Wow, it has been a busy month for me and for our nation. And it looks like this summer will be even busier. I apologize for the lull in my writing. It is time to drop in on a few of the critical issues being considered in our Capital.
Today’s topic is healthcare, the 1000 pound elephant that has been sitting in our living room for decades. Sure, every now and then we all complain about him. Congress and the Presidents make proclamations about him every four years or so and recently the Republicans have voted over 50 times to repeal him. But here he sits and shows no sign of moving.
The truth is no one in Washington wants to really tackle the healthcare problem. You might ask why when this is one of the most important and urgent issues that touches the lives and pocketbooks of virtually every American.
I think the American people are clear on what we want. We want good quality healthcare at an affordable price. We want protection against the catastrophic costs of serious and prolonged illness for ourselves and our families. We want reasonable coverage in cases of pre-existing or hereditary conditions. We want choice and convenience in our healthcare providers. We want the latest medical technology and miracle drugs.
Contrary to what many politicians would say, our current healthcare system is a manifestation of a free market capitalist system on steroids. This has resulted in layer upon layer of special interest groups and multinational corporations who all seek to maximize their profit by allegedly providing Americans the health care we all want. And for the most part, our system provides most Americans everything they want in healthcare except for an affordable price and protection from the cost of catastrophic illness.
This free market capitalists system has resulted in annual US healthcare spending of $3.2 trillion dollars or almost $10,000 per year for every American. This is almost 20% of our gross domestic product. We Americans spend almost two times more on healthcare than any other developed country and yet we are often less healthy and have no better outcomes than countries spending half as much.
Our legislators keep promising they will fix the cost and access problems we all want fixed. First attempt was with Obamacare and now by repealing and replacing Obamacare with Trumpcare. Yet all proposed legislation keeps ignoring the cost issues that are endemic to our healthcare system. They keep thinking that the magic of yet more competition will drive down prices. Meanwhile the major corporate players providing our healthcare keep consolidating and erecting barriers to entry of new players to keep their profits high and their completion limited.
Both Obamacare and Trumpcare amount nothing more than generous handouts to the insurance companies paid for by the tax payers. Obamacare did it with subsidies and Trumpcare proposes to do the same thing with tax credits. Trumpcare is even worse in that it includes a massive taxpayer handout to the wealthiest. The top 0.1% of Americans will get a tax cut averaging $165,000 with Trumpcare. What is this about? How is this solving our healthcare cost problem?
The health insurance companies represent massive overhead and contribute about 30% of additional healthcare cost to our system. Of every 70 cents they spend on providing healthcare coverage, they pocket 30 cents for their executives and shareholders.
In comparison, Medicare has an overhead of only 5% and most senior Medicare recipients love their Medicare coverage so much they protect it with their votes. Yes, Medicare has its problems but because the service does not need to make a profit, it can provide healthcare insurance for a fraction of the cost of our large consolidated corporate insurance companies.
Our legislators are under tremendous pressure by the corporate insurance lobbyists to eliminate Medicare and turn the Medicare fund over to private for-profit companies because these companies see massive profits in doing so. And they don’t like to see the government doing something for much less cost than they are willing to provide.
Medicare provides a working demonstration of a reasonable model for providing affordable healthcare insurance for all Americans. It provides a basic level of standardized coverage while providing for supplemental private insurance with consumer choice of additional levels of coverage. Any new legislation would be wise to build upon this working system rather than continuing to write legislation that rewards the healthcare insurance companies with more government handouts. Our Congress needs to stand up to the massive lobbying efforts by the healthcare insurance industry by working for the citizens and not the special interest groups who want to confuse the American public and line their pockets.
Our drug companies are another part of the healthcare system where costs are out of control. America’s pharmaceutical companies spend more for advertising than any other industry segment. Over 28% of pharmaceutical company expenses go to advertising. This is about $200 billion dollars. Of course, you are not going to hear about this because the media — lame stream, fake news, talk radio, internet etc all feast on this advertising money. Media companies profit more from drug advertising than any other product category.
Our Congress under George Bush even wrote into law that Medicare Part D must pay list prices for drugs. Our Congress also has enacted laws preventing Americans from buying drugs from other countries. The lobbyists for the drug companies got their way with our legislators. As a result, we often pay ten times more for a drug than do citizens in other developed countries.
We must demand legislation that requires most favored nation pricing. This means that if a drug company sells a drug for less in another market, Americans must be able to purchase that drug for the most favorable price. We must also demand legislation that requires Medicare Part D to negotiate the lowest prices for drugs.
We must outlaw drug advertising. Such advertising is banned in virtually every country except the US and New Zealand. Drug advertising accomplishes nothing other than raising the cost of our drugs and creating additional work for our doctors and hospitals.
Our hospitals and healthcare providers are also responsible for contributing to the high cost of healthcare. Lack of transparent pricing, high readmission rates, high rates of hospital caused infections, poor records and quality assurance systems all contribute to higher costs. In many communities, there is only one hospital provider system resulting in no competition. In larger communities, hospital consolidation is resulting in less competition.
Any healthcare system legislation must establish requirements to address these issues.
Yes, this is complex legislation and our representatives are under intense pressure from the industry lobbyists and special interest groups to only make changes which will continue to enrich their businesses. We must be involved and keep challenging our legislators to write and pass legislation providing for affordable and quality healthcare for every citizen as promised by President Trump.
We must also demand that President Trump make good on the promises he made to the voters. The Republican attempt to repeal and replace failed because President Trump was not involved in the details and did not follow through on his promises. Instead, he let Paul Ryan and a small group of industry backed lobbyists draft yet another piece of crap healthcare bill. Without leadership, Congress will always bend to the will of the moneyed interests and not to the will of the people.
Roger That! 