We all have bad weeks. Mine recently amazed me at the astonishing dysfunction of our health care system. When I mention the system, I mean no disrespect to the talented and heroic top performers in nursing, pharmacy, medicine and other providers who fight the system every day on behalf of our patients.
Despite these efforts, the sad but undeniable fact is that our healthcare system – the way the US distributes and pays for healthcare – has made it the costliest failed venture in the history of human civilization.
Part of what got me going this week was a series of examples of my patients’ chronic struggles to access mental health care. After years of poor funding and a surge in demand since the start of the pandemic, there is a shortage of providers. Scarcity is accompanied by barriers imposed by insurance networks. Without adequate access to services, GPs like myself become psychiatrists of first and last resort, pushing the limits of our competence. But what else can we do?
A second portion of the week’s meal was the latest barrier to drug therapy. The cost of so many drugs is so high that even insured patients are struggling. Take Ozempic. There’s no generic drug and it’s a financial drain of nearly $900 a month, but it helps my diabetics — until last week when they couldn’t find it. Why? Due to its newly recognized weight loss use. It is suddenly so popular that the pharmacies are running out. How can a system allow wealthy individuals to shed a few pounds to use their money to marginalize diabetics who really need the drug?
A third blatant failure of our health care system that looms in the background for doctors like me every week is hospital funding. For years, hospitals have survived by collecting large fees from commercial insurers to subsidize losses in treating Medicaid and Medicare patients. With healthcare costs rising and a shift towards patients on government plans and away from private insurance, even the most respected and well-run hospitals, both locally and nationally, are facing an emerging wave of red ink. Many are drastically cutting costs to maintain solvency. In a rational system, the revenues that support critical facilities such as hospitals would not face ongoing financial crises.
These are just a few examples of how the failure of the US healthcare system is now weighing on doctors. Here’s another thing that should haunt every American: The cost of this failed system is beyond comprehension. By comparison, World War II aptly set the benchmark for unrestricted government spending, when the U.S. government poured nearly $6 trillion (in current dollars) into the military from 1940-1945. We now spend over $4 trillion on healthcare every year. What do we get for this incredible amount? Statistics compiled by the Organization for Economic Co-operation and Development tell an embarrassing story. On critical rankings such as life expectancy at birth and deaths from preventable diseases, the US was near the bottom.
Why has the US, the world leader in drug and health technology, fallen so far behind? The answer is that the system stopped serving the public a long time ago. It meets the needs of those who benefit from health care. Powerful lobbies from insurance companies, pharmaceutical companies, medical associations and others block meaningful reform.
The insurance sector is the biggest obstacle. Administrative expenses are about 17% of sales, compared to Medicare, which spends only 2% of operating expenses on administration. If a federal payer system — like Medicare for all — saved even 10% of what insurers waste on administration, the extra billions could revolutionize healthcare. That amount could expand mental health services, subsidize access to medicines and stabilize hospital funding.
As we pay more and more for substandard care, inevitably more and more attention is drawn to the glaring weaknesses of the system, particularly administrative waste. Overcoming the special interests and solving the problems will not be an easy task. The inertia of our political system required the Depression to introduce Social Security. Improving access to insurance through the Affordable Care Act required an influx of law reformers inspired by the 2008 financial crisis.
I’m not sure what national catastrophe it will take to break the status quo this time around, but America’s health care failures are certainly on the rise. When an inevitable major reform finally arrives, those like me who deserve our existence in healthcare deserve a contribution. But the patients who pay the bills and live and die in our system deserve changes that put compassion before profit.
Daniel J. Stone practices internal medicine in Beverly Hills.
Source: LA Times
Andrew Dwight is an author and economy journalist who writes for 24 News Globe. He has a deep understanding of financial markets and a passion for analyzing economic trends and news. With a talent for breaking down complex economic concepts into easily understandable terms, Andrew has become a respected voice in the field of economics journalism.
