Essay: Hospitals in Crisis - 2.26.09

We have a health care system that for years has been held together by the equivalent of twine and paper clips, coupled with what used to be called “benign neglect.” That’s also known as the ability to overlook the millions without any health care coverage at all.

I personally have what we used to call Cadillac coverage through two different employers, but I know lots of people without any coverage, primarily my students. Now, as layoffs mount, there are a lot more of these. President Clinton was elected seventeen years ago on a platform of providing universal health coverage, and blew it.

I have been trying ever since to decide who I am angrier at: The health care lobby, which successfully managed to destroy any prospect of expanding coverage, or the Clintons’ ham-handed attempt to ram through a complex system nobody really understood.

When it was all over, I heard then-Senate Majority Leader Bob Dole say that if Clinton had tried merely to provide some form of coverage to the totally uninsured, it would have passed.

Now, the problem has gotten worse, and the cost to fix it will be much higher. I know upper-middle class people who have waited more than a day in suburban hospital emergency rooms.

When, three years ago, I stepped on a dog bone and broke two toes, I decided not to go to the emergency room because I didn’t have that kind of time. Instead, I went to a walk-in clinic because I could afford to pay to do so. That was a small sacrifice to make.

But we are facing a far more ominous problem.

Michigan has more than 140 hospitals, and they are now losing money on patient care, according to the Michigan Health and Hospital Association. Accordingly, a survey by Crain’s Detroit Business found, they are laying off workers, cutting services, and delaying projects.

The hospitals will tell you that none of this affects the quality of patient care, but common sense will tell you that of course it must.

We as a society face an eventual choice. The medical community could stop providing uncompensated care. We can let the homeless mother give birth by herself in the street, and let the uninsured gunshot victim bled to death. Or we can join the civilized world, and provide some form of universal health care to everybody. They do this in a far-off country called Canada. Back when the Clintons were trying to reform health care, I went up there and looked at their system.

We’ve been sold a lot of negative and false propaganda about it. Yes, there are inefficiencies – some of which could be fixed.

Yes, they do have to wait longer for some specialized treatment. But in the main, for primary care, the Canadian system works very well for most people most of the time. I happen to believe we could take that system and improve on it. Meanwhile, in this country we have more and more people who are being involuntarily switched to America’s no health care plan. Sooner or later, socialized medicine may not seem so bad.

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Comments

[Anonymous]

There are a number of sensible, meaningful healthcare reforms that have been militantly opposed by Democrats.

One is medical malpractice litigation reform. It is a significant driver of healthcare costs in many ways. Inusrance costs and premiums rise. Health care providers are distracted by ongoing litigation. Health care providers are effectively discouraged from practice in areas that are in dire need of medical services but which are also litigation hell-holes. Places like Wayne County. Medical malpractice litigation also drives another aspect of cost; defensive medicine.

All these (and more) are costs of our medical malpractice litigation system. When people like Jack Lessenberry or Michael Moore raise "Canada" or "Western Europe" as models for a reformed American medical system, one might ask whether there are counterparts to Geoffrey Fieger in Canada, Sweden, or England. Do those countries have a history of tort verdicts for individuals of $10, $20 or $30 million?

Michigan, remarkably, has done a pretty good job of reforming its malpractice litigation system. Much more can be done, but no one should ever forget that what progress we have made was by the hard work of Republicans, over determined Democrat opposition.

Now, after the election last fall in which Democrat trial lawyers funneled thousands of dollars into the campaign of Wayne County Judge Diane Marie Hathaway, and the State Central Committee of the Michigan Democratic Party financed the infamous "sleeping judge" ad which featured phony staged "video" of the false story about Chief Justice Clifford Taylor's supposedly sleeping while on the bench, we now have a state Supreme Court in which much of that reform is threatened. Or so the Democrats' trial lawyer backers hope.

But Justice Hathaway will likely do no good for medical costs in Michigan.

And for those who say that malpractice awards, and case filings, are drastically "down" in Michigan, those Engler-era reforms are why. We'd be in far worse shape, now, without those pre-Granholm reforms.

[Anonymous]

The grand subject of medical cost containment is beyond any single essay or comment.

But one simple fact is worth noting: there are some areas of health care in the United States, in which costs have been driven down.

It is amazing, actually. When we see costs rising almost everywhere in national health care, mostly at rates well above the general inflation rate, to think that there are areas in which costs are holding steady or decreasing, is a stunning fact.

So in what realm of health care are costs well controlled? It is the general area of elective and uninsured surgery. Things like Lasik eye surgery, cosmetic surgery and other elective surgeries. And why are costs coming down? Simple. Consumers of those services are paying the first dollar, and quite often the last dollar, for services rendered. The providers are in a competitive environment. There is cost competition. They must compete on price, and on service. Providers are encouraged to develop and make effective use of the newest technology to aid productivity. All of the things, in other words, that we'd like general hospitals to do.

Just maybe, what we need is not more "insured" Americans, but fewer. More Americans watching their own health care bills, deciding how much defensive medicine they really want to pay for and how much they feel they'd like to pay, and who they'd like to buy their health care from.

[Thrasher]

I have worked in the malpractice insurance industry and greed is what drives the costs not the juries. Defense counsel rips off policy holders just as insurance carriers rip off policy holders.

Truth is insurance companies pay only a small faction of collected premiums in claims..Many of these insurance companies have convinced policyholders to not file claims or have a large deductibles these policies actually make money for insurance companies and allows them to waste money on wall street seeking investment income..

The health care industry must be nationalized for all americans to benefit from quality health care..

Fact is the best heath care is not praticed in suburban venues and the morbidity and mortality rates reflect this truth..