It’s Not Skepticism Or Caution That Keeps Us From Upending Our Bloated Health Care System, It’s Unwillingness
March 18, 2016
Democratic presidential candidate, Bernie Sanders, relentlessly scoffs at the idea that Wall Street is Too Big To Fail. But it is his proposal to provide Medicare For All that exposes the real industry that is, in many people’s mind, Too Big To Fail—health care. A recent
Washington Post article all but admits this and the Post is not alone in its thinking.Throughout this very long campaign cycle countless politicians, policy wonks, economists, writers and everyday people have characterized Medicare For All as unrealistic or in Hillary Clinton’s recent words, “…too good to be true...” Seriously, how many euphemisms can opponents use to say what they’re really thinking—the health care industry is such a big part of our economy that we can’t change it. They are, however, right about health care being a large part of the U.S. economy in terms of money and jobs.
- Health care expenditures make up 17.5% of the nations gross domestic product (GDP). That means it is basically about 20% of the entire U.S. economy
- We spent a little over $3 trillion for health care in 2014
- The health care industry employs over 13 million workers and is the largest private sector business sector
It’s one thing to be concerned about the impact on the economy if the health care industry undergoes a major overhaul overnight, it’s another to think we should take a break from addressing health care’s growing affordability issues. However, it seems that every proposed change to make our health care system more transparent, accountable and affordable is met with excuses or snark.
Electronic Health Records (EHR) – too expensive to purchase; time-consuming to evaluate and implement; have privacy and system compatibility issues; lack protections for proprietary information
Drug Price Controls – stifle innovation; scare away investors; halt production
Price Transparency – ignores quality standards; too difficult to determine; ignores geographical price differences; limited number of shoppable services to make a difference
Mission Accomplished…
With surprisingly little effort, the health care industry continues to win the battle to maintain the health care status quo. They make sure that any health care reforms strengthen, not weaken, their market position. And although the Obama administration and many state governments keep trying to impose greater health care reforms, they consistently encounter a lack of support from peers. There is this impossible to meet standard that every reform must come with a no negative impact guarantee. This standard only makes sense if we had a well functioning and affordable health care system to begin with. We don’t. And every effort to change that is blocked by the courts, politicians and realist policy wonks and writers.
Two recent examples of how impossible it is to make minor or experimental changes to our health care system involve the state and federal government:
- Gobeille vs. Liberty Mutual – The state of Vermont passed a law requiring health care entities (insurers, self-insured plans, providers) to report health care payment information to the state to create an all-payor claims database and an employer who self-funds their health plan took them to court to challenge the law. The Supreme Court ruled in favor of the employer.
- The Centers for Medicare and Medicaid Services (CMS) – CMS wants to test different drug payment designs to lower Medicare prescription drug costs. Immediately, several Senators came attacked the proposed experiment, claiming it could prevent seniors from getting the drugs the need.
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Denise Perkins
