The Battle for Health Care Reform - Summer 2009

In 1945, President Truman proposed universal health care system for the United States. He was the first U.S. president to put his full support behind universal health care. Unfortunately, in 1946, the Republican's gained control of Congress, and had zero interest in health care reform. They said such a system would lead to a "socialistic" society, or worse yet, Communism. Sound familiar?

In 1965, Lyndon Johnson, through a successful grass roots effort, was able to get Medicare and Medicaid passed through Congress, which was a form of universal health care, that is administered by the government in concert with private health insurers. Republican's fought vehemently against Medicare.

In 1994 Hillary Clinton led a fight to include universal health care for everyone but again was defeated by the same Republican forces and the same fear tactics that defeated universal health care in 1946. In the Summer of 2009, once again the battle lines are drawn between proponents of universal health care, and the same conservative groups that were aligned against health care reform over a decade ago.

There is one major change today in the fight for health care reform that did not exist in the past: the advent of the internet and the emergence of 24/7 cable news outlets. Both have been a huge factor in getting the message out about health care reform, both positive and negative. American's if they choose to do their homework about health care will find a plethora of easily obtainable facts about the state of health care in this country and health care services in other industrialized countries.

There are certain truths about health care in the U.S. that are pretty much agreed upon whether conservative or liberal in your belief system.

1. Our health care costs are higher per capita than any other industrialized country in the world, about double the next highest country.

2. We have the best hospitals and medical personnel in the world, if cost is no object. The rich and famous usually come to the U.S. for their health care needs. If Steve Jobs needs a liver transplant, he has the financial wherewithal to get a new liver.

3. There is a strong correllation between income level and good health care availability in the United States. The wealthier you are, the chances are better that you will receive excellent health care. In countries with universal health care, like our neighbor to the north, Canada, there is no correllation between degree of wealth and access to good health care.

4. Our prescription drug costs in the U.S. are much higher than in other countries, which is why many U.S. residents try and get their prescriptions filled in Canada.

5, We are the only country in the world where it is possible to go bankrupt through excessive medical expenses. 700,000 Americans went bankrupt last year due to medical expenses.

6. One out of six Americans have no health insurance coverage at all. Millions of other Americans are underinsured.

7. Health care insurance costs that are borne by American companies are making them less competitive in global markets.

8. Our health care delivery systems are very inefficient - they do not take advantage of cost efficiencies through information technology innovation, and the claims approval process is very paper intensive, and bureaucratic. Thus health care administration costs are the highest in the world.

The bottom line is that American's are not getting their money's worth when they pay for health care. We either need to make changes to our health care delivery that reduce costs, or get better delivery of health services. The focus of the health care reform in 2009 is to improve health care access to American's who currently get no health care outside of running down to the emergency room of their local hospital, and cost containment, for American's who currently have health care coverage.

The debate this Summer over health care is being argued over the merits of making the monetary investment in providing health care coverage to all Americans, while putting in place a process to reduce health care costs over time. Universal health care advocates view the expenditure as an investment in America, whereas conservatives view it as an unnecessary expense. The question conservatives put forth is how America afford to do this reform in a time of economic turmoil. President Obama is saying how can we not do it now, when our health care costs continue to escalate every year, making the reform process even more difficult with each passing year. Obama wants a system in place with a universal health care option for those who are not happy with their current health care coverage. For those American's who are happy with their current health care, they can keep it.

Health insurers while recognizing they have a problem with health care costs are not thrilled with a universal health care option which would be overseen by the U.S. government, thereby providing competition for them, and the potential for erosion of their profit margins as they are forced into cost reductions due to the presence of a single payer option. But of course this is a key strategy in bringing health care costs under control. It is the model other countries used to contain costs and get health services delivered to all of their citizens.

Switzerland and Canada at one point had health care systems very similar to the United States. Both went to a form of universal health care - Switizerland's citizens voted by a bare majority for universal care. Today not many Swiss would go back to the U.S. model for health care, nor would many Canadians. Depending on which poll you believe, most Canadians (70-93%) like their health care and would not trade it for a U.S. version. In fact many Canadians are angry that American politicians disparage Canadian health care, when they don't really know the true facts about Canadian health care services.

The best approach for the U.S. would be to do what Taiwan did. They studied the health care delivery systems of 15 leading countries, and took the best practices from each, to come up with their own health care model. Needless to say, they were not very impressed with the U.S. health care model - too expensive and too inefficient. Michael Moore recommended this approach in his movie Sicko. He was of course ridiculed by the health care providers as a radical and a subversive. Now some are saying he was right all along.

We can only hope that in the Summer of 2009, we will at long last have the health care reform that Harry Truman fought for way back in 1945. We can't afford to wait any longer.