Toledo Blade: Universal healthcare more equitable than current system

From John Curry, April 21, 2008

Subject: ...from a Toledo surgeon....we are in a bunch of sinkholes!

Photo: Dr. S. Amjad Hussain‏

"One sinkhole gets all the attention but in reality is a tiny one. Malpractice insurance premiums and jury awards constitute but only 0.46 percent of total health spending."

"The big sinkholes are the healthcare insurance and pharmaceutical industries."

"Since 2002, health-insurance companies have raked profits that defy any business model and could be labeled as obscene. Between 2002 and 2005 they had profit margins of 152.7 percent, 60 percent, 32.9 percent, and 21.4 percent respectively."

April 21, 2008
Toledo Blade

Universal healthcare more equitable than current system

THE American healthcare system is broken. But instead of addressing the core problems, we are constantly being bamboozled by razzle-dazzle and smoke-and-mirror routines to make us believe we have the best healthcare in the world. The simple and plain truth is we do not.

The first pinprick to deflate our self-delusion came eight years ago when the World Health Organization ranked healthcare systems of 191 countries. While Italy and France got the top spots, the United States was ranked 37th. We were 33rd in death rates for children under 5 and we ranked lower than some countries in sub-Saharan Africa for immunization.

More recently the prestigious Commonwealth Fund has been publishing comparative health statistics from industrialized countries and we don't look good on that scale either.

The Commonwealth Fund compares indices like access to healthcare, health coverage, status of national health, quality of life, and fairness of the system to the citizens. We trail the industrialized countries in all indices. While we were better in providing emergency and acute care, we lagged behind in taking care of chronically ill.

And then there is the elephant in the room that no one seems to notice or care about. There are an estimated 47 million people in this country who have no health coverage. A majority of them just cannot afford to buy the coverage. President Bush in his "decider" mode said that these people could always get treatment in an emergency room. In his simplistic solution one could hear the echoes of Mary Antoinette, who is believed to have said that if the peasants cannot get bread they should eat cake. Some of our uninsured do go to the emergency rooms when they are acutely ill but otherwise they have no safety net.

In one area, expenditure on healthcare, we are far ahead of industrialized nations. We spend $6,102 per person (15.3 percent of the U.S. economy) on healthcare, whereas other industrialized countries spend little more than half that amount. And they live longer than us, have better health, and are generally more satisfied with their care than we are.

So where is the sinkhole that sucks up all that money for which we have precious little to show? Actually there is more than one.

One sinkhole gets all the attention but in reality is a tiny one. Malpractice insurance premiums and jury awards constitute but only 0.46 percent of total health spending. Practicing defensive medicine by ordering unnecessary and redundant tests adds about 9 percent to the cost but, according to the Department of Health and Human Services, it is not in itself that significant.

The big sinkholes are the healthcare insurance and pharmaceutical industries.

Since 2002, health-insurance companies have raked profits that defy any business model and could be labeled as obscene. Between 2002 and 2005 they had profit margins of 152.7 percent, 60 percent, 32.9 percent, and 21.4 percent respectively.

The pharmaceutical companies are no different. According to Dr. Marcia Angell, a professor at Harvard Medical School and a former editor of the prestigious New England Journal of Medicine, the top pharmaceutical companies made more in profits than the rest of the Fortune 500 companies combined. In just the six months after the cumbersome, complicated, and industry-friendly Medicare Drug Plan became law in January, 2006, the 10 largest pharmaceutical companies raked in $8 billion in profits.

This broken and inherently unfair system has been with us for decades, and all efforts to reform it have been defeated in the Congress. A majority of lawmakers, on both sides of the political divide, are beholden to healthcare insurance companies and pharmaceutical companies.

During her husband's first term as president, Hillary Clinton tried her hand at reforming the system but was soundly defeated. Now, in the wake of the forthcoming presidential election, both she and Barak Obama are repeating the same gospel of change. One wonders if they would have the political courage to take on the healthcare giants. As we all know, it takes more than wishful thinking to plug the giant sinkholes that have been sucking the life, literally, out of American people.

Universal healthcare is the crying need of our country. It is not a perfect system - no system is - but it is more equitable and fair than the one we have been living under for so long.

Dr. S. Amjad Hussain is a Toledo surgeon whose column appears every other week in The Blade.