Healthcare Dan Hall, a Self-Described

Healthcare

Dan Hall, a self-described veteran of more than a couple of decades as a healthcare employee states the following in regard to the healthcare industry in America, "I have always been struck by the Tale of Two Cities story of healthcare in America. By that I mean it is the best of times for some, and the worst of times for others" (Hall, 2008, pg. 34). By that, Hall means that concerning technological capabilities, advanced microsurgery, interventions accomplished by nanotechnology, a plethora of pharmaceuticals and imaging systems that are 'amazing' America offers the best of times. He also realizes, however that "accessing the system is fraught with problems" (pg. 34) which makes it the worst of times for individuals counting on Medicare or Medicaid insurance for accessibility.

Now that Barack Obama has seized power in Washington by promising 'change', healthcare and government officials seems to be taking more seriously the different proposals being floated by the various entities in Washington. Some of these entities include lobby groups, insurance companies and government agencies, many of these groups are looking to guarantee coverage to the almost 45 million individuals currently with little or no medical insurance. There are good reasons behind their desire to do so.

The population is growing older every day with many baby boomers reaching an age where medical care becomes more important. The cost of caring for these individuals is going to be borne by society, whether the majority of those costs are assumed by the private or public sector remains to be seen.

America's Health Insurance Plans (AHIP) is a national organization that represents approximately 1,300 companies currently providing health insurance to more than 200 million Americans. The group recently announced a proposal to cover up to 45 million additional individuals as long as the government mandated coverage participation by all Americans. AHIP denied that they put forth the proposal now due to the Democratic control of Congress and AHIP spokesman said "We decided to put forth this proposal because we recognize that the current healthcare system is not working for everyone. Reform is needed" (Galloro, 2008, pg. 10).

Obama has expressed his desire to see 'nationalized coverage, but like almost everything else Barack Obama has touted, and continues to tout, his health care 'plan' is small on detail, large on rhetoric. According to the White House website, "The Obama-Biden plan provides affordable, accessible health care for all Americans" (Healthcare, 2009). Of course the plan does not spell out exactly how that will be accomplished, just that he will accomplish it. His website also touts the idea that his plan will build on the existing healthcare system, and will use existing doctors and providers to implement the plan. Such statements are true only because he cannot use any other healthcare system (there is only one system being used), and current physicians have to be employed in his plan because there aren't any other doctors he can use, unless he plans on using doctors from other countries that is.

Actually using other country's physicians might not be such a bad idea, since doctors from other countries would be familiar with socialized medicine and the mediocrity that it creates.

Obama is not the only one pushing for this nationalized healthcare plan, other influential Democrats are pushing it as well. Senators Max Baucus and Ted Kennedy are pushing Obama and other senators for passage this year of comprehensive healthcare reform. The senators tell Obama in a letter "We have a moral duty to ensure that every American can get quality healthcare" (Brown, 2009). Again, great sounding rhetoric, but with no specific plans on how to achieve such noble ideals.

Many conservatives feel that America already has one of the best healthcare systems on the planet, and that socializing the system will mean that, like other nationalized systems, Obama's plan will mean less for more (less medical care for more people). Dennis Smith is a fellow in healthcare reform who believes that a nationalized healthcare system will mean that government takes over, and private programs will be a thing of the past. Smith states, "whether you get there incrementally or in one fell swoop, we're still talking about those plans leading to a collapse of the private sector system" (Brown, 2009). The problem with that scenario is that government has notoriously been known for incompentence and excess costs.

The Obama-Biden plan which is being pushed as providing affordable, accessible health care for all.

In actuality what it means is the demise of affordable accessible health care, instead it will be supplanted by long waits for operations, doctors who are overwhelmed by the large number of patients demanding care, and a lack of competent individuals who wish to enter the medical field. Not only will the plan severely limit the compensation professionals will be receiving but it provides little incentive for drug manufacturers and medical suppliers to invest in new technology and research. That is one version of the worst-case scenario.

Obama's version of the same scenario is that the 'rich' will supplement the costs for the 'poor' and that everyone will be guaranteed coverage and accessibility to a system that some say is the best medical system in the world. How realistic that line of thinking may be will certainly be tested in the coming years. Obama says that his plan will "lower health care costs by $2,500 for a typical family by investing in health information technology, prevention and care coordination" (Healthcare, 2008). Other experts challenge those assertions saying that there is no way to lower the cost while maintaining the quality of care that Americans are used to.

One recent article on healthcare reform states "while most health plans support expansion of coverage to more individuals, few have faced the reality of cost constraints that accompany that expansion, including efforts to pay for quality and not volume" (Reform, 2008, pg. 14). Of course the same article recognizes that with the support that the federal government can offer it seems possible to accomplish such a goal.

The article quotes Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector Authority in Massachusetts as saying "with critical support from the federal government, we're showing it can be done" (Reform, pg. 14). Still, the funds have to come from somewhere. The federal government can't just print more money, that solution just means inflationary prices for everyone. As for taxing the rich to pay for the poor, the facts remain that lowering taxes actually increases revenues, not raising taxes.

The Congressional Budget Office agrees with that assessment and recently presented a report with more than 100 ways to reform healthcare. The CBO "laid out scores of ideas as a way to help federal lawmakers craft what could become the most sweeping legislation seen in a generation" (DoBias, Lobell, 2008, pg. 6).

The problem with sweeping legislation is that it oftentimes sweeps the good with the bad, leaving a landscape berefit of viable options for consumers. Obama's website touts the fact that the Obama-Biden plan "will require coverage of preventive services, including cancer screenings, and will increase state and local preparedness for terrorist attacks and natural disasters" (Healthcare, 2008). Again, it sounds like pie in the sky economics that is long on rhetoric with few, if any, substantiations of funding. This is especially true in a recessionary environment such as the one currently being experienced in America. Requiring coverage on items not currently covered by most insurances will add tremendously to the cost of such insurance.

Additionally, how those requirements to do so will increase state and local preparedness for terrorists attacks and natural disasters is up to anyone's imagination. It all sounds good, but the proof is in the pudding, and when costs are seriously analyzed, cooler heads may prevail on such lines of thinking.

Another avenue of savings touted by both President George W. Bush and President Obama is in the implementation of a much more comprehensive and cost effective information technology.

Both men assigned "healthcare information technology a key role in the movement to reform healthcare" (Conn, DerGurahian, 2008, pg. 10). Though it may be a high priority, it may not produce as much in savings as what either man hope for.

"The results of the 10-question survey, conducted by AHA Solutions, a for-profit arm of the American Hospital Association, College of Healthcare Information Management Executives, and the National Alliance for Health Information Technology, indicate that the still-bottomless downturn is really going to hurt both existing it programs and future plans" (Conn, DerGurahain, pg. 10). The recession can only be prolonged when adding billions of dollars in spending to the current budget as proposed by the Democrats in Congress and pushed by President Obama. If the pork-filled "stimulus" bill is an example of how Obama and Biden's healthcare plan will be, then costs will far outstrip any conceived benefits of such a program, especially in an industry that continues to see a growth in spending (albeit at a much slower rate than previous years). A recent article touted the 6.1% growth of spending on medical care in 2007.

The same article cautioned however that, "most experts know that no matter what the numbers say, there is still a great deal of work ahead to reform a healthcare system that is still fundamentally broken -- and is facing one of the worst economic recessions in decades" (Lubell, 2009, pg. 6).

Government and industry officials have been working to reform the industry for more than a decade yet the problem seems to be getting worse rather than better. More and more individuals are finding that insurance takes too much of their income and are forced therefore to forego that expense. Government is leery of committing to the cost of such expense, and industry is reluctant to offer expanded coverage without the backing of the federal government. As the interested parties do the two-step the problem becomes exacerbated. One recent survey showed that "so far, many agree that successful reform would include expanded coverage and access to care for the more than 45 million Americans who currently are without health insurance" (Dobias, 2009, pg. 27). The article goes on to articulate additional agreements that "any congressional platform to fix what is widely seen as a broken system must includes ways to lower costs and raise quality over the long-term" (Dobias, pg. 27).

Again costs of providing that care and raise the quality of care are the key components that should be established in any healthcare reform. One way to address this issue is by cutting back on the excessive costs and wasteful spending that is currently taking place in the healthcare industry.

According to some experts that wastefulness is much more prevalent in American society than it is throughout the world. A 2008 report by the Robert Wood Johnson Foundation found that "high prices, inefficiencies and the added cost of insurance administration outlays for healthcare in the United States are much higher than in other developed nations" (Wechsler, 2008, pg. 4). The same article shows that "expanding insurance coverage to more people, while desirable and ethical, will boost spending even more" (Wechsler, pg. 4).

Expenses are especially worrisome to an industry that requires a return on their investment portfolios that has been missing in recent months as the stock, bond and real estate market have all been socked during 2008. One expert states that in the near-term, the health insurance sector is "better positioned to weather this storm that other sectors" (Kongstevdt, 2008, pg. 29) but at the same time all insurers depend on investment income and some have already been so negatively affected that they are "running negative underwriting margins" (Kongstevdt, pg. 29).

So how does healthcare reform address such issues? It is a problem that desperately needs to be addressed as the American society grows older and with that aging begins to experience all the medical malaise experienced by older bodies.

Many experts feel that a nationalized healthcare system is the answer to all the industry's problems. However, other countries look at the system in the United States and are envious of its obvious benefits.

France has a healthcare system that "has been running a deficit for more than a decade...and (where) failure to make sweeping changes will result in an added deficit of 66 billion euros per year by 2020" (Newman, 2008, pg. 10). The problem in France is that many of the citizens are so enamored with the idea of a 'free' healthcare system that they do not even realize that they are paying for it with more and more taxes resulting in less coverage and accessibility.

Similarly "many people in Great Britain view their nationalized healthcare system as failing, and although the British press routinely criticizes American health care some experts believe that Great Britain should adopt a similar model" (Blizzard, 2002, pg. 8).