Healthcare Reform

December 14, 2022

Mission

The Healthcare delivery system in the United States is a patchwork that leaves much to be desired.  It is the most expensive system among the top 35 industrial countries and covers far fewer participants delivering lower levels of quality care than many of our peer nations.  This blog will provide:

·      Current problems in healthcare

·      Actions you can take

·      Background information on healthcare

·      References.

Current State of Affairs

In this section of the newsletter I will highlight different problems with the current system that need to be addressed.

The United States has been proposing a universal healthcare system since Theodore Roosevelt proposed one in 1910.  The latest ones have been proposed in both the House of Representatives (HR 1976 – Jayapal) and the Senate  (S. 4204 – Sanders).

The problems are, of course myriad and have been brought to light in the face of the COVID-19 pandemic.  One in 3 deaths due to COVID -19 were due to a lack of health insurance. 

A large part of the problem is that so many people make money by standing between patients and doctors.  This includes insurance companies (over 900 of these), pharmacy benefit managers, who help keep costs to patients high, pharmacy companies who operate on an “All the Traffic Will Bear” mentality and even hospitals that take unfair advantage of their patients. 

In fact, systems that work well, like Medicare, are under assault as well by Medicare Advantage and other schemes.  These typically cost the government more and provide subscribers with fewer benefits.

I will be addressing these issues in detail in future editions but for now, here is a link,

, to a CBS news program that discusses how one medical company purchases hospitals, closes or outsources key functions like Ob-Gyn and Emergency Rooms, takes out large loans, and makes a fortune for their investors leaving the public high and dry.  Sadly, this is not a unique situation. As one of the people in the presentation says, “It is lawful, but awful”.

What You Can Do

You can call or email your Senators and say

My name is _________, I am a constituent and live in zipcode ________.  We can all agree that we need better medical care and healthcare.  The non partisan Congressional Budget Office recently released a report showing that over $400B is spent yearly in the healthcare industry on overhead alone.

I want the senator to give serious consideration to Senate bill S.4204, Senator Sanders Medicare for All and consider being a co-sponsor.  Will the senator do that please?  I will be watching.

You can call or email your Representative and say

My name is _________, I am a constituent and live in zipcode ________.  We can all agree that we need better medical care and healthcare.  The non partisan Congressional Budget Office recently released a report showing that over $400B is spent yearly in the healthcare industry on overhead alone.

I want my representative to give serious consideration to Representative Jayapal’s Medicare for All - HR 1976 (which will be renamed in the new session) and consider being a co-sponsor.  Will the representative do that please?  I will be watching.

Background

The history of healthcare in the United States is a rather long subject.  In each of these letters I will describe some of it so that over time you will see how we arrived where we are today.

Most of the industrialized world has some type of universal healthcare covering most if not all residents.   The systems employed to accomplish this vary wildly because the values that each country cherishes vary from each other.  There are four major ones.  Today we will discuss the Bismarck System

History

Today let’s start with the beginning of healthcare as a service. It all began with the unification of Germany in the late 1883.  The industrial revolution was well underway.  Otto von Bismarck had a couple of important needs to hold on to power. Keep factories working so the economy would be strong (subjects like that) and give people something they can’t get anywhere else (they like you for that).

Bismarck chose healthcare.  His team devised an important service for industrial employees.  They would provide healthcare (access to doctors and hospitals) for factory workers and their families and provide compensation to workers who were sick so their families would not starve in the event the worker had to be off of work for a significant time.  Read this as access to healthcare and providers, paid sick leave and worker’s comp.  It only covered about 20% of the people and was funded through employee and employer contributions to nonprofit “sickness funds”.  The sickness funds were similar to nonprofit insurance companies.  Over time Germany expanded access to this system to virtually all residents.

Many countries use a system like this today.  These include Germany, France The Netherlands, and some countries in Latin America.

References

There are a number of important references to keep handy

Kaiser Family Foundation –a good source of current data and problems with healthcare.

https://www.kff.org/

Physicians for a National Health Plan (PNHP) has a number of good background presentations and often describes actions you can take.

https://pnhp.org/

The Commonwealth Fund, a good source of healthcare research.

https://www.commonwealthfund.org/