AUSTIN, Texas -- Bet you if I had a nickel for every time
someone has started an article or a speech in past five years by saying,
"The nation's health care system is facing a crisis," or, "Our health care
system is falling apart," I would be a rich woman today.
I suppose I could come up with some dramatic metaphor for the
crumbling, tottering, greed-rotted structure, but hey, why don't you check
out your health insurance premiums and see how you're doing? Up by 12
percent, 22 percent, 40 percent?
Larger premiums, higher deductibles, increased payments for
prescription drugs? Employer dropping your coverage? Are we having fun yet?
Our money-corrupted political system isn't about to address the
systemic problems. I think it's almost self-evident that a single-payer
system is the best answer to all the problems, but since we have to deal
with political reality, let's shelve that plan for now. Last time anyone
tried to do anything about the whole system -- Hillary Clinton with a
not-very-good plan back in '93 -- she was shouted down by $10 million in
insurance company ads, still the record for the most money spent ever to
defeat a single bill.
Now, we've got 41.2 million Americans with no health
insurance -- 14.6 percent of us -- which ends up costing us more than it
would to pay for their insurance. We pay the world's highest health-care
taxes. Our government spends $2,604 per capita, the highest of any nation,
including those with national health insurance, even though only a quarter
of our population is covered by government insurance.
We spend 13 percent of our GDP on health care, the highest in
the world. The average in the European Union and in other developed
countries is 8 percent. According to the Organization for Economic
Cooperation and Development, we spend a total of $4,600 per capita for
health care, more than twice the average of other countries. We ain't
getting much bang for our buck, either. Forget the "we have the finest
health care in the world" claims. In both life expectancy and infant
mortality, we're below the median for developed countries.
If you stand back and look at the fiscal crisis in the states
and cities, you will see that almost all of it is driven by health-care
costs. Naturally, the strapped states and cities can't think of anything to
do except start knocking people off Medicaid and the new Children's Health
Insurance Program (CHIP). That just means they wait and get sicker before
they finally end up in the emergency rooms, costing us all more money in the
long run.
Sometimes the sheer stupidity of our choices is amazing.
One chunk of this insanely complicated system the politicians
are now preparing to tackle is medical malpractice costs. "Med-mal," as it
is known in the trade, is currently the subject of a particularly fruitless
pissing match between Republicans and Democrats over whether the trial
lawyers or the insurance companies are to blame for astronomical increases
in premiums. This is complicated by the fact that trial lawyers give money
to Democrats and insurance companies give money to Republicans.
We've all heard of ridiculous lawsuits by trial lawyers looking
for a buck. The insurance companies have well-funded campaigns to publicize
idiotic suits -- they do not publicize it when the suits get thrown out of
court. Of course, we've all heard of ridiculous medical mistakes, as well.
It has never been clear to me why the American Medical
Association goes along with blaming trial lawyers rather than insurance
companies when their malpractice rates skyrocket. The fact is, malpractice
is committed by a tiny percentage of doctors -- 5 percent according to Publi
c Citizen -- and the AMA could save itself and everyone else a lot of
trouble by getting rid of them. In Texas, we've had zero doctor's licenses
revoked because of medical errors since 1997, despite 6,038 medical
malpractice claims reported to the state, including 150 times surgeons
operated on the wrong part of the body.
Of course, trial lawyers do drive at least a part of med-mal
costs, but if you examine the competing claims (under the Bush
administration, you have to be wary of government data because it
increasingly uses only insurance industry figures), the insurance industry
is the primary villain. (If this were a lawsuit, the trial lawyers would
figure out how much blame to assign to each of the parties to the last
decimal point.)
According to The Wall Street Journal, the insurance industry is
jacking up prices not just because their investments in the stock market
have fallen dramatically, but also because they fouled up their pricing
practices in the early '90's. They seriously underpriced med-mal and are now
trying to recoup, and for this they blame the trial lawyers.
California is an interesting case in point. The state passed a
tort reform bill, limiting what one can recover in a lawsuit, in 1975 and
waited expectantly for insurance premiums to go down. They nearly tripled in
the next 12 years, finally leveling off in the early '90s. And, amazingly
enough, California just happened to have passed strict insurance regulations
in 1988.
To find out more about Molly Ivins and read features by other
Creators Syndicate writers and cartoonists, visit the Creators Syndicate web
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