The health care system is seriously flawed in this country and getting worse. Many in Congress, especially those within the GOP/TeaParty, want to do more of the same that has created this quagmire. Clearer thinking about what’s involved with a government-funded single payer program could help alleviate the concern many have about their increasing medical expenses.
The main argument being touted by those who oppose single-payer programs like the ones in most every other Western Country, including our neighbors to the north and south of us, is that it will ration care and increase our taxes. There is no real evidence of any consequence that justifies the “rationing health care” claim but clearly taxes will increase if such programs are implemented. Health care after all isn’t free.
This latter fact however really shouldn’t alarm people if they would only look closer at their overall out of pocket expenses they already pay for health insurance and other health care coverage not covered by insurance.
We spend almost $3 trillion nationwide on health care, about twice the average of all other wealthy nations. Our health care system has plenty of problems, but a shortage of money is not one of them. Historically, we in the U.S. have responded to problems in health care by throwing money at them. This mountain of money has led to a lot of wasteful spending.
High health care costs have raised taxes and insurance premiums, depressed wages and eroded public budgets. The more money we pump into our health care system, the worse it seems to get.
We spend so much because we have the highest prices for products and services in the world and often overuse them. Experts estimate that 30 percent of health care services provided in the U.S. offer little or no benefit to patients. SOURCE
That we pay too much for products and services that we overuse was brought to light in a recent “60 Minutes” segment. In Leslie Stahl’s report, Treating Depression: Is there a placebo effect?, research has shown that anti-depressant medication like Prozac has little if any affect on many patients who are treated with this product that rakes in $11.3 billion annually. This information was revealed in Stahl’s interview with the Harvard expert who has done the research.
Irving Kirsch is the associate director of the Placebo Studies Program at Harvard Medical School, and he says that his research challenges the very effectiveness of antidepressants.
Irving Kirsch: The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people.
Lesley Stahl: So you’re saying if they took a sugar pill, they’d have the same effect?
Irving Kirsch: They’d have almost as large an effect and whatever difference there would be would be clinically insignificant.
Stahl: But people are getting better taking antidepressants. I know them.
Kirsch: Oh, yes.
Stahl: We all know them.
Kirsch: People get better when they take the drug. But it’s not the chemical ingredients of the drug that are making them better. It’s largely the placebo effect.
Irving Kirsch’s specialty has been the study of the placebo effect: the taking of a dummy pill without any medication in it that creates an expectation of healing that is so powerful, symptoms are actually alleviated.
What appeared to go unnoticed late in the 60 Minutes report was an example that demonstrated how a government-controlled single payer health care program could eliminate such needless costs and better utilize those funds to treat depression without invasive drug use. Great Britain’s National Health Service (NHS) has changed it practices following its own review of clinical trials with anti-depressants, eliminating the use of drugs in most cases where they serve no real benefit, and redirecting those funds to create jobs by training more talk therapists to bypass the chemical dependency of anti-depressants.
Dr. Tim Kendall, a practicing psychiatrist and co-director of the [NHS] commission that did the review says that like Irving Kirsch – they were surprised by what they found in the drug companies’ unpublished data.
Kendall: With the published evidence, it significantly overestimated the effectiveness of these drugs and it underestimated the side effects.
Stahl: The FDA would say that some of these unpublished studies are unpublished because there were flaws in the way the trials were conducted.
Kendall: This is a multibillion dollar industry. I doubt that they are spending $10 million per trial to come up with a poor methodology. What characterizes the unpublished is that they’re negative. Now I don’t think it’s that their method is somehow wrong; it’s that their outcome is not suitable from the company’s point of view.
Because of the review, new public health guidelines were issued. Now drugs are given only to the severely depressed as the first line of treatment. For those with mild to moderate depression, the British government is spending nearly half a billion dollars training an army of talk therapists.
Further evidence revealed by the NHS showed that physical exercise has an equal curative effect for those on anti-depressants who are classified as mildly depressed. Imagine the costs savings to this program which gets passed on to the taxpayer because of this study and the policy change it effected. Now imagine if there were a single-payer program in this country that severely limited this needless drug for many of the 17 million Americans currently taking some form of anti-depressants. The argument by those who oppose government-managed health care would be significantly weakened.
In fact if you go back to the argument that government-managed health care would “ration” health care you would find that such rationing is exemplified in changes like that with England’s NHS’s decision to eliminate unnecessary products. Much of what is increasing our health care costs in this country are physician prescribed tests and drugs that many patients ask for having been influenced by the heavy commercialization of these controlled medications and procedures.
What all this points to, like the information I shared with you in my last post concerning Merck Corporation’s bogus claims about Vioxx, is that there is a concerted effort in this country in the health care field where private, for-profit interests take precedent over a patient’s need. Also, those governmental agencies that are established to look out after our interests are found to be too friendly and cozy with Big Pharma and the major health care providers in this country, often looking the other way when evidence shows that services and products are being needlessly touted for the beneficial needs of consumers.
Corruption and inefficiency can occur in any effort where large sums of money are involved, public or private. Examples like this show that unjustified expenses which impact high health care costs occuring where private sector policies and practices along with weak and negligent government oversight exist, have negative consequences for American citizens.
Private industries don’t review their practices in ways that necessarily cut consumer costs because it is the profit they seek over any savings for consumers. Only when some outside watch-dog group has spotted this profiteering does the company then either try to justify it or take corrective action. But by then a lot of damage has been done and huge profits have already been paid out in the form of stock holder dividends and executive bonuses.
Medicare and Medicaid have been judged too costly and inefficient in this country by those who champion privatization but research has shown that rising costs are the result of fraudulent claims in the private sector by medical suppliers, some physicians and health care institutions. However, consumers can also be conned into adding to this cost issue. The influences of those companies that manufacture medical devices, pharmaceuticals and provide services, through their direct appeal to consumers on TV, radio and newsprint ads, has increased a needless demand for such commodities that either insurers are expected to cover or must come out of our own pockets. As these unwarranted procedures and medication usages increases, those costs get passed on to us directly in the form of higher premiums.
To their advantage a diligent, certified set of people within the insurance industry can often catch needless health care recommendations, refusing to pay for them and thus help keep overall costs down. But like the pharmaceutical companies and health care providers that they have to deal with, health insurance companies are also motivated by profits and sometimes get too zealous in their efforts to deny services for patients; services that are genuinely needed to save a life. There are also built-in incentives at some insurance companies for employees to deny as many claims as they can through various unethical methods.
A government run health care program that’s always being transparently scrutinized by the public and their representatives is highly motivated to keep tax payer costs down by insuring that only qualified and necessary goods and services are being utilized. What’s key in implementing such a program though is to establish criteria that makes it tough if not impossible for people who serve this government function to have any ties or allegiances to the private sector.
With better access to affordable and adequate health care for all people we become a more productive society and thus set the stage for generating greater wealth for more people. This is something that clearly needs to be addressed as we have slowly watched a once vibrant middle class in this country disappear over the last few decades.
People now sense something new. Something fundamental is wrong, not just if we elect the next guy. That’s a big deal in history when that begins to happen and I think that’s one of the things coming out of this pattern of decay and stagnation. - Gar Alpwerovitz, author of America Beyond Capitalsism
