We might recall President Trump admitting to his “great friend” from Australia, ”You have better health care than we do.” That moment of accountability was refreshing.
Perhaps he was reminded that Australia is ranked 4th for positive healthcare outcomes by the Commonwealth Fund, while the U.S. is in last place. We also have the highest drug prices and lowest life expectancies among the nations studied by the Kaiser Family Foundation, and the OECD is finding better healthcare outcomes in 29 other industrialized nations, although our costs are by far the highest.
A resident of Scotland visiting relatives in Easton suggested the “big lie” underpinning American health care is that “markets are always more effective than collective action.” She may have a point, considering our outcomes. Capitalism is essential to our economy, but oversight is frequently required in consideration of our general welfare.
Her friends back in the U.K. “thank their lucky stars for universal coverage.” Like the citizens of most other industrialized nations, they have proportionately more physicians and see them more frequently. We were heading to the U.K., too, until their system became overwhelmed, and we were required to do more than establish a local address.
Our own Dr. Andy Harris has been warning us, “Medicare is not single payer,” and suggesting that the marketplace must lead the way. Competition is helpful, but Medicare offers options for additional coverage, as do the single-payer systems of nations whose citizens are spending less, enjoying better outcomes, and living longer.
Once the Affordable Care Act was passed following a year of public hearings, review by 3 congressional committees, and the consideration of 130 amendments. President Obama continued to prioritize reducing costs. A measure he proposed shortly before leaving office would have reimbursed physicians a set amount for the Medicare prescriptions they write rather than basing their reimbursements upon a percentage of the cost of each, thereby encouraging prescribing more expensive medications and driving costs up.
Having attempted to repeal the ACA 60 times over 7 years, Republicans rejected that, too. Now, with control of both the White House and Congress and 7 months of behind-closed-doors meetings, no viable replacement plan has been offered. The Republican health care bill has virtually no industry support and little public support. We have been promised a viable plan within 2 years.
In the meantime, progress is being made. Kaiser Health News and the National Alliance Healthcare Purchasers Coalition are reporting that covering preventive care is paying off. The impacts of chronic conditions such as diabetes and high blood pressure account for a majority of our health care spending, up to $2.3 trillion per year, yet preventive care for these conditions is rarely covered by insurance with high deductibles.
Coverage for the maintenance of type 1 diabetes is paying off in Minnesota. Over $1 million has been saved on emergency room utilization and hospitalization so far. HealthPartners is suggesting it’s time to change our conversation about healthcare spending.
Our president has made pretty much every statement imaginable concerning health care, from “Everybody’s going to be taken care of,” to “Let it fail,” and “We’re not going to own it.” At this point we might simply hope to hear someone ask, “What good capitalist could argue with better outcomes at less cost?”
Carol. Voyles
Sherwood
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