2004-11-05 / Columnists

The Progressive

Health Care Delivery
By John Paul Culotta

A few days ago, I was watching commercial television and during the advertisement breaks I noticed the number of advertisements that concern drugs that promise to cure may of the ills of modern men and women. Americans are urged by the pharmetucial companies to ask our doctors for all kind of prescription drugs. There are drugs for weight loss, hypertension, arthritis, allegories and sexual prowess. These advertisements reminded me that for the past few months as a nation our attention has correctly been focused on terrorist attacks, the presidential campaign, Iraq, hurricanes, the Olympic Games, and baseball. At the same time, our pressing domestic issues have not been discussed adequately. The health care delivery system and the role of crony capitalism in that industry in our nation needs to be discussed. According to Dr. Marcia Angell, Americans spent $217 billion on prescription drugs. In 2002, the top ten drug firms earned $35.9 billion in profits-more than the rest of the Fortune 500 combined. Dr. Angell is the author of “The Truth About Drug Companies: How They Deceive Us and What to Do About It.” Drug companies argue that the cost of drugs is high because of the cost of research. Again according to Dr. Angell, in 2002 drug companies spent $67 billion in marketing and $31 billion in research. Doctors are often given incentives (vacations, baseball game tickets, golf trips) by drug companies according to a recent New York Times article. I sat in my primary physician’s office and noticed a number of drug company representatives waiting to see him. For many doctors their only source of medical advances come from drug companies.

Corporate leaders are complaining of the increased cost of medical benefits for their employees. The cost of health care is having a detrimental effect on profits and may also lead to the increased export of jobs to low wage countries. Employees are complaining of the increased cost of their health insurance premiums that are increasingly being shifted to them. At the same time, co-payments for services and drugs have increased. As the cost of medical care rises dramatically, many companies are reducing the amount of services that are covered. At the same time, forty five million Americans do not have medical insurance. Federal employees and their dependents will be offered high-deductible health insurance that will include tax-free savings accounts. The government employees unions and many health care policy experts are criticizing this offer. The New York Times on September 16, wrote: “The critics predict that the savings plans will mainly attract people who are healthy. That, critics say, could lead to higher costs for traditional insurance plans that would be left to cover sicker members.” John Rother, policy director of AARP, stated that for federal employees “it is a potential threat to the affordability of more traditional plans.” In other words the people who need medical care the most will be forced to pay more and in some cases become destitute. Federal employees in Illinois will be offered faith-based health savings plan that will not cover abortion services or contraception. It should be between a patient and their physician as to what medical service is needed. Military personnel also find their choice in care is limited by political considerations. When you look to Europe and Canada, areas of the globe with our standard of living, and their health care delivery system, the lack of adequate health care coverage is criminal. A congressional committee has been assigned to investigate kickbacks hospital supply companies are given by hospitals. Many hospitals have merged and become for-profit entities. The idea (according to the explanation given by the health care industry) was that the larger the entity the more cost savings would occur. These larger entities could negotiate savings from suppliers because of bulk buying of products. The opposite has happened. Of course, much of the funds for these kickbacks come from us – the health care consumer and taxpayer. Physicians complain of medical malpractice insurance premium cost. At the same time, the professions involved have not regulated malpractice properly. Residents are required to work long hours and without adequate rest. Physicians are asked to limit the time they spend with their patients by HMO’s. I often feel that when I see a physician (s) he is rushed for time. Often, insurance companies deny treatments that may be beneficial because of cost. Experimental treatments for patients who have diseases that are incurable are denied. Nurses are frequently required to work many shifts because of short staffing. Some political analysts have noted that the campaign for the referendum that caused former California Governor Gray Davis to be replaced was initiated when he signed legislation to have adequate levels of staff nurses in hospitals. The hospital industry prefers short staffing to keep down costs. Recently, I have visited nursing homes and hospitals and it is clearly evident that the sick could not be properly cared for with the nursing levels in the facilities. Right-wing observers do not want the government involved in health care delivery system. The truth is our government is heavily involved in the industry. Pharmaceutical companies since 1980 have been allowed to buy publicly funded academic research when the discoveries have been patented. The Veterans Administration saves by buying drugs in bulk but Medicare is not allowed to do this. All medical care providers, consumer groups, unions, business, and clergy should demand a more humane medical care delivery system.

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