Healthcare system: the next financial meltdown?

When Tommy Thompson scans the horizon, here's what he sees. "The next catastrophe." Thompson is former secretary of Health and Human Services under President George W. Bush, former governor of Wisconsin, and former Republican presidential candidate. He held a conference call with Kenneth Thorpe, former deputy assistant secretary of policy at HHS under President Bill Clinton and now executive director of the Partnership to Fight Chronic Disease. "Healthcare has the potential of being the next calamity," Thompson said.

They're looking for bipartisan solutions to the healthcare mess, the main solution being to prevent chronic diseases such as diabetes, heart disease and obesity in a U.S. population that is seeing epidemics in all three.

Those conditions stay with a person for a long time -- or until death -- once they hit, and chronic diseases eat up 75% of all healthcare costs. That's three-quarters of the total $2.2 trillion spent on healthcare in the United States. That comes to $1.65 trillion, if my online calculator serves me correctly.

That's more than two Wall Street bailouts.

America can't wait for another segment of the economy to collapse before doing something about it, they said. "There's some concern that given the current state of the economy, taking on healthcare might be too much, too big," said Thorpe. "I would argue the opposite. Failure to act on the issue of making healthcare more affordable is a recipe for disaster. This issue is too important to ignore. As wages slow down and the deficits rise, we've got to find places in the public budgets and in the private sector to make healthcare affordable for families and businesses."

They suggest some major redesigns of the system, including the efficiency of electronic medical records (which Thompson says should be government funded to speed up their implementation) and a team approach, using nurses, nurse practitioners and physician assistants, to prevent and control chronic illnesses.

It's too big an issue, they said, to be anything but bipartisan.

-- Susan Brink

Comments

[Steve Bernard]

I love being an American: we are the wealthiest country, yet we have terrible healthcare. Anyone with a brain can see this is the precursor to using the Shock Doctrine to privatize healthcare even further, and to cut benefits for vast majority of Americans receiving benefits through their employers.

The technique? Create a huge (I mean HUGE) shock to the system (e.g., 9-11, financial sector meltdown), then use the ensuing shock/stupor to push through "reforms" that benefit very few at the expense of many.

Watch Tommy Thompson closely. You'll start to hear him say these sorts of things. It's no different than what's being done in the financial sector.

[David]

The first thing you've got to do is break the hammerlock the AMA has on the number of doctors added to the system each year. The AMA amounts to a trade union with a monopoly on medical services. If you break them, you can increase the number of doctors, foster competition in the system, and reduce costs.

The second step is to loosen 'Certificate of Need' regulation of health care facilities. These regulations have been used for years to keep the number of primary care facilities artificially low, in order to bolster prices.

Remove the government-sanctioned monopoly elements from the health-care system, and costs will decline. Combine that with sensible regulation of the health-care industry, and we can avoid the next meltdown.

[Cycledoc]

There is a bubble in health care. Patent holders abuse the system charging thousands of dollars for medications (up to and over $100,000/year for medications alone in my specialty). These new drugs while innovative so far show only moderate, sometimes no, improvement over more conventional means--with one or two exceptions. Drug companies spend much more on drug promotion than research. Guess who pays?

Health care is a cost plus business with few incentives for providers and insurers to be efficient and little ability of patients to find value. Patients can't knowledgeably shop for care because the info is obtuse and many times emergency care is needed. Companies and providers charge whatever they wish particularly those holding patents which give them monopolies for a generation. Our costs are almost double that of other industrialized nations and our outcomes mediocre.

Health care is already a failure of "free markets." It's failure is manifest in our outcomes and excess mortality. Because of cost people delay seeking care and die.

[DBX]

Problem: we have an epidemic of chronic illness in this country unprecedented in human history and unparalleled in the developed world. As Banks, Marmot, Oldfield and Smith point out in their excellent 2006 article in the journal of the American Medical Association, our rich people are no more healthy than people in the projects in Britain. As for our poor people, we're talking Third World. And you see it when you go to Europe (or keep your eyes peeled for Euro tourists here). 50-something Europeans, unless they're Tony Blair, look like 40-something Americans.

Another problem: our hospitals have run amok with an orgy of construction of new facilities that hospital and insurance networks then refuse to share with one another. Who services the debt of these often duplicated or even triplicated facilities? We, the patients. What do other countries do? They don't overbuild. They have planning authorities that prevent it.

Yet another problem. We've managed to create a private bureaucracy that makes government bureaucracies look efficient. The private insurance industry is an utter drain on our system as presently configured.

Until we deal with preventative health care and diet and lifestyle and planning our facilities and streamlining administration, we're doomed to face unsustainable healthcare costs, no matter whether the system is government or private. And hardly anyone on the left or the right seems to acknowledge this.

[JCA]

Alright, let's get this party started!
Eighty percent of you have made it to around 65...

Now, 20% of you are going to show up with your terminal cancer around 65. You will live on average two months, despite all therapies. If it's diagnosed earlier, you will live longer from diagnosis but you will die, on average, just where you would have if it hadn't been diagnosed. Often you will die just after you start chemotherapy. Chemotherapy is pretty rough stuff but if you die from it's effects, it will save you and your family from a more miserable death and save you a lot of money Mostly your standard of life will be good until the end stage. If you are lucky and have a good doctor, you will have morphine and anti-anxiety drugs and end your life in a one or two week episode of self starvation and self induced dehydration. Better than going out in pain.
Another 25% of you are going to live on to around 75 years old. You will die of organ failures. This is where the metabolic syndrome will kill those of you who were only moderately fat. Here are the heart failures, the heart attacks, the kidney failures, the end stage diabetics. You've had 5-7 years of mostly cheap medicines and lots of expensive tests to "watch" things. You haven't had much in the way of effective therapies because there aren't any. Plenty of theories and promises but damn little that really will make a difference. If you didn't get the diabetes from overweight, don't worry. You can get it later while you are skinnier. You are likelier to have surgery, likelier to get that new device. You take a lot of pills. Most aren't going to help. Some will relieve your symptoms and most of those are drugs your grandparents would have taken. If you knew how inefffective most drugs are, you wouldn't be willing to pay for them. You will have a few "scary" episodes in the hospital. It will be a slow decline until the precipitous fall into death. You will have time to say good bye.
Now, here's the next group. 40% of you will live past 85. You are all going to become increasingly frail and head towards dementia. Fifteen percent of you willl die before 90, that's about 7.5 percent per five year period. Five percent will die between 90 and 95. Then eighteen percent of you will die before 100. And 2 percent of you will live on past 100. . You are mostly in nursing homes. now. You are frail, your medicines aren't really very effective but in theory they may save a life here and there so you shell out lots of money just in case they might save yours. If you were paying cash and were getting the true statistics, you wouldn't buy the drugs. If you had to pay for the hospital care and end stage tests, you'd decline the honor.

So much for end-of-life medicine in the United States. It's big business and big money.

[Stanley J Zychowski MD, Personal Fitness Trainer]

Problem: Almost all doctors live unhealthy and do NOT exercise enough.

This makes it impossible for them to become believable with their patients when they give advice. Wellness problems don't help hospital employees.

People with my qualifications are never consulted.

www.LifeFitnessCoach.org
Stanley J. Zychowski, MD
Nesta certified Personal Fitness Trainer

[Steve Wimer]

Healthcare costs can be contained without denying care. First, stop keeping people alive that have no chance of recovery, that are in pain, and no resources. Second, stop drug companies from selling drugs that don't work as well as natural remedies, which the FDA (arm of the drug lobby), tries to squash. Third, have schoolchildren exercise, not play team sports, with a goal of fitness, not "team play" goals. Fourth, publish calorie counts, and suggest calorie limits, at all restaurants. A bill just passed in California was watered down because the restaurant lobby paid off politicians. It doesn't go far enough. That's why the AHA removed its approval of the bill. Fifth, replace "table salt" with seasalt, real salt. Sixth, limit the amount of sugar in processed foods (and its cousin corn syrup).

[Alan Shore]

My wife, daughter and I moved from LA to New Zealand in 2004. We have amazing health care coverage here provided by the Government. I was in an auto accident a few years ago and needed surgery. The ACC (Accident Compensation Corporation) which is run by the Government paid for two surgeries I needed. In addition, they had a taxi come and pick me up and take me to the doctors/surgeons office. My medications were free as well as is my ongoing physiotherapy. There was a $40 charge for two dinners my wife had while I was in the hospital. They billed me for that. Imagine, leaving the hospital, without paying. Shocking!
Being from the US, I was born and raised on the brainwashing that "SOCIALIZED MEDICINE" is some kind of curse, to be avoided at all costs.
Well, it just isn't so. Our experience here has rivaled anything we ever had in the way of care back in the US. And, not having to worry that if you lose your job, you'll be unable to get health insurance has relieved so much anxiety. It's fantastic.
Oh, our taxes are the same or lower than back in the US. If a country of 4.5 million can do, why can't the US of A?

[josh]

Is it too idealistic to think that if the connection is made between abstaining from twinkies and feeling good physically and mentally that any person would drop the twinkie in a heartbeat? We should be educating people on all the benefits of eating better from an early age. That is the most effective preventive medicine. People do certain things because those things feel good. Eating junk feels good. Eating well feels better. People have to see the connection or they will eat only what feels good to them at any time.

[Stratos]

This industry shares a few similarities to the spotlighted banking industry.
CEO's and higher-ups aren't the only ones getting golden parachutes on dismissal or on moving to another health care group. The business side of medicine is skating under the radar as far as leeching the system, with redundant jobs and exorbitant payrolls to people not on the front lines.
If people think the physician's salaries and shortages are the pressing issues, they are indeed naive. In fact, most physician enter the workplace at the prey of the healthcare industry with a 6 figure debt. Those in primary care will struggle to survive, and will not have the desired doctor-patient relationship that brought them to medicine.
If there is any area that may need future restriction, look no further than health care corporations.

[Tom]

JCA, please, please just take my money I save by dying earlier.

[Emily]

Our health system will be a disaster, for anyone that isn't rich enough to afford good care as long as the top priority for politicians is keeping insurance companies billionaires and doctors multimillionaires and drug companies trillionaires before taking care of people.

Only opening a lot more spaces in medical school and putting an end to private insurance companies will ever give American's decent medical care. We need the kind of healthcare system that most of Europe has and we need to put an end to what the drug companies have done.