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Americans favor changes, but both plans likely to encounter opposition.
Sunday, August 24, 2008
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DAYTON — Neither plan proposed by Barack Obama or John McCain will fix this nation's health care system woes, local doctors say.
Dayton internist and Beavercreek resident Dr. Richard Wyderski believes the best way to rein in health care costs and provide coverage for all is through a single-payer system, taking for-profit insurance companies out of the equation.
"I endorse an expansion of Medicare as the best solution to our health care dilemma, although there doesn't seem to be a lot of debate about that option," said Wyderski, who teaches at the Wright State University Boonshoft School of Medicine's Center for Global Health Systems, Management and Policy.
"There's a lot of vested interest in our current system," he said, "and everybody's afraid to make major changes to it."
Democrat Obama promotes universal access to health care, not guaranteed coverage. If consumers can't find a private insurance plan, he would offer a new public plan much like the one that covers members of Congress and charges income-based sliding scale fees.
Republican McCain would offer tax credits — $2,500 for individuals and $5,000 for families — to offset the cost of insurance. Consumers would purchase a plan of their choice anywhere in the nation and the feds would send a check directly to the insurance provider. More choice, more competition, more cost savings, the reasoning goes.
Surveys show America favors major changes, especially as all the usual statistics associated with health care in the United States continue to rise: total spending ($2.3 trillion in 2007), health insurance premiums (up 6.1 percent last year) and the number of uninsured (47 million).
Eight in 10 Americans believe that the U.S. health care system needs to be changed or completely rebuilt, according to survey results released this month by The Commonwealth Fund.
A majority of physicians — 59 percent — now support government legislation to establish national health insurance, a dramatic shift from just five years ago, Indiana University researchers reported this year in the Annals of Internal Medicine. Also, the nation's largest medical specialty group, the 124,000-member American College of Physicians, endorsed a single-payer national health insurance program for the first time in December.
Under a single-payer system, a government agency would collect all health care fees, pay out all health care costs and guarantee coverage for everyone, according to Physicians for a National Health Program (pnhp.org). Advocates argue such a system would save money by reducing administrative waste and marketing costs and eliminating multimillion dollar salaries for CEOs of for-profit health insurance companies.
Nonsense, says local colo-rectal surgeon Dr. Deepak Kumar, past president of the Montgomery County Medical Society and current member of the state medical board.
"People think, 'All I need to have is insurance and if I have insurance everything is going to be fine.' That really isn't true. How many people have insurance and they're not happy?" Kumar said. "Just because you have insurance doesn't mean you're going to get the care you need and the care you deserve."
Kumar said Obama's and McCain's plans just tinker on the surface. What's needed, he said, are "wholesale" changes in the way individuals and society manage health care. It begins with personal responsibility, an active, vested participation in one's health care and a desire to do that in a cost-efficient way, he said.
"We have a mind-set: What the public expects is they want the best health care, they want the best drugs, they want the best technology, they want it yesterday," he said. "And the irony is they want somebody else to pay for it and they want someone else to determine how much to pay for it."
In Kumar's world, people would have expanded health savings accounts that would pay for general health care. They would back that up with a health plan that would cover catastrophic illnesses and injuries. Also, the government would sponsor free clinics where people could get preventive health care checkups, screenings and tests so no one would have an excuse to not seek care. The for-profit elements in health care would remain, but with greater scrutiny and "restrictions on how profit can be generated."
"Both of them have some good ideas," Kumar said of Obama and McCain. "The details are lacking."
Contact this reporter at (937) 225-7408 or agottschlich@DaytonDaily
News.com.
National health care spending
Total spending in 2007: $2.3 trillion, or $7,600 per person.
Projected to increase to $4.2 trillion by 2016, or 20 percent of the nation's gross domestic product.
Amount spent on administration and overhead: 31 percent
Average annual premium for employer-sponsored health plan: $12,100. Worker's share, $3,300.
Premiums rising four times faster than earnings since 2000.
Source: Federal and industry statistics compiled by The National Coalition on Health Care (nchc.org) and Physicians for a National Health Program (pnhp.org)
