Looking at health care by the numbers

Published 9:42 am Friday, November 13, 2009

This week a Gallup poll reported for the first time in several years that voters today would favor a general Republican over a general Democrat in the 2010 elections. Why not?

The Democrats have managed to take a powerful majority in Congress and make it look and act like a weak minority on virtually every issue important to the American people, and health care seems to represent their signature failure.

The American health care system is both the best and the worst of systems on the planet. Our medical procedures and technologies along with our pharmaceutical innovations are the best on the planet.

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But our delivery system is far and away the least capable of delivering cost-effective, patient-centered care.

We pay more than any nation for care and live less long and with fewer people insured. We saddle our corporations with costs that no other nations’ businesses must pay.

And yet our Congress seems wholly unable to address the central issues while dithering over the meaningless details.

Fundamentally, any health care system based upon profit rather than care can never provide the best care. With the advent of health maintenance organizations (HMOs) in the 1970s the nation placed health care in the hands of insurance companies and removed it from doctors and their patients. The current schemes do nothing to correct this relationship that is based upon profits enhanced only by the denial of care.

Our system welcomes the young and the well and denies the sick; it thrives within the framework of “pre-authorization” that denies doctorbased care; and it profits only when less care saves money and the outcomes are financial statistics.

We have the best health care that profit can buy, why not simply accept that and stop trying to nibble around the edges of a system that can never be more than it is … good for insurers, not as good for the physicians and the patients.

But it is not just insurers who love the current health care system in America.

The Big Pharms are also pretty happy with the status quo. In 2007 the seven biggest companies spent an amazing $97 billion on marketing and sales promotion, convincing you and I to demand their products from our doctors because more prescriptions will make us live forever and thrive through restless leg syndrome.

And of that $97 billion they spend $27 billion feeding physicians and giving away free samples. How much of this helps you and I stay healthy? None.

The seven Big Pharms also had some pretty high payrolls, about $76 billion, including $29 million to the CEO of Johnson & Johnson, and $25 million to the chairman of Wyeth.

And then of course we are Americans, and our American exceptionalism tells us we should use our medical technology to live forever, never die. So we spend 27 percent of our annual health care budget on end of life care, for terminal patients extending their lives by days, weeks, or months, nursing each additional moment in the hope that somehow that final moment can be eluded by medical miracle.

And that medical miracle is, after all, the myth that keeps us from wanting to really change our system.

Maybe if we spend enough, hang on long enough, deny death another hour or another day, our magic medical care can keep us alive.

While the Democrats manage to create a solution that is entirely missing the problem of health by profit, the American myth goes on … maybe we can live forever.

Or maybe Miguel de Cervantes was right in 1605, “Well now, there’s a remedy for everything except death.”

Jim Crawford is a contributing columnist for The Tribune and a former educator at Ohio University Southern.