Friday, February 19, 2010

National Health Care Conversations

This morning I was privileged to sit through the first "National Conversations" forum put together by Indiana Wesleyan University and co-sponsored by the Sagamore Institute, Christianity Today, and WFYI in Indianapolis. Here is the website, where you can watch the "civil conversation" today on health care.

It was very enjoyable. Knowledgeable people on multiple sides of the issue. Former Mayor Bart Peterson was the only one I had known of previously. There were advocates for removing state boundaries on buying insurance, advocates for reducing the way doctors are paid, advocates for innovation in rewarding wellness, advocates for a long term solution and not just a short term fix...

I really liked Peterson and am sorry he won't run to replace Evan Bayh. He basically said that both extremes are unconvincable and that we should be working with the moderates on both sides of the isle toward solutions.

I did have a typical dream, for which I would like to give credit for the inspiration to my nephew Alan Garcia. One of the complaints by the Dean of the IU Med School is that doctor's accumulate a debt of about $150,000 in school. Yikes! What about a med school that made you a nurse first and then a doctor? You would work as a nurse and get paid well for it while then going on to be a doctor.

I also had other brainstorms. Teaching hospitals associated with universities where this scheme was implemented, with salaries rather than pay according to how many tests you perform or patients you see.

One of the most interesting bits of data from the day was the fact that Americans pay more than any other nation for our health care and get significantly less health care for it. In other words, the amount of money we currently pay for health care would be enough to insure everyone in America if we had a health care system like any other developed nation in the world (Canada, Germany, Britain, France, etc...). Also, I forget the statistic, but some outrageous number of tests we have done here (30%?) are unnecessary.


Rick said...


It's difficult to feel sorry for a physician with $150,000 in debt when they expect to be paid that much their first year of work. I'm far from an expert on such things, but it sounds like a pretty good business deal.


Angie Van De Merwe said...

I found it interesting that Europe was mentioned several times as an "example" for Americans to follow. And yet, they are going bankrupt, just as we are. How is that a exemplary example to us? Have you ever experienced their healthcare system?

I thought the Chamnber of Commerce person was a little "soft spoken" esp. since they are for the "free market system"..

Ken Schenck said...

The stat that most stood out to me was that Canada insures its entire population for a third of what we spend on the equivalent number of people. I also remember it being said that Americans were more individualistic than Europeans, that Europeans do not consider it a loss to have less self-directed care so that everyone can have basic health coverage.

I had a little experience with health care in England. One nice thing was that you didn't have to weigh the cost of a visit to the hospital with how seriously you were hurt. Most of us think very, very long and hard about going to the hospital, even when we have insurance. They feel free to go as need arises.

I remember when a friend got hurt playing Rugby in England. In America we probably would have waited a while to see how serious his injury was. There we just took him to the hospital, checked him out, and left. No big deal.

It is interesting that we are the only developed nation that does not have universal health care. Christians in Canada, England, France, Germany, Switzerland, Finland, Sweden, Norway, Japan would no doubt laugh at the suggestion that they are part of some communist plot or that their health care system is unchristian.

I don't know what we should do--I'm not knowledgable about the specifics. Maybe we can do better than all these nations, although intelligence and entrepeneurship is not something I've observed in our leaders in this discussion--on any side.

Angie Van De Merwe said...

YES! People DO tend to spend other people's money more readily than they do their own!!! THAT IS THE POINT!!! People won't give second thought to going to the hospital or doctor's office. That is why it takes SO long to get seen, long waits. I have had experiences in Canada, Holland, and England!!!

The more people being seen the less there is to "go around" to maintian costs, thus the less people will get the tests, EVEN when they need them!!! So, we will get to go to the doctor and wait a long time to get an asprin, so to speak!

The private sector is the most productive BECAUSE they have incentive to produce GOOD QUALITY healthcare, AND make a profit, to boot. Just let competition take the steering wheel...and let the government grant across state access to insurance overage!

Socialism has never been an answer! This is why the more socialized Europe has gotten (after the EU and euro), the more problems economically!

Angie Van De Merwe said...

BTW, Wim's Dad went into the hospital with routine surgury on his veins. But, when there were complicatons, we highly suspect that nothing was done. He was in his 70's. It would have been a simple procedure to perform and he would have been fine...Of course, no more litigation, either, to hold doctors accountable...(although I do believe that America is too "sue happy"...)

Ken Schenck said...

I'm sure there are stats on these things. I have IWU coverage and IWU pays an awful lot for it, but I'm not convinced my health care is really any better than it would be in Canada. It takes weeks to get in to see my doctor or dentist. The first visit is usually worthless with some meaningless placebo prescribed, then I have to wait again for several weeks to get in again. I still end up paying hundreds of dollars in copays. I get tricked every once and a while as the insurance company plays a shell game with who is in and out of network (I'm currently paying off a thousand dollar bill for a colonoscopy because I believed the hospital when they said they were in network).

Frankly, I'm not convinced we have the best health care in the world. Certainly I don't think we do on average. I'm open to being convinced to the contrary, which makes me unusual for an American these days.

Jason said...

Thanks to Tea Party Paranoia, it's probably impossible to convince most Americans that a single-payer healthcare system as seen in many European states is NOT socialism. America should adopt a hybrid form of universal healthcare that keeps privatized systems intact. The way to do this is by getting rid of the incentive for private insurers to deny care. We should look to the Netherlands for how this is done. A government tax pool is set up to pay out private insurers who pay above the other insurers in health care costs (this happens when they take high-risk, high-care, or no-pay individuals). Surpluses in this pool occur often, which goes to the benefit of the private insurers. This leads to the nutty situation where the private insurers are actually COMPETING with each other to take on the sickest and poorest patients! Government-sponsored websites are set up that chronicle how well any one particular insurer, doctor, or hospital perform (information supplied by users of those services), and customers can drop their insurance at any time with no fees in order to go with another carrier (insurance is still required by law). So performance and patient satisfaction is important to the private insurers. Are these things important to America's private insurers? That's laughable. The only thing that matters to American insurers is profit. When profit is favored over patient satisfaction, we have a broken system. If it is cheaper to lose a paying customer then treat his/her condition, then we have a broken system. We would be wise to consider adopting a similar system to the Netherlands. They rank consistently in the top ten for world healthcare performance and there's no question why. France, Australia, Spain and Italy also perform consistently well, but theirs are the more "socialist" forms of single-payer. Although calling these systems socialist is like calling public schools or fire departments socialist --more Tea Party paranoia.