Here's What Some Experts Had to Say about Health Care Reform

This was originaly published in the UMass Lowell Student Newspaper The Connector on April 27, 2010.




Professors Offer Opinions about Health Reform

The debate about health reform, which has gripped this nation for the last year, has been filled with issues that probably seem perplexing to many. Even after the passage of the final bill several weeks ago, there still appears to be a lack of understanding about what the bill actually means for many across the country.

After talking to three professors from the community health and sustainability department along with Monica Galizzi of the economics department, it is clear that the university’s faculty can cast some light on this complex topic.

These professors have been spending their entire careers looking into issues that politicians in Washington, and pundits across the country, have been heatedly debating for months.

Particulary there seemed to be a general agreement between all four professors that while the reform is historic, it does not go far enough to address some of the most fundamental issues within the present system.

For example, A. James Lee, an economist who has held various positions within the government, private and non-profit sectors analyzing health care’s cost effectiveness, offered an observation of how money is spent on health insurance when he said, “As much as thirty percent or more of health care services being provided today are either unnecessary or possibly dangerous…with the current financial relationship providers get paid more for doing more.”

His assessment is related to a growing, but rarely discussed, consensus amongst health economists that the current methods of reimbursement for health services are unsustainable.

Prof. Craig Slatin, whose primary area of research is public, environmental and occupational health policy, sees this issue and other financial inefficiencies within the system as a result of the negative influence of those who profit from it. Discussing the insurance, pharmaceutical, hospital and high-tech medical equipment industries, he said “the system’s designed to support the financial needs of those sectors… what the bill barely did was to remove their clout.”

Despite this criticism, he did see the bill as a step in the right direction. “It’s a major shift in how we’re thinking about health care. It says that running a system that neglects 50 million people outright… that’s unacceptable,” said Prof. Slatin.

Prof. Slatin sees a single-payer system, like in most other western countries, as the only solution that will begin to effectively address this issue of the uninsured along with cost control issues. This type of system features everyone in country being provided with health insurance paid for by the government through tax revenues.

He noted that single-payer would do the most to reverse what he sees as the most fundamental problem with the current system; namely too much focus on individual choices and not enough focus on environmental and financial issues, which have been shown to have a statistically high effect on one’s health.

However as Prof. Carlos Eduardo Siqueira, who is also an advocate for a single-payer system, explains this solution was “off the table” from the beginning of the debate about health reform.

He added that even a public option, a non-profit government run insurance alternative, did not make its way to the final bill, despite wide public support.

Prof. Siqueria suggested that a public option may have been an effective method of cost control. Prof. Lee was slightly more skeptical casting it as a “red herring” in the debate unlikely to have much of an effect.

Additionally, while discussing about a portion of the bill which mandates everyone in the country be insured, Siqueira said “We should provide [health insurance] as a right to people; I would prefer that you had rights instead of mandates.”

Prof. Siqueira, who was a practicing physician in Brazil for years, was hesitant to compare the two country’s health systems due to the enormous gaps in wealth between them. He did say that Brazil, which has a single-payer system, does a very good job insuring its citizens despite rampant poverty.

Nevertheless there have been numerous arguments made that single-payer or any more government involvement in health care would bankrupt the nation.

Prof. Monica Galizzi, an economist who specializes in labor economics, has some doubts about a congressional budget office study which determined that the bill would reduce the federal deficit over the next decade.

However she noted that when deciding how to allot money for health care, the question of how much value a society puts on health must be dealt confronted. She added that personally she viewed health care as “a basic need.”

Yet Galizzi who comes from Italy, another single-payer country, understood that there was not wide acceptance of the notion that health care is a basic need in the United States.

While thinking that single-payer is an effective method of insuring a country, she doubted whether implementing a similar system would be possible in the United States. She views this as a result of “[ideological] resistance about government intervention as well as a traditional reliance on the free market. It would be something very difficult to sell here.”

Offering a slightly different opinion about the reason that the fight for health care for all Americans, an almost century old fight, has not succeeded Prof. Siqueria suggested it was due to the power and influence of private insurance companies, “They are becoming oligopolies… They are not allowing the country to have options that many other developed countries have.”

A Response to Ron Paul on Health Reform

A few weeks back Ron Paul made a very interesting speech about his stance on health reform. Now I find a lot to admire about Ron Paul, he is willing to discuss the deficiencies of American foreign policy, he was a big supporter of third-party candidates in the 2008 election and he generally avoids towing the party line. However in this speech, in which he lays out 17 points against health care reform, I find one of the most major flaws in his positions exemplified, namely his unwillingness to challenge corporate power.

If you click the link you can read his arguments and I will provide some brief responses to them.

1. If one assumes that an individual does not have a right to health care then you are assuming that someone's right to property comes before that right. Meaning that property is given a higher value than life and health.

2. This assumes that a government run program will not function with the interest of the people in mind. Although government has proven that this is often the case, through neglect of the public interests, a government run health care program should be the opposite of this neglect. Certainly a non-profit government problem would care for its recipients more than health insurance companies who function only for their own self-interests and profit.

3. This statement is historically false. Any significant government entrance into the health care industry has been denied since Teddy Roosevelt first introduced the idea and Harry Truman later made the first strong push for it. These possible reforms have repeatedly been halted through health insurance companies cries of socialism.

4. There are numerous efficiently run government-programs, including medicare. To argue that governments providing any service creates an inherently flawed system is to argue against some of the most fundamental American institutions.

5. I concur with this statement.

6. I concur with this statement as well if (as he most likely is not) referring to laws that favor private insurance companies monopoly over the health care industry.

7. I do not believe that inflation has a lot to do with this debate.

8. Bureaucrats should never interfere with health care as they do in numerous way through the current system, where most insurance companies pay individuals to search for pre-existing conditions through which to deny care. In a single-payer health care system (which there has been no significant fight for by congress) a person would be provided care by a hospital or other health institution and would not have to be approved for care as the current system does.

9. I agree with this statement, with the understanding that it would do little to change the current system. For people to really begin spending less money a non-profit entity is necessary.

10. The cost of litigation is a relatively insignificant aspect of the money most health care providers spend. The government should not take steps that defend medical practitioners who make mistakes that harm their patients.

11. This is one of the most common talking points used by insurance companies when making arguments for their forms of 'reform.' I don't see why this shouldn't be done, but it would do little to lower health care costs as most companies from state to state follow the same business model.

12. I concur.

13. Health insurance is fundamentally different than most other forms of insurance in that it affects individuals, and by extension society, very directly. Individuals often find it difficult calculating risk with regard to their health. Insuring everyone some form of cheap insurance will ensure that people are not weighing the financial burden private insurance will put on them against the risk presented by not having it.

14. I agree that the insurance industry does have an all too close relationship with the government, but this relationship primarily takes the form of the government allowing massive insurance company bureaucracies to exploit their customers.

15. I believe that the usefulness of fines is certainly debatable especially when they are being forced on the most poor, but when one considers this one must also consider the fact that those without health insurance often incur more costs upon themselves and society when they are injured or fall ill. Fines are simply a patch and do little to fundamentally change things.

16. I concur.

17. I concur.

Ron Paul in his speech presents some of the most common and most influential arguments against reform. I think common ground is possible in this debate, but not when the interests of the majority of the citizenry are ignored.