“US Health Care – Do We Need a Revolution?”

April 22nd, 2008: Dr. Nancy Nielson, micro-biologist and President-elect of the American Medical Association (AMA), gave a dynamic yet personal presentation at the Rotary Club of Charleston today. Starting with the problem she noted only 60% of U.S. employers offer health insurance; the decline to this level is due to the current cost of health insurance. Why then is American health care based upon an employer based system? Basically, there were two factors: first, the shift of women into the work force during WWII. The health care incentive was needed to get them to leave their homes. In addition, wages were frozen during that war so the employers devised the notion of adding health benefits in lieu of wages to further entice the labor force. Secondly, a ruling by the IRS that health benefits could be excluded from taxable income.

Currently 1 out of every 7 persons in America is uninsured and these workers are from all levels of the economy. Currently, each of the presidential candidates has “an answer” to this problem. The AMA, however, takes a very different position. They are not in favor of a single-payer system currently in place in Canada and Great Britain, though there are things to be learned from both systems. The AMA supports individually owned, affordable health insurance, not tied to ones current employer, though the employer could make the payments on behalf of the insured as a payroll deduction. There are thousands of cases of persons transferring from one job to another who, despite the assurance of a right to transfer, find themselves without insurance for periods of time. Many are then caught with so called “pre-existing conditions” when they do get accepted into a new plan and in every case they are totally at the mercy of the particular specifics of coverage or non-coverage that the employer has elected to buy for them in a group manner. 88% of those employers who do offer health insurance offer just one system. The answer is to get away from employer-systems and into one in which YOU own your own plan, and can build it to fit your needs. A typical husband and wife today are paying at least $765 per month for one person, and over $1300 for two; they could easily spend an additional $18,000 over six months.

In a call to action, Dr. Nielson noted things which must take place: 1. In terms of a revolution: we must stop finger-pointing at the current health insurers and meet together to solve the problem. No more hand-wringing; we need solutions. 2. We must invest more in preventative health care which will save more in the long run. 3. We must do studies of the comparative value of various medicines and processes. Such comparative research is regularly done in Europe, but not here. 4. We are spending 15% of our GNP on health care and this is way too high. 5. Each and every individual must invest in the plan together for only if all are involved will the cost become affordable; everyone must be in the risk pool. 6. Change the tax law from eliminating tax on health insurance to one in which a tax credit is given. The current plan, from a tax standpoint, helps the more affluent citizen, but does little to help the lower income person. In questioning from the floor she responded:

Why is the cost so high?
Costs are out of control. A couple turning 65 today and participating in Medicare will still pay out an additional $225,000 for health care in their lifetimes. While some years ago many people could pay the bills, today the costs are being driven by the health providers. We have many, many more medicines available to day that are very expensive [the U.S pharmaceutical companies fund almost 100% of the world-wide research costs]. We have many, many more diagnostic tools today that are regularly used.

How do you get persons, particularly those young and healthy, to buy into an insurance plan?
We must make everyone realize while they can perhaps fund the little things it is virtually impossible to fund a major illness, let alone the cost of a single emergency room visit.

How do we get a divided Congress to create a solution even with all candidates making medical proposals?
We elect the Congress and each of us must make it clear to those for whom we vote that we expect them to act, and we need to find out before we vote that it is the intent of the person in Congress to fix the problem; the problem is far too big to be handled by business alone. “More people are in bankruptcy today due to medical costs than for any other reason.”

Reported by Fred Sales, Keyway Committee