The financial crisis in healthcare dwarfs all other federal budget problems. It is an iceberg, and the ship of state is headed right for it. The ACA does not do enough to rein in medical costs that continue to outpace inflation, and the GOP’s Ryan plan simply shifts the burden to those who can least afford to pay while the wealthiest Americans either have medical insurance or they are so wealthy that they can pay their own bills, including buying into concierge arrangements with doctors.
The problem of course is with the poor and the middle classes who defer concerns about healthcare, usually until they are candidates for an ER. Did you know that even families that make $88,000 a year pay only 37% of their hospital bills? Such families can afford health insurance but they simply choose not to.
Did you ever wonder how the ACA passed muster with the healthcare lobbys? Here is a revealing paragraph from the above link:
Hospital officials are “nervous” about proposed medical cuts in the House budget, he said.
“Most of the major hospital associations were supportive of the Affordable Care Act for this reason,” he said. “They were willing to take some cost reductions in Medicare payments, and in return, the government would insure 32 million people.”
No wonder then that the costs outpace inflation year after year! Unsustainable. The normal mechanisms of supply and demand are not in play here. In a pure capitalist arrangement it would be fee for service and if you can’t pay, you die. Fortunately we are more civilized than that. The other end of the spectrum mirrors the socialized single-payer systems found in Europe, but those lack the quality and responsiveness of the U.S. system.
USA Today recently (5/6/2011) published an article that provides a revealing look inside the medical industry, an industry that, so far, is thriving and vigorously competing for dominance in the niches of a very lucrative market. It is a market rife with practices that leverage patents, kickbacks and consulting fees to achieve remarkable profits.
How are they getting away with it? In addition to courting doctors to prescribe their products through advertising and personal lobbying by skillful sales reps, they are enlisting medical societies that represent specialists:
Yet, one area of medicine still welcomes the largesse: societies that represent specialists. It’s a relationship largely hidden from public view, said David Rothman, who studies conflicts of interest in medicine as director of the Center on Medicine as a Profession at Columbia University.
Professional groups such as the Heart Rhythm Society are a logical target for the makers of drugs and medical devices. They set national guidelines for patient treatments, lobby Congress about Medicare reimbursement issues, research funding and disease awareness, and are important sources of treatment information for the public. (emphasis supplied)
Dozens of such groups nationwide encompass every medical specialty from orthopedics to hypertension.
“What you’re exploring here is the subtle ways in which the companies and professional societies become partners and — wittingly or unwittingly — physicians become agents on behalf of the interests of the sponsoring company,” said Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic.
“It has a not very subtle effect on medicine,” said Nissen, an expert on the impact of industry money.
There is a strong odor of corruption about all of this. I can’t help but suspect that many medical society recommendations for standard practice have more to do with profit than patient welfare. The evidence is circumstantial, but it is strong.
The rest of the article is just as disturbing. So long as one political party insists on the very best healthcare for everyone and so long as the other party refuses to even discuss paying for those who can not afford such treatment, the financial system will careen toward the cliff and financial disaster. They fuss over ice cubes as the berg looms. And the medical-society parties will continue full-swing. Party favors for everyone!
I am close to concluding that the government will eventually have to take over the system. I just hope the process isn’t too damaging. The 2012 elections could be decisive on the issue if either party prevails overall. Otherwise? Stalemate and collision with the berg.