Healthcare Facts Count

A recent Pew study concluded that 60% of Americans believe that the government should be responsible for providing healthcare coverage. http://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/

The first thing that people need to ask is was the methodology used to perform the study a valid way to extrapolate what over 300 million people really want? And second, can accurate conclusions be drawn from a study that relied on only 1741 people with a majority who are likely to be in favor of Medicare for all/single payer? 

As with all statistics you can get any answer you want based on what the question is, and how many people are included  in the poll. The future of Healthcare in the US should not be based on polls, but on facts. 

Since the passage of the Affordable Care Act there has been a dramatic shift in our healthcare system. 

1. It has moved to a centralized and corporatized system at the expense of choice and access to affordable healthcare

• Community and rural hospitals have closed and have largely been replaced by large corporate hospital systems
• Independent private doctors have almost been driven to extinction while there has been a dramatic shift towards doctors becoming employees of corporate healthcare systems

The effect of both of these changes has been both an increased reliance on the emergency room for care which is more expensive, and an increase in the waiting time to see both primary care physicians and specialists.

2. There has been an acceleration of the physician shortage leading to less access

• Doctors have been leaving the profession through early retirement, leaving the field of medicine, and tragically some physicians have lost the joy of practicing medicine and are experiencing burn out. 
• Because of the Balanced Budget Act passed by Congress in 1997 which limited the number of residencies, there are doctors in the US who cannot complete residency training; and therefore, can not practice medicine, further limiting patient access to healthcare. 

3. The cost of prescription drugs has continued to rise exponentially and there has been rationing and limited access to certain medications and supplies

• The 1987 Medicare anti-kickback Safe Harbor statute exempted hospital group purchasing Organizations (GPOs) (for in-patient care), and Pharmacy Benefit Managers (PBMs) for out-patient care from criminal penalties for taking rebates/kickbacks from suppliers. This has morphed into a 600 billion dollar money making monopoly that has led to the artificial rise in the price of medication, medical devices, and supplies on the backs of patients.

4. The cost of medical insurance has continued to rise.

• We now have 4 major insurance companies which control the marketplace. In some states there is little to no competition leaving patients at the mercy of whatever the insurance companies want to charge. 
• The insurance companies control access to physicians by limiting the panel of physicians on their plans this increases the length of time it takes for patients to see a physician.

These are just a few examples of what happens when the government gets involved and tries to control the outcome. Invariably, it works against individual choice, limits access and increases cost. The solution is choice, price transparency, and healthcare consumerism.