For a long time, the Colorado Medical Society was a neutral observer as the debate regarding the shortcomings of the U.S. health care system swirled around us. Recently, CMS vowed to work toward a comprehensive financing strategy to cover all Americans.
Last year, the Colorado Nurses Association voted to work for universal health care. Indeed, everyone I know agrees the U.S. health care system is broken and “something” must be done.
This vision and impetus for reform are countered by the weight of those reaping huge profits from the health care business. Large HMOs gobble up smaller ones to become Goliaths. UnitedHealth Group’s purchases PacifiCare Health Systems for $8.1 means insurance executives pocketing millions of dollars. It’ll make UnitedHealth a giant few will ever be able to move or influence.
Sadly, companies like UnitedHealth, Wellpoint Health Networks and others seem to lack the desire or wisdom to play an active part in reducing our nation’s uninsured. They are, in fact, the engines that help increase the rolls of the uninsured by making insurance unaffordable.
For me, one sign of good corporate citizenship is for highly profitable corporations, like Wal-Mart, to offer their employees health coverage, thus reducing the number of uninsured. Instead, Wal-Mart’s average salary of $15,000 a year generally doesn’t include health insurance. Often, “associates” resort to Medicaid and other public aid.
Across the nation, legislators are trying to force employers of 3,500 or more people to offer them health insurance. A similar move in Colorado, House Bill 1316, recently died in legislative committee. Its demise was celebrated in a Rocky Mountain News editorial on March 5. “Colorado’s version of the ‘get Wal-Mart’ bill is dead,” the editorial read. “Thank goodness.” Many of us are less sanguine; if we’re to lower the rolls of the uninsured, we must be creative. HB 1316 was one such creative move.
Fortunately there still are brave legislative souls trying to reform our health care system. A Health Care Reform Committee has been proposed in the Senate to study how universal coverage for all Coloradans could work.
Critics have alluded to the cracks in the Canadian single-payer system and lauded the private sector that’s making inroads there. The Canadian system has many problems; it doesn’t, however, have 15 percent of its citizenry unable to obtain reasonable health care.
Many critics fear a government-run universal health care system. We forget that Medicare is already such a “socialized” system. It is more efficient, more cost-effective and has lower administrative costs than all private HMOs. Arguably, the Veterans Administration system has the best health care outcomes in the United States.
VA providers have lifetime relationships with their patients. Compare that to HMO patients, who are frequently herded to new doctors, new HMO plans and new therapies. In addition, the VA computerized all its patients’ medical records. A patient can go to any VA facility in the U.S. and his records will always be at his physician’s fingertips. HMOs are not about to invest in such recordkeeping.
Our current private system has failed many: the unemployed, the self-employed, the working poor. And, it’s uncertain whether it can be retooled to cover every American and deliver quality treatment.
It’s important for all of us understand how we can wrestle a monster that’s killing many helpless citizens each year.
It’s not enough to point to cracks in other systems; we must show how we plan to repair the myriad flaws of our own private medical system.
Nor is it enough to claim health care is too complex an issue and leave it at that.
We have an obligation to work at it, until we arrive at a reasonable solution.
The answer lies somewhere between the Canadian, the European and American systems.
We must find what best works in those systems, making certain they’re solutions that include coverage of the 45 million uninsured Americans.
Pius Kamau of Aurora is a thoracic and general surgeon. He was born and raised in Kenya and immigrated to the U.S. in 1971.
