National health care rising in popularity, but not among pols

4/5/2008

OUR health care system is broken.

An estimated 47 million people are without health insurance today; another 50.3 million are "underinsured."

We pay the most in the industrialized world, per capita, for health care, but have poorer health outcomes. Lack of insurance alone accounts for about 101,000 preventable deaths each year.

In Ohio, we waste $11.6 billion yearly on unnecessary administrative paper work and profits. This is more than enough to cover 1.2 million uninsured Ohioans.

We can do better, and we must.

This past week, researchers at Indiana University published an important new study that reveals a growing consensus among medical professionals on a path forward.

Reflecting a shift in thinking over the past five years among U.S. physicians, a solid majority of doctors, 59 percent, now support national health insurance.

Support among primary care physicians and psychiatrists averages well above 60 percent. Even 55 percent of the usually conservative general surgeons now support national health insurance. They know when to clamp a bleeder, and our sickness care non-system is hemorrhaging money.

This growing consensus among physicians on the need for national health insurance is no doubt connected to the waste and inefficiency they witness on a daily basis.

Our private insurance industry consumes 31 percent of every U.S. health care dollar, much of it on bureaucratic paperwork and overhead.

As doctors, we have seen more and more of our patients experience a deterioration in the quality of their employer-based coverage or lose such coverage altogether.

Too often, this leads to financial ruin.

National health insurance plans typically involve a single, federally administered social insurance fund that guarantees health care coverage for everyone, much like Medicare currently does for senior citizens. They eliminate or substantially reduce the role of private insurance companies in the health care financing system, but still allow patients to go the doctors of their choice.

It is past time for those seeking high political office to stop avoiding the "elephant in the room" - the private health insurance industry - and the obstacle it poses to delivering quality affordable health care to everyone who needs it.

Disappointingly, none of the leading candidates for president are taking on the elephant. Rather they are following the elephant with shovel in hand. None offers a sound approach to solving the crisis.

Republican Sen. John McCain's solution can best be described as missing in action.

He proposes tax incentives to encourage the uninsured to buy coverage, but these subsidies fall far short of the cost of adequate insurance.

Senator McCain says his plan would let the "free market" work to bring down health costs.

In fact, his plan would change the tax code to encourage business to drop coverage for their workers, forcing millions of workers to seek coverage in the high-cost, high-overhead individual market.

His proposed tax credits are a fraction of what an individual health insurance policy costs, and far below the cost of the taxpayer-provided coverage he enjoys.

If Senator McCain has his way, tens of millions more Americans will join the ranks of the uninsured and scantily insured; only the wealthy will be able to afford anything but bare-bones coverage.

On the Democratic side, Sens. Hillary Clinton and Barack Obama are offering either full or partial "mandate" models for reform.

Under these models, the government would require us (or our employers) to buy private coverage, in effect criminalizing the uninsured, while offering an expanded Medicaid-like program for the poor and near-poor.

The incremental changes suggested by Senator Clinton and Senator Obama cannot solve our problems, because they share the fatal flaw of Senator McCain's: they leave the big private insurance companies in place.

State plans based on these mandate models, as in Massachusetts, have already begun to falter.

The fines for failing to purchase health insurance in Massachusetts will exceed those for murdering your neighbor's cat or beating your spouse.

If you go to jail for failure to buy insurance in Massachusetts, at least you will get health care for free while in jail, as required by law.

What must be changed is the system itself. It's time for the big private insurance companies to go.

At one time or another, both Senator Clinton and Senator Obama have said they could support a single-payer national health insurance system, a kind of "Medicare for all," as a solution to the health care crisis, but they have apparently calculated that it is not politically feasible to advocate it today.

The new survey of the nation's doctors suggests otherwise.

These findings dovetail with those of an AP/Yahoo public opinion poll last December showing 65 percent of Americans favor a similar approach.

National health insurance is not only necessary, but increasingly popular.

Winston Churchill is remembered to have said of Americans that we always do the right thing, after we have exhausted all the other possibilities.

It is time for our political leaders to stand up for the health of the American people and implement a nonprofit, single-payer national health insurance system.

It will save lives, save money, and the 15,000 members of Physicians for a National Health Plan will be there to support them when they finally do the right thing.

Dr. Johnathon Ross is an associate clinical professor of internal medicine at the University of Toledo and medical director of outpatient internal medicine at St. Vincent Mercy Medical Center. He also is past president of Physicians for a National Health Program.