Healthcare in the United States: The Feasible, the Reasonable, and the Expected in 2016
By Allison Berkowitz
Healthcare today is a result of changing labor structure, policies, and demographics with the evolution of medical services and technologies. For instance, America after World War II saw the emergence of employer-provided insurance systems, and today, we see the baby boomers’ toll on government-funded Medicare. With this in mind, it is no surprise that national healthcare expenditure has gone from around 4.5 percent GNP in the 1950s to 18 percent today. It is apparent that we invest a significant amount in healthcare and, in consequence, entangle economic growth with our health. Therefore, it is important for every voter this 2016 election to be critical of the health platforms and experience of candidates as all will be faced with the consistent dilemma to protect industry -- including insurance, hospitals, pharmaceuticals, along with the farming and restaurant industries -- or to protect the health of the American people.
What is not often talked about are the short and long-term effects of changing policy. In simple economic terms, if policies are put in place that are adverse to business but good for health, industries will be hurt in the short term. However, considering growth in the long term, most of these industries will recover and see the emergence of new industries. The American economy will be the same, if not better. Besides direct consumption, it is the health of the labor force that will help aid in productivity and growth. In turn, this growth will lead to better living standards and, in theory, better life and health overall.
Then what is going wrong?
On a massive scale, the United States, though situated as one of the richest nations in the world, does not have the healthcare system necessary to accommodate both industry and health. In fact, in the United States, four systems exist: private, government, public, or none. We can look to models such as Great Britain: where there is socialized medicine and public health measures are tremendous, Germany: where hospitals compete for government funding, and Japan: where prices are set and frequency of visits is very high. Yet, America is missing the extension of governmental intervention into direct medical supply.
The question then remains, how does one continue capitalistic quality to care that markets afford whilst addressing the need for widespread comprehensive healthcare?
The answer was the Patient Protection and Affordable Care Act, otherwise known as Obamacare.
The aim of this law was to increase the quality and affordability of insurance coverage, reduce governmental healthcare costs, and lower the uninsured rate. The act also allowed for more coverage by setting minimum standards and promising same rates for pre-existing conditions. Thus, insurance companies and contributing health businesses could continue operating as a competing market while healthcare could be improved.
The key for any strong GOP platform in 2016 and beyond is continued discussion of cutting governmental healthcare costs and again addressing different types of public coverage. Most are reluctant due to the misexecuted Obamacare, from the technical to the lapses in coverage and ability to exist in the current healthcare mold. Regardless, the financial incentive to expand healthcare cannot be avoided. It may seem counterintuitive, but part of the key to finding a solution is saying yes more than no. Several reports note that administrative costs for any insurance company account for at least a 15 percent of spending. This is the paperwork, the callbacks to see if you are insured, lab reports, etc. It has been proposed to get a more computerized system to cut back on such costs; this would mean a stronger central system between specialists, insurance companies, and government, and the need to get more people into the system. Republican or Democrat, these savings are real and the Patient Protection and Affordable Care Act realizes this in several ways, most importantly by expanding the inclusion of people into a system with discount to administration and costly and ineffective treatments.
Second, if you’ve ever wondered why a quick blood test or any medical treatment costs so much, then you probably didn’t realize that it is in part due to all the other people also getting the treatment. Signed in 1986, the Emergency Medical Treatment and Active Labor Act put into law that hospitals that accept Medicare (almost all of them) would have to provide treatment for a medical condition, regardless of citizenship, ability to pay, or legal status, and would not provide reimbursement. These costs are then absorbed into the hospital and dished out to every patient who can and will be billed. Unfortunately, most of the medical services have to be in dire emergency situations, meaning an illegal migrant worker who comes in for heart pain cannot be treated, but if he comes in with a life threatening heart attack, he must. The heart pain could have been treated with baby aspirin for close to nothing, a heart surgery into the tens of thousands of dollars. Thus, if more coverage for basic treatment is provided there would be a lessening of built-up debt and a more even dispersal of medical costs by alleviating cost-shifting.
Thirdly, the less talked-about field that would have a heavy advantage globally in the next ten years is medical technologies. Producing cheaper and more effective technologies will cut direct cost and medical visit times, improve health outcomes, and could provide an area of national industry where the intelligence exists to produce effective medical devices for use both here and abroad. This, after a decade of biotechnology and pharmaceuticals, in my opinion is the next tech bubble.
What needs to be seen from each and every candidate on both sides is a lack of inclination to give into lobbyist groups and big business in favor of lasting health. The diseases most pervasively plaguing Americans are chronic diseases — diabetes, stroke, and heart disease, to name a few. In most cases these disease are preventable through lifestyle choices such as nutrition and exercise. This is also incredibly intertwined with socioeconomic conditions and hold on public health measures, such as those that Great Britain has undertaken to improve health through media campaigns. Moreover, Cuba, while incredibly poor, has one of the best health outcomes in the world. It is thus not always living standards or quality of healthcare that matters most, but rather access to healthcare and choices made. The regulation of nutrition, of media campaigns, and effort to fund public health assessments are crucial. The candidate this country needs is one that does not work with and around lobbyists; it is one that works for health.
This is not about the right to a happy meal. This is not about a dip in the shares of one company. This is about the health and economic growth of one united country.