Is our healthcare system broken more now than it was 10 years ago?

oh-oh it’s broken..

Is our healthcare system broken more now than it was 10 years ago? If so will the Affordable Care Act fix it or make it worse?

Yes it is, and this is why.

The biggest problem is we have a shortage of doctors right now and the problem is getting worse. According to AAMC estimates, the United States faces a shortage of more than 90,000 physicians by 2020—a number that will grow to more than 130,000 by 2025.

Congress capped the number of federally supported residency training positions 15 years ago with the passage of the Balanced Budget Act of 1997.  As a result of ongoing budget discussions, cuts to doctor training will worsen the physician shortage and jeopardize the health of patients around the nation.  It takes years to train a doctor.  For more doctors tomorrow, there must be increased funding for doctor training today.

If someone chooses to become a doctor and go to medical school it will take eight years to complete and then you have residency, you are looking at about ten years before you start making more than minimum wage.  By this time run up a bill of $419,738.  Then you spend the next 30 years paying it back.

Note: My previous blog outlines how to pay for this increase in education funding.

Then imagine you are a doctor, with a huge debt, and you have the government or insurance companies telling you how much you can charge, what services you can perform and bill for.

Next, will we have enough Hospital beds?

No we do not have the infrastructure to support the projected 20 million people to be brought into the healthcare system all at once.  Our hospitals are already overburdened and many are having to cut back staff to meet the cost cutting guidelines outline by the ACA.

One example is the Cleveland Clinic is the region’s largest employer which has roughly 42,000 workers.  The Clinic has told workers they will be laying off an unspecified number of employees as part of an overall, sweeping cost-reduction plan.

The clinic spokeswoman Eileen Sheil said personnel represent 60 percent of the Clinic’s budget.  She said early retirement would be offered to 3,000 eligible employees. Most vacant jobs are not being filled.  She attributed most of the budget reductions to looming changes accompanying the start of the Affordable Health Care Act.

Is it the Affordable Care Act the solution?

The problem we have here is the huge bureaucracy is being created to support it, which increases the cost of the ACA.  Now remember when the President said this will be self-funded by the cost savings?  Well that went out the window.  The CBO now say the net cost is now estimated to be $2.6 trillion over a true 10-year period

Do you also remember they said it will drive your cost down because the risk will be spread across the entire population?  They were banking on those 18 to 34, the problem is this group does not believe they need insurance, they are invincible.  Now we are left with those 35 and up, many in this group already had health insurance, now they are the group who will be footing the bill for everyone.  Keep in mind; most of your life-time medical expenses are in the last 5 years of your life.

A recent study by the National Center for Public Policy Research shows that:

About 3.7 million of those ages 18-34 will be at least $500 better off if they forgo insurance and pay the penalty.  More than 3 million will be $1,000 better off if they go the same route.

“President Obama promised a joint session of Congress in 2009 to spend $900 billion over ten years on his health care law: ‘Now, add it all up, and the plan that I’m proposing will cost around $900 billion over 10 years.’  A Senate Budget Committee analysis (based on CBO estimates and growth rates) finds that that total spending under the law will amount to at least $2.6 trillion over a true 10-year period (from FY2014–23)—not $900 billion, as President Obama originally promised.”

“In an Obama administration, we’ll lower premiums by up to $2,500, (now they say you will pay $7,500 more) for a typical family per year….. We’ll do it by the end of my first term as President of the United States”.   

The ACA will also play a role in the slowdown in 2014, with hospitals working to hold down expensive re-admissions (or face the law’s penalties) and employers being given greater power to influence employee behavior through increased or discounted premiums—up to 50% in some cases.

What we have created a system that tells doctors what they can charge for and what services they can provide.  Then to pay for it the government taxes the medical equipment needed to deliver these services.  So that cost gets passed on to the doctor, he just has to eat that cost because he can’t charge any more than the government tells him he can.

Can the US government be successful in healthcare?  That is easy, just look at the failure of the VA system and how so many patients go without treatment for years.

Today, more than 865,000 veterans around the nation waiting to receive disability benefits from the VA. Of those veterans, almost 576,000 are considered part of the VA backlog, meaning that they have been waiting for a decision for more than 125 days.

Yet you hear the media, politicians and others touting other countries, including the UK of having socialized medicine, how great it is, saying we should do the same.  They never seem to tell you the whole story.  Europe is bankrupt and their unemployment rate is higher than America.

In 2009 a report was release in the UK stated:

A UK health and social care watchdog has warned that the country’s healthcare system is on the brink of collapse, and that many patients – particularly the elderly – are going to hospital for emergencies when they should have been seen much earlier.

“If we don’t start closing acute beds, the system is going to fall over. Emergency admissions through Accident and Emergency (A&E) are out of control in large parts of the country. That is totally unsustainable,” Prior said.

“The patient or resident is the weakest voice in the system. It is classic market failure. We can talk about competition until the cows come home but if you live in Norwich there is one hospital,” said Prior, the former chairman of Norwich University Hospitals foundation trust.

The Mid Staffordshire NHS trust is now in administration following reports of “appalling” care that led to the deaths of 400 patients between 2005 and 2008.

Can you afford this?  Are you starting to see how crazy this is?

Were there other options to fix our healthcare system?

Yes…  and none of them involve the government.

The easiest and most cost effective solution is to use the system we already have in place.

It would be pretty easy to change and use the competitive nature of business to drive down cost.  The only thing required is to ensure the state to state regulations are uniform and monitor compliance.

You open up the borders to insurance companies and let companies compete border to border for your business.  You may have thought that was already in place. Nope.

Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders. Large employers who self-insure are exempt from these state regulations. The result has been a patchwork of 50 different sets of state regulations; the cost for an insurer licensed in one state to enter another state market is often high.

Let’s make your insurance portable and when you change jobs or states, your insurance can travel with you.  If the coverage is what you want and can afford, keep it, and if not start shopping.  Your employer would simply fund into your “Cafeteria Plan”, which already exist today, to pay for their contribution of your premium.  This would allow you to choose any level of insurance you want and give you control.  If you want the best, you would just pay more out of your pocket, is you only want the lowest you pay very little.

If you are self-employed you would access the same network as the large employers and this would spread the insurance risk even farther.

Privatize Medicare and Medicaid, creating an additional pool of insured to spread the risk across. These would be entry level programs to aid and cover those unable get coverage elsewhere.  This would be the same border to border insurance network and be the same HMO level many others in the market currently employed would choose.

Enact tort reform so that attorneys are not filing frivolous lawsuits and therefore reduce the outrageous cost of malpractice insurance

·       The average expense of defending a physician against a medical liability claim in 2010 was $47,158—an increase of 62.7% since 2001.

·       In 2010, 63.7% of closed claims against physicians were dropped, withdrawn, or dismissed without any payment. Each of these claims costs an average of $26,851 to defend, accounting for more than one-third of the total annual defense expenses.

By doing so we would be able to cover every citizen with coverage we can all live with.  All this without the cost of the huge bureaucracy being created, keeping the government out of the insurance business.  Relieving the taxpayer of the $2.6 trillion tax burden.