System failing

U.S. health care limping along

The system of health-care services in the U.S. is in decline. Readers may choose to disagree with me.

However, there is no denying that nearly every week a hospital somewhere in our country is seeking relief from bankruptcy. Some are bought by other larger hospital systems, some reorganize their debts and continue, but far too many are closing their doors. This is happening in large cities, but more disproportionately in rural areas where the locals do not have another option for emergency and acute-care services. The financial difficulties of our hospitals are just one piece of a very complicated puzzle.

Next, we have the high cost of medication. Many comparisons of our drug costs and those of other countries like India, Mexico, or Canada have been researched and documented. Our drugs can cost 10, 20, or even 100 times more than theirs. Some really expensive drugs have been around for a long time, far after initial R&D costs have been recovered. Even insulin, developed in 1922 and turned over to pharmaceutical manufacturing companies for free, has become outrageously high-priced.

There is no discernible reason for these high drug costs other than profiteering.

So far, Congress and the executive branch have failed to pay much more than lip service to this problem, which hits our poor and elderly hard enough to make them choose between lifesaving drugs and food. Our little two-person family spent nearly $10,000 in tax year 2018 on medications despite having Medicare and Medipak, which covered 70-85 percent of the initial bills.

There are only four or five really large pharma companies in our country. I have no proof there is price-fixing, but shouldn’t we be investigating? Otherwise, under our great capitalistic system, competition would surely drive the prices down. Right?

Finally, let’s look at the quality of delivered services by health-care providers.

The people who are adamantly opposed to universal health-care coverage often make the point that national health-care systems cause long delays in elective medical needs. You may need a knee replacement to live a relatively pain-free life, continue working, or enjoy being an active adult. We are told that in all of the national healthcare programs you would just have to suffer for months if not a year or more before surgery could be scheduled.

Many folks in Canada tell us this simply ain’t so. They get their surgeries and other medical services in a reasonable time frame and have good results.

Then there is the argument that our facilities and physicians and surgeons deliver better results, so a national or universal system for health care would be a step backward.

I have no direct experience with the Canadian, British, or Norwegian health-care systems. However, I have had a lifetime of of experience with the U.S. “system.”

System is in quotes because what we have in this country is a hodgepodge of private providers, for-profit insurance companies, Medicare, and Medicaid. And about 27 million uninsured folks.

The reality is that your knee replacement may be scheduled a few months down the road—even when you have good insurance—if your surgeon is really busy. There are often delays in both elective surgeries and diagnostic services in many parts of our privatized system. Our emergency room services are pretty good, but on most days they are overwhelmed. If you are not dying but merely miserable, you are going to wait hours before seeing a doctor and being treated.

I once waited three hours in a first-class hospital emergency room in Little Rock to get my 92-yearold mother’s broken arm treated. And it was only moderately busy that day.

Let’s get back to those 27 million or so uninsured folks. We don’t even track the delays they experience. That’s because no one knows how many put off seeing a doctor until they are either physically incapacitated or near death simply because they cannot afford it. By that time, any treatment they get has a poor chance of succeeding and will likely be very expensive.

Assuming this hypothetical person gets treatment and returns to good health, he or she may likely be bankrupt. All of these unpaid medical bills continue to add to the debts of our hospitals.

The Affordable Care Act, aka Obamacare, has many flaws, but at least it offers the people at or barely above the poverty level a chance at getting covered. Eliminating exclusions on pre-existing conditions and requiring a list of basic services mandated for coverage was a great improvement. During the first two years of its existence we began to see rural hospitals and clinics significantly improve their financial situations and hiring more staff.

Recent attempts to limit or weaken the ACA have made providers skittish about future revenue. Politicians who have ridiculed and attacked it have also made it difficult to retain popular support. So a bridge to a privatized or hybrid system of national insurance coverage is being demolished with no alternative plan for replacing it.

It’s not socialism that we need to fear. What we should be fearing is our elected leaders who simply will not sit down and discuss real options that will insure the uninsured, save our hospitals, eliminate billions of dollars of workplace productivity lost to sick days, and improve the quality of life for our citizens.

We have fallen to around 20th on the list of best countries based on quality of life, median income, environment, and general happiness. How much further do we need to fall before we are in total crisis?

Our health-care system is not “great” when compared to nationalized systems. It is just more complicated. And right now it is limping along on life support.

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