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Health Care Reform and You (and Me)

As the Washington battles over health care reform continue, these past weeks have left me seriously conflicted. My moods swing between glee at the thought of health care reform and gloom as it seems we’ve once again capitulated our country’s needs to corporate bottom lines. You’d think that as a lifetime Chicagoan, I’d be used to this by now.

From the looks of it, if any health care reform gets passed, the costs will be enormous, with the overruns channeled into the giant private health insurance companies which, to quote a long-dead and once-jailed Illinois politician “can smell that meat a-cookin’.”

The result I’m anticipating seems a far cry from a system that would give equal health care coverage for all.

If you want a reasonable analogy to our current health care system, it might be helpful to compare it to cancer. Yes, that’s right. The health care system has become America’s cancer and unless its growth is stopped, it may ultimately destroy our nation.

The first malignant cell appeared in 1973 when Congress passed the HMO bill (bipartisan, by the way, authored by Teddy Kennedy and signed by Richard Nixon), essentially encouraging health care for profit. In the ensuing 35 years, this cancer has metastasized throughout the entire health care system. Simple greed compels everyone to seek a piece of the action.

• Health insurance companies rake in incredible profits. UnitedHealth Group’s CEO Bill McGuire has earned $3 billion in salary and options–that’s not a typo–while the people his company insures grovel for their benefits and doctors file lawsuits against United for reimbursement.

• Pharmaceutical companies license drugs developed abroad before marketing them to the US public at prices many times the price the identical drug sells for in the country that developed it (Forest Labs CEO Howard Solomon’s paycheck for this creativity was $36 million).

• Hospitals bill patients and insurance companies as if someone’s finger was stuck on the “0” button. My wife’s recent four-day stay tabbed in at $95,000. My five-minute skin cancer removal $5,000.

• Even relatively small players try to cash in. Medical equipment suppliers sell aluminum walkers for $250, when you can buy one in any resale shop for $5. Medical laboratories bill insurance companies (and patients) hundreds of dollars for blood tests that cost pennies to perform.

• And, believe me, there’s no national tag day in the works for most doctors, whose mantra for 30 years has been “Bill ‘em high, bill ‘em often.”

In the end, we spend mountains of dollars on pretty mediocre health care. Europe and Canada have far better health statistics than the US. When I last checked, we were not quite at third-world levels, but somewhere close to the Balkans. Those stalwarts who continue to believe America’s health care system is so great remind me of the old joke about the restaurant where the food is awful but you keep going because the portions are huge.

If the health care system continues unchecked like this, we’ll be wiped out economically–both individually and as a nation. See? It’s like cancer.

But to carry the analogy one step further, there are, sadly, few magic bullet treatments for cancer. Although I myself would like to awaken one morning with universal single-payer health care a la Canada, I am realistic enough to know there are probably too many vested interests, too many lobbyists, too much money involved, and too much public confusion for this to occur in my lifetime.

In reality, cancer is a chronic illness with setbacks and gains. These days more and more cancer patients live for decades, often dying of old age or illnesses utterly unrelated to their formerly-fatal diagnosis.

It’s going to be this way with health care, our 21st century “chronic illness.” We’ll see a major gain when Obama’s bill passes–at least there won’t be 50 million uninsured Americans. The trade-off is that a lot of the people paying for it won’t really see much of an improvement and the lion’s share of tax dollars earmarked for health will continue to make the rich richer.

For me, as a practicing physician of many decades, I do embrace Obama’s broad outline of a plan. Every single work day as long as I can remember, I’ve been compelled to make uncomfortable decisions about what diagnostic tests, treatments, and specialists any given patient can afford. I’m disappointed that supporters of Obamacare had to relent on so many important points and feel a knot in my stomach when I see a photo in the news of an unemployed (and likely uninsured) single mom holding up a sign that reads “Fight Obamacare.” Somebody paid her to hold that sign, likely so she could feed her kids.

I urge you to click two articles. First, this New York Times editorial entitled “Health Care Reform and You.” It’s a couple weeks old, so it’s dated already. Nonetheless, the decisions Congress makes in the next few weeks will affect us all for decades to come.

Second, sent to me by my editor Heidi Hough, whose friends report you can see smoke coming from her ears when she reads about the way the health care bill is going. Here’s why.

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