Senator Baucus and his committee recently announced, with considerable fanfare, that they have worked out a healthcare bill that would only cost an additional one trillion dollars to fund over 10 years. The Senate Republicans, however, feel universal healthcare coverage for a decade would cost even more, 1.5 trillion dollars. The more I listen the more I am convinced that the principle players in healthcare "reform" are really sidestepping the central issue of reform and are throwing these numbers around to make it seem they are making progress in the first instance and to simply discourage reform in the second. There is already enough money spent on healthcare annually in the United States to fund universal coverage, it simply needs to be re-distributed.
In 2007 we spent approximately 2.2 trillion dollars on healthcare in the United States on approximately 304 million people. This is an average of over 7000 dollars per person. It seems that other countries can supply universal care to their citizens for approximately 5500-6500 dollars per person. So where is all that money going? Consider the following:
· 2.2 trillion dollars spent in 2007.
· One third of all Americans are covered by a private "for-profit" health plan supplied by one of the 7 largest insurance companies in the US.
· These private health plans use between 25-35 percent of money collected for profit and overhead (Medicare overhead is less than 4%).
· 2.2 trillion x 1/3 x 20-35% gives a range of 183-256 billion dollars taken from the system each year and used to pay the upkeep of just these sever large for profit corporations and to pay dividends to their shareholders.
· Is this not the billions of dollars needed to supply universal coverage?
In exchange for these billions of dollars sucked up by these companies, what do we get in return? Two years age I had a patient with an expensive private insurance plan and a patient with traditional Medicare + Supplement. Each come to the emergency room on the same night complaining of chest pain. They each ultimately went for cardiac bypass grafting. In the process they had the same work up, cardiac imaging, drugs, private room, surgical referral, cardiac surgery, post-op care, rehabilitation, medications and out-patient follow up care. So what did the first man with the private insurance plan get that the Medicare patient did not get? The answer is nothing! For the privilege of having a plan that cost half again as much, the first man received exactly what the Medicare patient received. So, what is the advantage of private insurance over Medicare/Supplement? Nothing! Only the privilege of supplying the for-profit private health insurance companies with enough money to pat their overhead and profit margin. In addition, I had to get approval from the insurance company for the private plan patient for his treatment and pre-authorization for his medications.
So why are the President, all the Republican Senators, Senator Baucus and his Committee, and most all of Congress refusing to tap into this needlessly wasted wealth to offset the expense of universal care? Why are they dancing around this issue? Instead, they seem to be asking everyone else to make concessions (hospitals, providers, pharmaceutical companies, etc). Are these insurance companies sacred or are they just major contributors to everyone involved in these negotiations? I am not sure if they are in the dark over what is good for America or if we are in the dark as to their true intentions or abilities.
If Congress passes a "reform" bill that includes maintenance or expansion of these for-profit companies, much less a tax-payer mandate to subsidize the purchase of for-profit insurance for those not currently covered by a plan, they are simply forcing the taxpayers to prop up an industry that supplies nothing of value, and should be allowed to pass into history like the beaver hat companies, the steam locomotive industry, and the "snake-oil" medicine salesmen. The time of the for-profit health insurance company's usefulness in America is past. Let us phase them out over the next 4-5 years and move American Healthcare into the 21 Century.
Mark E Green MD
463 Physicians Office Building
Maryville, TN 37804
