A long way to go on health reform

By Umang Malhotra

Friday, April 15, 2011 at midnight

The American health care system has been leaking like an old car for decades. Congress, in the search for a universal solution, is using a piecemeal or duct tape approach to stop the leaks. Our lawmakers bemoan the expense, while using the most cost-ineffective solution.

The system is undeniably broken. By reputable measurements, America ranks first in obesity, 27th in life expectancy, 37th in infant mortality and 54th in access to health care (tied with Fiji). CIA World Factbook figures are even worse. Despite the U.S. spending twice what the next affluent country spends per person, all international comparisons show that America lies near the bottom on health care. According to AARP data, it also lags far behind other countries in long-term care for seniors. Nearly 50 million people in the U.S. are uninsured; millions are underinsured, and more than half the personal bankruptcies – over 1 million a year – are caused by medical bills, something unheard of elsewhere.

America is the only affluent nation unable to provide universal health care for its residents – astonishing for the richest country in the world.


The reason is a money-driven system – riddled with interest groups selfishly fighting to protect their own constituencies. With the cost of health care rising at more than twice the rate of inflation, it is already a huge problem for businesses and governments. If it continues, it will be disastrous.

The health care bill signed by President Barack Obama is neither universal nor is it likely to ever be cost-effective. It is nearly 2,700 pages, and with the addition of all the enabling regulations, becomes a minefield open to interpretations in the hands of insurance companies and lawyers – a bureaucratic nightmare. The cost of premiums and payments from your pockets will keep on rising.

Sadly, many legislators turn the issue into an ideological controversy, rather than a search for common good. They bury their heads in a sand of partisanship, power and hypocrisy; accepting government health care plans for their families while denying the same to the rest of the population.

Other issues, uniquely American, are lobbying by insurance and drug companies, and the involvement of vast armies of lawyers. The same drug costs much more in America than in other countries, while frivolous malpractice lawsuits escalate the costly practice of defensive medicine.

Health-related spending makes up more than 17 percent of America’s nearly $14 trillion economy. Of that, more than 30 percent goes to administrative costs, compared to the 10 percent to 15 percent spent by other rich countries. If America cut the cost of paperwork and bureaucracy and reformed malpractice law, it could save nearly $4 trillion in 10 years. Add reforming the insurance and drug marketing industries and you can begin to see how America could afford to rebuild a better system.

Many people with health insurance fear the concept of reform because they fear losing what they have. To fan these fears, interest groups use scare tactics to create fear of a single-payer system – yet a single-payer system is precisely the very efficient system that veterans and federal employees use. Some other rich industrialized countries combine a low-cost, single-payer system that guarantees basic services to all, with supplemental insurance to cover extra needs, thus eliminating mostly useless paperwork. It is a very practical solution.

In the short term, the practice of medicine must be given back to doctors and patients, not insurance companies, lawyers and bureaucrats. Common-sense solutions must include cutting administrative and bureaucratic costs, giving basic health insurance to the uninsured, closing the doughnut hole for seniors, accepting pre-existing conditions, reforming malpractice law and using electronic records. In the long term, after costs are controlled, a well-thought-out single-payer universal health care system can then be developed.

Health care should be a basic right, not a luxury. America has the best minds and medical institutions to develop such a system. It can neither afford to make this a partisan issue nor be too proud to learn from other countries.

Malhotra is chief executive of Artistic Goods LLC of San Diego. He is the author of “Solving the American Health Care Crisis – Simply Common Sense.”

This health care article originally appeared in the San Diego Union-Tribune on 15 April 2011, Section B

Copyright © 2010 Umang Malhotra. All rights reserved. Reproduction in whole or in part in any form or medium without express written permission of the author is strictly prohibited.


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