The coronavirus pandemic didn’t cause our health care system’s problem but it does expose the reality that ours is crying out for reform. How long can we believe our own lie that our system is the envy of the world?
We have about 30 million people without any insurance at all and another 44 million with deductibles and out-of-pocket costs that are so high, they are essentially uninsured. When it comes to life expectancy, we are not number one; we are actually number thirty-six, better than Albania but not as good as Chile.
We offer a trifecta; incomplete coverage, poor care, and staggering cost. We’re taken for a ride when we pay for a prescription or a hospital bill or get stuck with a bill from somewhere out in left field...a surprise bill. Medical debts and bankruptcies are crippling our families and soaring costs of publicly funded programs like Medicaid are squeezing our State’s budgets. It doesn’t help that fully one-third of the $3.5 trillion we spend each year is going to waste.
A recent Commonwealth Fund poll showed that two-thirds of Americans are so concerned about the costs of care that their decision to get care if they had symptoms of the coronavirus would be impacted even if they had insurance. Recall that our health care system is driven to make profits for its owners.
What is our cost is their revenue.
Loss makes up the other side of the balance sheet and inventory is a loss. Profit driven corporations make use of just-in-time inventories to keep their loss as low as possible. Understandably. stockpiling beyond current needs is anathema since it lowers bottom lines on profit and loss financial statements.
When the bedrock of a system is the profit driven corporation, we should expect high costs and low inventories.
Now imagine a system with different bedrock, one that is designed to serve a public good, instead a high return on investment for a few. Such a system would provide universal coverage leaving no American without care .
The single payer, the government, would have massive bargaining and regulatory power and would negotiate prices down to the level of our peer nations. Further, a federal system would have the wealth and the incentive to invest in an emergency medical supply reserve. We have such a reserve to protect our economy.
The United States has a Strategic Petroleum Reserve with a total capacity of 727 million barrels theoretically replacing about 60 days of oil imports. We have about 200,000 soldiers in The United States Army Reserve in case of war. We invest in reserves to protect our economy and our borders. We need to do the same for our health.
Covid-19 exposed our health care problems for all but the blind to see. Major administrative and legislative changes are needed. It’s time to stop kicking the can down the road.
Gilbert Simon, MD
California Northstate Medical School