Its the dollars,dummy

Published June 27, 2009 Stockton REcord
Wealth trumps health for many

It's the dollars, dummy!

A year ago, I found myself at the other end of the stethoscope. As a patient, I personally experienced American health care.

I was fortunate to have access to the best care that one could get, but a pervasive burden as I made my medical journey was my insurance.

It determined which physician or hospital I could seek treatment from and the medications I could get.

The day after surgery, a discharge planner informed me that I had exceeded their approved "length of stay" for the recently performed surgery. I would now be responsible for any costs incurred by continued hospitalization. I willingly signed an agreement of responsibility as an intravenous drip transported me to a pain-free narcotic nirvana.

Health care reform is the current conversation du jour. Discussions about it are passionate, with liberals describing it as a social necessity and conservatives as a socialist conspiracy.

A television talk show host with attractive "experts" recently expounded on the topic; a Google search revealed the "experts" had degrees in art history and law. Cyberblather is driven by interests not really interested in health but in their wealth.

The contentious parties all agree that health care should be available to all Americans. The debate shifts to costs and what interest groups must sacrifice to control them. Every dollar of medical care is a dollar of income for them.

In excess of $2 trillion is consumed by health care, more than all the expenditures of a billion Chinese and twice as much per person as countries with standards of living similar to ours.

Yet we have nearly 50 million uninsured Americans and areas of overutilization where Medicare costs per individual exceed their per-capita income.

Who really pays for this? The answer is, you do.

In the past 30 years, after adjustments for inflation, health insurance premiums have increased 300 percent, corporate profits per worker before taxes 150 percent and 200 percent after taxes, and average hourly earnings for nonagricultural workers have decreased 4 percent as wages stagnate to pay for health care.

The American Medical Association opposes a public option, fearing that physician fees would be subject to Medicare-like price controls.

Forgotten is their opposition to this program, a major source of its members' wealth. Lip service is given to primary care; organized medicine is afraid that pay increases would lead to reduction in prices of overutilized specialist services. Removing a skin blemish is better compensated than treating a gangrenous appendix.

Health plans oppose a public option, citing competitive reasons. Sen. Lindsey Graham, R-S.C., rejects it as putting a "government bureaucrat between a doctor and the patient."

Not mentioned are insurance dictates that result in physician effort which, if compensated, would increase the average physician income nearly $70,000 per year.

This sum translates to nearly $31 billion a year, enough to cover a significant portion of costs of health reform.

Pharmaceutical companies fear change would force them to bid competitively in the public marketplace while they ask Americans to pay multiples more for the same drugs they sell at a discount in controlled health economies.

The losers may be your community hospitals; they operate on margin caring for the poor and uninsured. Their survival depends on the abolition of community tax benefits for their "not for profit" competitors, whose charity is clothed in legal sack cloth and ashes.

The difference between wealth and health is a single letter of the alphabet.

We can measure the former, but not every health care intervention promotes health.

When health care waste is abolished, we will be healthy and wealthy.