U.S. Health Care: Convoluted Care

As my first post on anything tangible to the real world, I considered writing about some prominent issues regarding health care that are swirling around right now. Of course there is the re-instatement of SCHIP for four and a half years signed by Pres. Obama earlier this year. There is also the economic stimulus package that fosters billions of dollars in much needed aid for Medicaid, the National Institute of Health, etc. And there are also major appointments to be made to the Health and Human Services and US Surgeon General.

I guess the most salient feature that arose from this brainstorm is - and it should come as no surprise - that the health system in our country is completely convoluted. There are HMO's, PPO's and Medicare, Medicaid, SCHIP; individually purchased insurance and employer based insurance. We pay premiums, co-pays, deductibles and out of pocket expenses for all the areas somehow aren't covered by one of the choices above. Above all that, there is an abundance of paperwork, fine lines and hoops associated with health insurance. Got denied on your claim? You should have known your hypertension excluded you from certain procedures. Just make a little bit more money than the federal poverty line? Well, you wouldn't qualify for Medicaid, but you might qualify for SCHIP unless your making too much over FPL. Yikes!

And its not just us patients who are bogged down by this torpid system. Physicians across the board have seen their amount of paperwork steadily increase. That equates into less time spent with the patient and more overhead costs. In fact, a recent survey of primary care physicians found that nearly half of them would consider leaving medicine!

"Of the 12,000 respondents, 49 percent said they'd consider leaving medicine. Many said they are overwhelmed with their practices, not because they have too many patients, but because there's too much red tape generated from insurance companies and government agencies." (CNN)

See how convoluted it is? [Disclaimer: Agreement with the last question is required to proceed.] I would have to blog on nothing else but this for the next two years to cover all the inadequacies of our health care system.

All I am trying to express is this: we spend over $7,000 per capita on health care which is twice as much as nearly all industrialized nations. Yet, roughly 15% - more than 45 million - of U.S. citizens have no form of insurance. Even if you have insurance who knows what will or will not be covered under your plan. Some people can't even get an appointment with a primary care physician within the next 8 months in their town.

So, will continued market based insurance schemes help us out? Are fragmented forms of public assistance going to solve the problem? I side with the 59% of physicians recently polled that exclaim we need a single payer health system (CBS News/NY Times Feb 2009 Poll). We need a system relieved of the excessive overhead and the greed from for-profit insurance companies that stymie our access to affordable and efficient health care.

Pres. Obama hasn't given much to hope for when it comes to health care reform. He has consistently stated that he does not support universal health care. This stance has also been bolstered by the President's recent proposal of Dr Sanjay Gupta as U.S. Surgeon General. Dr Gupta is also opposed to universal health care. But with most health insurance coming from employers, and unemployment steadily rising, right now seems to be a good time to reanalyze the whole system. We should all heed the words of the Physicians for a National Health Program when they say "nothing less than single-payer national health reform will work".

- m.tsang

[For more information on single-payer health care and the health care debate check-out: Dr Arnold Relman's Book titled "A Second Opinion", HealtCare-Now.ORG and HR676.ORG]