Save Trillions with Universal Health Care

chapter 1

Medical treatments were on schedule to cost Americans $4 trillion in 2020, (doubled from $2 trillion when I wrote the first draft of this chapter in 2006). Measured by life span, infant mortality, teenage pregnancies, infertility, rates of disease and disabilities, our medical system has the poorest outcomes for industrialized nations, yet they spend far less money per person on their versions of “socialized medicine.”

Our ranking in healthy life span was at the bottom of the barrel for wealthy countries when the World Health Organization measured “disability adjusted life expectancy” in 2000, with Japan at the top of the heap. “You die earlier and spend more time disabled if you’re an American than members of other advanced countries.” Christopher Murray, director of WHO’s Global Program on Evidence for Health Policy said.

Americans aren’t getting great value, since other industrial nations spend less than half as much per capita, while their citizens enjoy better health. No health benefits resulted from $700 billion of medical treatment according to the Dartmouth Institute for Health Policy and Clinical Practice in 2006. Despite this record, most health care reformers focus on symptom tinkering, instead of systemic change. 

Even Single Payer Health Care, with the government funding all medical costs, won’t solve the problems plaguing Americans. It could even worsen them. A Hearst Company study concluded that 200,000 Americans died from iatrogenic (medically induced) causes in 2009. Few of their many recommendations to reduce medical havoc were adopted. A more recent study, calculated between two hundred and four hundred thousand Americans die from Medical Treatment each year, making it the third leading cause of mortality in America, without counting bad nutritional advice and unadmitted deaths. 

Dying is ridiculously expensive. The American Medical Association found that 30% of Medicare reimbursements are spent on the last year of life, with 80% of this in the last month. These costly, medical procedures mainly increase suffering, yet Death Panels to reduce this painful waste, panic patients and industry alike.

Medical bills are an economic catastrophe for patients. Toxic sub-prime mortgages did less damage to the housing market than medical expenses. The Kaiser Family Foundation found that 49% of foreclosures in California were caused by medical problems in a 2008 study, made during the height of the housing bubble meltdown. 

The American Journal of Medicine found that medical expenses caused 60% of bankruptcies in the U.S., whether insured or not. Medical bills are the largest driver of bankruptcy, even with insurance. Medical treatment costs Americans more than housing or food and is a bigger expense for businesses than materials. Private medical insurance is predicted to cost 100% of the average family income by 2032. 

Medical insurance corporations posted 25% profit margins annually before the Affordable Care Act, (ACA) or ObamaCare capped it at 20%, while subsidizing premium payments for lower income enrollees. The medical insurance industry pocketed a quarter trillion dollars profits a year, while millions of sick and injured Americans went belly up with debt. Their cash torpedoed a public option in ObamaCare and they’re still making out like bandits, while crying poor. They pay top executives millions, mainly for shaving costs to increase profits.

Reducing the 20% overhead of private insurance companies to the 2% administrative costs of Medicare/Medicaid is possible. Billing expenses and reimbursement hassles for doctors would be reduced significantly with single payer. Allowing all Americans the choice to buy into Medicaid through state insurance exchanges, with subsidies based on income would provide the most affordable universal coverage, but would require state buy-ins. It would save Medicaid by pumping money in and skewing their patient demographics towards younger and healthier. Nevertheless, many states would rather punish their poor than heal them.

Other approaches to control spending have been plugged. There are pet ideas by political think tanks to slow the rate of increase in medical costs. Electronic billing will shave off a few percent, while further eroding patient privacy. Medical errors cost $30 billion in 2014. Most could be avoided through recommended changes in procedures, yet even surgical checklists haven’t been widely adopted. A standard claims form and identical approval rules would save $18 billion a year.

Malpractice reform might reduce some expenses that hospitals, physicians and insurance companies accrue. This is unlikely to change the practice of over treatment, sometimes called defensive medicine because of those feared lawsuits, because built in profit margins from fees for services of unneeded tests and procedures drive this culture.

Prescribing generic pharmaceuticals and allowing Medicare to practice collective bargaining for drug pricing would save patients and providers billions. Simply use the discounts already negotiated by the General Services Agency for federal agencies. No need for duplication of bargaining processes.

Some of those savings might actually go to consumers. However, these are all symptom tinkering, unlikely to save more than 20% of total medical costs. Even those savings will still bankrupt federal and state governments from the silver tsunami of 76 million baby boomers reaching their golden years in the next two decades.

Projected medical costs for a morbid, aging society spiral upwards, while all signs point to the fiscal cliff American lemmings are headed for. To be blunt, the bankrupting costs from abysmal health of our nation are caused by the American Way of Life, (AWOL). Focusing on creating health, not treating the symptoms would plug the holes we’ve been pouring money into. Most proposed “fixes” only pay for treating epidemics of chronic illnesses and preventable injuries. And then we die, when a natural event is milked for maximum expense.

Americans’ poor health is not primarily the fault of conventional medicine, but they profitably treat the symptoms of a sick and toxic society. The enormous expense of allopathic medical treatment funds politically powerful interest groups opposed to systemic change. The medical industry employs more than eight million Americans, four times the automobile industry. It’s one- fifth of the economy, bigger than the military industrial complex.

Reducing their profits promotes the general welfare, while squeezing an influential chunk of the economy. Illness is their white bread and trans-fat margarine. An array of hospital, physician and medical profession associations, private insurance companies, pharmaceutical and medical supply corporations, mainstream media and advertising/PR conglomerates, government regulators and legislators, along with a slew of academic, scientific, business professionals, and industry funded consumer groups stand opposed to systemic health care reform. These are the modern leeches of medical bloodletting.

Any hope of improving Americans’ health will have to weave through the warp of their intertwined interests. It couldn’t hurt to click your heels together three times while visualizing Universal Health Care, but only an alliance of public health educators, dissatisfied physicians, alternative medicine practitioners and impatient citizens will succeed in cutting through this Gordian Knot while running with sharp scissors.

Alternative practitioners will gladly compete with allopathic medical systems for patients choice in a fair market. Using accurate assessments of health outcomes for specific and/or combined treatments for the major chronic illnesses and injuries that plague Americans, we will prove more effective with lower costs. Some fields will bloom, others wither and dry like seeds in a thorn thicket.

At worst we will offer a cost saving Placebo Effect, better than most medical treatments with less Nocebo Effect. We wager we will do far less damage than treatments reimbursed for that don’t help, only hurt, like many conventional treatments. We will improve measurable outcomes for the major chronic illnesses, prevent more injuries and reduce crisis incidence that modern medicine is more adept at treating while helping to save trillions. We can serve as the gatekeeper for admitting patients to hospitals and clinics we’re unable to help, not vice versa like it is today.

Universal Health Care paid for by charging Medical Mitigation Fees on products and practices that cause illnesses and injuries, with targeted taxation to reduce income inequality is the most progressive plan for saving trillions on medical costs while patching our social fabric and improving health spans for Americans.