Why is needed health care unavailable and unaffordable to so many of our citizens? Why does the cost of health care continue to escalate faster than general inflation? Why does the USA spend about 16% of our Gross Domestic Product (GDP) on health care compared to about 8% in countries that have subsidized single payer universal health care for all their citizens? Why do all government employees get liberally tax subsidized health care benefits that are tax free while many wage earners pay through their noses without any subsidy at all, if they are able to pay? Even employer subsidized health insurance is provided tax free to the recipient. The rest of us pay taxes on all taxable income without these tax benefits.
The approximately 3 trillion dollars that is spent annually for all health care in the USA is equivalent to 100 billion dollars per person per year, and increasing every year. Assuming that 250 million of us are covered at an average price of $4,000 per year or a total of $1 trillion annually, where does the remaining $2 trillion go out of the $3 trillion?
Private health insurance companies and other private health care and pharmaceutical companies make very lucrative profits and pay multi million dollar compensation to their executives. Stock holders are awarded with significant investment returns. Doctors paid by fee for service, that is most common, are paid hundreds of thousands of dollars for family care and generally more than $500,000 annually for specialty medical services. The few hospitals and clinics that pay salaries are exceptions. Hospitals too are typically profit making institutions. Administrative costs range from about 10 to 20% of revenues, and total salaries are about $ 11 billion dollars annually according to the US Bureau of Labor Statistics. We still have to account for over $1 trillion annually, and this pays for operating costs, research, and education plus accrued earning and taxes. The health care industry is a profit making cash cow that has become the second highest money making operation only exceeded by the military weapons industry. The prices of services and goods from both are determined by profits and established by the executives who manage the businesses. Both industries share the mind set of bottom-line performance as measured by return on investment, just as any business usually does. However, both the health care and military weapon industry are essentially oligopolies or near monopolies that are able to set prices with little or no regulatory or competitive constraint.
The US medical industry has changed over the last 60 years from family oriented practices where house calls were the norm to conglomerate corporate operations where care is secondary to profits. We cannot return to the small family practice model but we can change the purpose of the health care industry from profit making to health making.The two purposes are not compatible. This requires the health care industry to become non-profit and to adopt a salary structure for all practitioners and executive pay limits, or alternatively have total take over by government that already pays for about 40% of all health care costs with subsidies and tax write offs. Anything short of single payer non profit health care system will result in uncontrollable costs as the profit motive drives prices higher and higher and more people are left without affordable health care. Possibly, fixed salaries and pay limits can suffice for the short term, but only if the long term objective is single payer government subsidized health care for all paid for by prioritized and allocated taxes.
A level health care field must replace the very unlevel field we now struggle on. Bold action and return to the Hippocratic Oath is essential if we as a country believe that health care must be a right not a profit making venture. Speak out for what is right. Tell your elected Congressional representatives what you believe and why. The time to act is now.
No comments:
Post a Comment