examples, there are no simple and easy answers to our complex healthcare problems. It’s essential that we begin wrestling with the out-of-control costs and growing access problems and not place the blame on those who need healthcare services. That doesn’t mean we should simply sit idly by and throw up our hands. Instead we must begin unlocking our broken healthcare system.
It’s time to reveal the facts – coupled with critical analysis – and give consumers the tools and information they need. That’s the role of The Lund Report. We won’t shy away from controversy or be intimidated by powerful special interest groups. Our reporting will be based on facts – derived from pouring over public records, uncovering financial information about the industry and discovering which lawmakers are accepting the largest contributions from health industry lobbyists. We’ll tell you the truth about what’s going on behind the scenes. Join the discussion. Send us your comments and story ideas. We’re here for you.
