Is it time for the “next” health care, or a total reboot?

Posted on | June 6, 2018 | 2 Comments

Mike Magee

This week’s big news is no big surprise. “Medicare’s Trust Fund Is Set to Run Out in 8 Years. Social Security, 16”, said the New York Times. We told you so, screamed the Republicans, anxious to fulfill Paul Ryan’s dream of taming endowments. We told you so, blared the Democrats, claiming this was always the end game with the recently passed, mega-deficit enhancing tax break for the rich which purposefully pushed the programs over the cliff.

Both are right in that this was predictable. But both are wrong in expending energy pointing fingers at each other rather than addressing the real issues: 1) our health system is massively inefficient, 2) our system rewards profiteering at every turn, 3) our system fails to deliver health in an even and equitable manner compared to all other developed nations.

A few facts:

More than 60 million Americans rely on Social Security, Medicare or both.

Social Security and Medicare currently consume 40 cents of every federal dollar.

Trump’s weakening of the ACA, most especially the penalty for going uninsured, means that our broken system will have more “uncompensated care” which simply adds fuel to the fire.

American taxpayers contribute $13,600 for every Medicare beneficiary. In five years, the projected figure will be $17,000.

Quasi-privatization of Medicare through the use of Medicare Advantage plans that further pad the pockets of insurers, Pharma, and PBMs, skimmed off 20 million seniors this year. In 10 years, that number is projected to increase by 50%.

The ratio of workers to beneficiaries is in steep decline. It was 3.3/1 in 2005, 2.8/1 in 2016, and is projected to be 2.2/1 in 2035. By then, there will be nearly 90 million eligible for Medicare.

While elderly numbers are rising fast, teenagers and young adults are dying at record rates causing economists to worry about the “work-loss costs.” Unintentional deaths from opioids, firearms (suicides and homicides), and motor vehicle accidents (mostly tied to texting) have risen from 15,851 in 2012 to 23,984 in 2016.

Princeton economist Alan Krueger estimates that negative health impacts have led to a 20% decline in workforce participation in males 25 to 54, and a 25% decline in women.

As record spending and profiteering fuel biotech speculation, public health spending continues a decades long decline. We are the only developed nation that spends more on fighting disease than on all our other social service programs combined.

Mayo Clinic’s Michael Joyner says, “In addition to the specific mix of greed, bad corporate governance, and too much ‘next’ Steve Jobs, Theranos (the fraudulent testing company led by Elizabeth Holmes) thrived in a biomedical innovation world that has become prisoner to a seemingly endless supply of hype.”

Life expectancy in the U.S. will decline for the third straight year in 2018. Ironically, the last time that happened was exactly a century ago, during the Spanish flu epidemic.

Bottom line: Bad policy is killing us and killing our future. We need to nationalize health planning and health insurance for all. We need to admit that fighting disease is not the same as providing health. And we need to mandate price transparency and appropriate protections for all Americans.

Comments

2 Responses to “Is it time for the “next” health care, or a total reboot?”

azure
June 28th, 2018 @ 10:18 pm

agree. So what do the various physician organization intend to do about it? If anything? The AMA helped get us to where we are today, after all. And some of those ripping off or trying to rip off Medicare, et al, are physicians, along w/pharmacists, health insurance executives. . . While, as usual, the GOP alleges that poor/low people (receiving SSI, some SSDI, o SS retirement benefits, etc.) are commiting fraud, by far the most fraud and most expensive fraud is committed by those I’ve listed above.

What’s going to change within the profession?
Mike Magee
June 30th, 2018 @ 10:19 am

Thanks for your thoughtful comment. Code Blue (Grove Atlantic Press/Spring, 2019) addresses your questions in detail. In short, we will need to begin anew. 1st step, universal coverage coordinated through single payer, executed with protections on local level. Next step, segregate research and discovery (which is speculative and profit driven, from care delivery. Next, eliminate oversell and overuse of drugs including eliminating DTC advertising, and model Canada and Europe in setting drug proices.Next, create a real public health plan with integration of social services. Finally, redirect human resources away from intervention toward prevention and wellness.