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Solutions to
the Rising Cost of Healthcare
There are Solutions to the Rising Cost of Healthcare
SOURCE: Information gathered by the American Policy
Roundtable
Compiled by Professor Charles McGowen, M.D. and Chief
Medical Advisor to the American Policy Roundtable; August
11, 2008.
Free enterprise is one of
the utmost benefits of democratic republic; and that form of
government is what our founding fathers established.
Consumer driven free enterprise may even be, not just the
greatest stimulus to the maintaining of a democratic society
but also, the means by which we preserve the reasonable
health of a nation‘s economy. As individuals taste the
freedom that comes from our democratic system, they are
inclined to feel free to start their own businesses; they
become entrepreneurs. Throughout the 232 years since our
founders broke away from the suppressive control of the
British monarchy and established, as Lincoln said at
Gettysburg, “a new nation, conceived in liberty,” free
enterprise, especially deriving from the small business
community, has been the mainstay of the wealthiest nation on
earth; the United States of America.
Beginning in 1965 the
nation’s healthcare system began an insidious and persistent
slide away from the economic principle of free enterprise; a
decline that has brought it to its present state of
subservience to the business community (namely HMOs
established by insurance companies) and the state and
federal governments. 1965 was a time when President Lyndon
B. Johnson signed Medicare into law, congress having been
contemplating the legislation since the 1961 letter that
President John F. Kennedy had sent to them recommending
health insurance for the elderly under the Social Security
Act. The alleged purpose of handing the reins of the
practice of medicine over to the federal government was to
enable all senior citizens to obtain affordable healthcare.
As with most collectivist, liberal ideas, it has had the
opposite effect of that which was promised.
When the Medicare program
was inaugurated in 1965, the federal government projected
that Part A—the segment of Medicare that pays for
hospitalization—would cost $9 billion by the year 1990. The
program’s actual cost that year was $66 billion. Thus we
find that, after inflation, the cost of Medicare was 165
percent higher than the government had predicted it would
be. Is anyone surprised by that? When the figures had come
in, a sane person would have immediately seen the failure of
the government controlled health care system and turned the
health and welfare of the senior citizens back to where it
had been in 1965; the hands and brains of private
physicians. But then, insanity is defined repeating the same
errors while fully expecting a different result.
When I entered the practice
of internal medicine in 1967, health insurance companies
(Such as Blue Cross and Blue Shield), and the government
controlled Medicare plan, each required that a patient had
to be admitted to a hospital before they would pay for
certain radiological testing; upper gastrointestinal X-rays
and barium enema examinations for example. We physicians
thought that the restrictions were both inane and
unnecessarily expensive. It meant that the cost of a
patient’s X-ray would also have to include at least one
night’s stay in the hospital, paying for room and food, as
well as a minimum amount of laboratory work that an
admission to a hospital required. Furthermore it
necessitated payments to nurses, orderlies, nurse’s aids,
dietary personnel, lab technicians, administrative personnel
and housekeeping workers, not to mention the doctor’s fee
for making at least one hospital visit and performing a
complete physical examination. All of those costs could have
been avoided if someone in the world of business and
politics, had simply taken the sage advice from those of us
who really new how to run a healthcare system. That is just
one example of the unnecessary, financial waste that one
finds in a bureaucratic system of big business and
government.
Despite the failures in the
Medicare system, the new “control freak” on the block would
be the brainchild of the Nixon administration in 1971 and
what would become known as managed healthcare. The plan
would see to it that planning grants would be issued to HMOs
(health maintenance organizations) such that by 1980, 90% of
the US citizens would be enrolled in an HMO. In fact, by
1996 there were 600 HMOs in the country and only 25% of our
citizens (65 million at the time) were enrolled. Once
again the impetus for the plan was to control the cost of
healthcare. However, as everyone knows who pays a healthcare
premium or is aware of what their employer pays on their
behalf, the Nixon plan has been as dismal a failure as the
Watergate break-in that brought Nixon to an infamous,
embarrassed retreat from the world’s most powerful position.
The question thus arises,
can we do anything to put an end to the upward spiraling
healthcare costs and if so what are the alternatives? The
answer is a resounding “Yes. “ Over the next several weeks
of this newspaper’s Sunday edition I will attempt to explain
to the reader why we have to pay so much for healthcare and
that viable and reasonable solutions to the exorbitant rise
in healthcare costs do exist. The answer is not to be found
in a national healthcare program, as some who are running
for the offices in our executive and legislative branches of
the federal government would have you believe. The solution
is found in that which has motivated both the success, as
well as the cost control, of businesses of every stripe in
this great nation. The solution is found in a consumer
driven medical economy of free enterprise, a system that
puts the patient in charge of what we are willing to pay and
our ability to find the best doctor for the best dollar
cost. It works in the world of commerce and it will also
work in the world of affordable healthcare as well. I know
that because I practiced medicine for a few of my early
years in a world of free enterprise. While health care is a
privilege and not a right under our constitution, affordable
healthcare is something we should all strive for in this
nation where each citizen has been “endowed by our Creator
with” other “inalienable rights of life liberty and the
pursuit of happiness.” It is high time that the controlling
reins in the art and science of medicine should be handed
back to those who really know how to run the medical system;
physicians. The bureaucrats have failed us miserably.
C.H. McGowen, MD |
