Health Care and Socialism
by Richard Cummings
Health care costs are like a pinball machine, most anything can happen each day to us with a pull of the handle. We can be the best organizer, employee, or car driver, and by the end of the day, we are lying in a hospital bed. The result of bad luck, weather, or karma, illness, accidents, and sickness is out of our control. It's frustrating and an ugly fact, as Americans we spent 3.5 trillion dollars in 2017.[2]. In 2018, a census of 327,167,434.[3]. Both sexes life expectancy at about 79 (82 female and 77 male) years of age.
Health care cost is so high, it causes me anxiety to even think about it. Years ago I was taking a health care administration class. I remember the professor telling the class, healthcare cost was to begin climbing at an exponential rate. This seemed difficult for me to picture in my mind, but I knew it was going to happen. The baby boomers were going to start entering retirement placing a larger burden on not only Medicare but also the health care system in general. As you know, when we get older, our need for health care increases. The problem, regardless of socialized medicine, is you and I are going to pay for everyone else's care.
Another reason rarely mentioned for the rise in health care cost is competition, a product of a capitalistic economy and not within the socialist system. There is something called "Certificate Of Need", in the U.S. This is defined as follows:
The basic assumption underlying CON regulation is that excess capacity stemming from the overbuilding of health care facilities results in health care price inflation. Price inflation can occur when a hospital cannot fill its beds and fixed costs must be met through higher charges for the beds that are used. Bigger institutions generally have bigger costs, so CON supporters say it makes sense to limit facilities to building only enough capacity to meet actual need or demand.[4]. Unfortunately, the C.O.N. is ignored in the U.S. as a result of very high competition.
Let's imagine there are different hospital organizations, ABC, and the other one-mile away from the other, XYZ. Let's also imagine only one C.O.N. for a C.T. scanner is needed for a community over ten square miles. This would mean only one of the two hospital organizations, ABC hospital, has a scanner. The other hospital, XYZ, has to send patients needing a CT to ABC hospital. My current insurance pays for me to go to XYZ hospital. I would want to switch insurance companies which would pay for ABC hospital if I needed a CT scan. Therefore, for the sake of profit, both hospitals are going to have a scanner to be competitive. The problem is we, the consumers, pay for hospitals commodities through our health insurance, needed or not. If the U.S. would have followed the C.O.N., we would be paying less for healthcare. Even though C.O.N. makes sense, it is considered to be limiting profit for health care corporations.
Let's take a look at the country who thrives on a capitalistic system and has all the benefits of the U.S. system, "employment-based health insurance, free consumer choice of physician, and a delivery system that leaves clinical decision-making in the hands of the doctor". [5]. The U.S. would be wise to study and adapt their system whose overall costs of health care are about half of the American system. Their regulation is the main reason for the systems lowest cost. Their system incorporates equality to all citizens along with guaranteed access to it.
Japan also has one of the healthiest populations. "The infant mortality rate of 0.5 percent of live births (compared with the U.S. figure of 1 percent) places Japan in the top rank among industrialized countries. Japan's average life expectancy at birth of 75.6 years for males and 81.4 years for females also ranks high among nations."[5]. Its total population is almost half of the U.S. A healthier population does not need to access the medical system as often. The Japanese system is regulated and available to all citizens. The lifestyle of their system, which includes a different healthier rated diet, more active adults, is another reason for its unrivaled, overall health.
All health care in the Japanese system is considered to be a single-payer, uniform system. “Uniform” means that the same fee is paid by all insurers to all providers, regardless of whether the service is performed in a tertiary hospital or a rural clinic, by an experienced specialist or a recently qualified physician. Neither insurers or providers have the freedom to negotiate individually a different fee schedule."[5] The number one reason for the high cost of health care in the U.S. is a result of the methods we have used to administer it. One-quarter of the health care cost is associated with administration.[6]. In a single payer system, there is not the need for the level of staffing required.
In summary, the U.S. health care system is a dinosaur which is eating up everyone's profits and will eventually destroy mankind. It will destroy it because we will not have access to it unless you are bigger than the other dinosaur. It may appear we in the U.S. have the freedom to choose our provider, but if you can't afford to pay your co-insurance, and we certainly need to include your premium and deductible. I believe if we are going to have no choices in our health care in the long run because we will be too ill to care.
References
1. HealthCare.Gov. "Why health insurance is important -Protection from high medical costs".Retrieved 2019. https://www.healthcare.gov/why-coverage-is-important/protection-from-high-medical-costs/.
2. The Balance. "he Rising Cost of Health Care by Year and Its Causes". Amedo. 2017 .https://www.thebalance.com/causes-of-rising-healthcare-costs-4064878.
3. Wikipedia. "List of countries by life expectancy." Retrieved 2019. https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
4. NCSL-National Conference of State legislatures. "CON-CERTIFICATE OF NEED STATE LAWS" Retrieved 2019.
5.Health Affairs. "In Japan, All-Payer Rate Setting Under Tight Government Control Has Proved To Be An Effective Approach To Containing Costs". Ikegami, Anderson. 2012 https://www.healthaffairs.org/doi/10.1377/hlthaff.2011.1037
6. Investopedia. "6 Reasons Healthcare Is So Expensive in the U.S." https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp.
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