I've been watching various discussion about health care with interest even though until now I've been fairly silent on the matter.
Dave Jarvis for instance wrote a couple interesting pieces such as the one found HERE.
The one thing I seem to notice in most of the discussions however intelligent they may be is that they lack one fundamental step... analysis of the problem itself.
Let me diverge from the topic for a moment to share a story with you. I'm a computer programmer by trade and I occasionally have to troubleshoot errors in code. Recently the team I work with was looking at a problem and were so focused on solving what they saw that they didn't step back and look at the whole picture. A process that had been running fine for months suddenly started failing. The reason they saw that the it was trying to pull down a huge file over the network and it only allotted fifteen minutes for the file to copy. The proposed solution was to extend the amount of time it waits to process. I had to put the breaks on this fix and ask everyone to look further at the process with me as it never occurred to them to question why suddenly the file it copied down was so big. It turned out that a previous process in the chain broke causing duplicating in the data and the result was a file much bigger then it should have been. Fixing the problem at the source corrected the resulting problems further down the chain of processes.
Getting back to health care that is what I think we've been missing. Everyone sees little problems here and there and look for solutions to those individual problems but no one is looking at the entire picture.
In trying to determine the over all problems with our health care industry I was able to come up with a list of 7 key problems. A 8th was later suggested to me as well. They are as follows:
1) Prescription drugs sell for more money here then in other countries such as Canada. In looking at this further we find that countries like Canada have government controls which fix the prices. Drug companies as a result need to increase prices in the free markets to help recoup their initial investments into the research and development of these new drugs and treatments. In other words, the actions of other countries create increased costs on us. Now it may be suggested that we simply turn around and enact the same government policies restricting the costs companies can charge for the drugs. I would ask you to think about that one a bit however. Drug companies are no different then any other business in that their goal is to make money for themselves and their investors. If a company after investing millions in research and development is told they have no markets in which they can recoup their investment then I would expect fewer and fewer would even attempt to do the initial research to begin with.
2) FDA restrictions increase the initial cost of a drug making it to the market. It costs millions on top of the research and development costs to get a drug approved for sale in this country. It also takes sometimes years before getting approval through the process. These restrictions our government has put in place is why you often see life saving drugs for sale in other countries long before they become available here in the US.
3) FDA requires us to get prescriptions for many drugs that you can buy over the country in other countries. This leads to higher costs because instead of being able to simply walk into a drug store and buying the pills you need you must see a doctor (added cost), then the doctor must file the correct paperwork, you then need to go to the pharmacy with that paperwork for a pharmacist to process and fulfill (additional added costs).
4) Government programs grossly over pay wasting money and increasing costs. A friend of mine with a severely disabled child turned to the government for assistance with some of the costs associated with treatments and care of her child. During which she began looking at the amounts they would cover for things like his wheelchair and other medical devices and then she priced how much it would cost her if she purchased the items herself directly. In many cases she found she could get the items cheaper then what the government was paying. As a result she started a group which monitors spending of Medicaid and Medicare programs to make sure they don't over spend. Her reasoning was that if they spend $100 when they could have only spent $50 then that additional $50 isn't going to be available for someone else who many need it. In reality we know when it comes to government they'll just take that additional $50 needed for someone else out of the pockets of the tax payers without much though.
5) Drug companies after finding new life saving drugs apply and receive patents which prevent other companies from reverse engineering and selling cheaper generic versions of those same drugs. This is a protection granted by Article 1 Section 8 of the US Constitution which states "To promote the progress of science and useful arts, by securing for limited times to authors and inventors the exclusive right to their respective writings and discoveries;" Due to this clause in the Constitution we would be left with only two options to solve this. Either lessen the amount of time drug companies are given exclusive rights or amend the Constitution.
6) Americans as a whole lead unhealthy life styles compared to most other countries. We don't eat as well. Our kids sit inside playing games instead of taking part in sports or other physical fitness activities. Our obese society leads to more health problems.
7) Is an extension of 6, since fat unhealthy people have higher health risks they also have higher health costs. The problem with this is that we don't want to discriminate so insurance companies rather then charging fat unhealthy people higher rates, instead spread the costs out to all of us. Those of us who do eat well and do try to stay physically fit pay more.
8) As health care improves people are able to live longer resulting in more of a need for health care. Where as a stroke or cancer would more likely have killed someone 50 years ago more people survive but in surviving need more treatments and rehabilitation.
But instead of looking at these core problems we look at offshoot problems such as the increasing medical insurance costs impacting our town budgets (which is a topic in and of itself that I will try to dive into over the next week or two) etc. And solutions being proposed such as the communistic approach of HR 676 which is being sponsored by Kucinich among others do not truly look at all the problems. It pushes to have the government seize all medical businesses in this country and convert them to non profit government entities. Since the US government continues to prove it cannot handle education in this country I shiver to think of what it will do the the health care industry. Not to mention that if I were the stock holder in a drug company I would be very concerned that the government could just strip me of my investment.
Look at the problems and really take a moment to think about them. Government is the CAUSE not the solution for many issues we see here. I'd be interested in hearing others thoughts on this as well as any additional root problems you may think I missed.
*NOTE: I worked in the Health care industry doing risk management and Medicaid and Medicare data analysis prior to moving to New Hampshire in the late 1990s.