At this time in history, it may serve us well to reflect on the tortuous past, the harrowing present and the unpredictable future of health care in America.
First and foremost we must recognize we do not have “a health care system” — rather our health care is delivered in an uncoordinated, misaligned and exorbitantly expensive fashion. For example, 1 in 5 Medicare patients are readmitted to the hospital within 30 days of discharge, doctors are paid to do more than to do what is right, and we pay more than twice as much per person for health care as other industrialized nations. Health care today is a series of patch-up jobs from nearly a century of legislation.
It was after WWII when Americans decided to go on a path of employer-based health insurance. So now 50 percent of us get our insurance through our jobs. Often Americans choose one job over another based on the health insurance benefits.
Employer-based insurance left a gap among the elderly and the poor. So in 1965 Medicare and Medicaid were enacted to provide coverage for these populations. By 2000, though, some 40 million Americans were still without insurance, and so along came the Affordable Care Act or Obamacare, reducing the uninsured rate by nearly a half.
Now with many of the insurance gaps plugged up, we can’t figure out how to pay for all this. This is where things have gotten out of control. There are too many vested interests that have their hands in the $3.2 trillion health care industry pot: the payers (insurance companies and businesses), the providers (doctors and hospitals), the pharmaceuticals (drug and device manufacturers), and politicians (Democrats and Republicans). The ones who often are missing out on the decision-making are the patients.
Some say Obamacare is the devil that plunged us into this mess, and market forces are angels that will revive us. Such is not the case. One in 3 Americans do not even know that the Affordable Care Act and Obamacare are the same law, while many reap its benefits such as not being denied insurance due to pre-existing conditions. Also, health care does not follow simple free market rules of supply and demand. For instance, try standing at the front door of a grocery store and demand food when you are hungry, but if you are ill, you can walk into an emergency room and receive necessary life-saving treatment.
A simple fact often overlooked in our health care debate is that the root cause of our health system’s near-implosion is health care costs that are rising at an unrelenting rate. The cost burden falls on small and large businesses and government through Medicare and Medicaid.
Undoubtedly, health care in American is on life support, and the future is uncharted. Yet, America has dug itself out of other crises in the past, whether the Great Depression in the 1930s, the Vietnam War, in the 1960s or the energy shortage in the 1970s. Now, I believe, we will do it again. But a long struggle for “quality health care for all at an affordable price” is still ahead.
Manoj Jain is an infectious disease physician and contributor to the Washington Post and the Commercial Appeal. This article originally appeared in the Huffington Post. He can be reached at his self-titled site, Dr. Manoj Jain.
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