Our Sick Health-Care System
On my way to another chapter in the oddball Odyssey of Burris and Blago—which could be outdated instantly—a friend sent the sad story of the University of Chicago Hospital.
The hospital is about to trim $100 million or 7 percent of its budget by laying off hundreds of employees because of the economic downturn.
Very sad. Who wants to see hundreds more unemployed in the Chicago area?
But a bigger question comes to mind:
The Tribune reports that the budget and job cuts—including 15 “senior executive” positions—will not affect medical care.
If they don’t affect medical care, why the hell were they there in the first place? Medical care is the hospital’s mission.
Among those big-money positions is one held until recently by Michelle Obama, who was paid $300,000 yearly for a Southside community outreach program—presumably a useful project. But the hospital said her role will be absorbed by a “longtime executive vice president for strategic affiliations and external affairs.”
So if that work can be folded into another guy’s, why was it separate in the first place?
This not to suggest patronage was at play, creating a position for the spouse of an incumbent senator. Nor is it to denigrate her capabilities: the brilliant, talented Ms. Obama easily could make triple that pay at any law firm.
Rather, it strikes me that perhaps a separate job was not crucial in the first place—like so many administrative gigs permeating everything from the school system to the banking industry. They add costs without justifying their existence.
It is especially toxic when payroll padding makes our health-care delivery system more expensive. Add up all those needless millions in salaries and you realize why a hospital charges you five bucks for a couple of aspirins.
Well, they won’t bill you if you’ve got insurance. They’ll bill your insurance company a nickel or a dime.
I’m not kidding. I recently had some tests done at Northwestern Memorial Hospital. They sent me a bill for $1,653 for the lab work alone. Fortunately, I’m on Medicare, so the bill was forwarded to my government.
They asked the government to pay only $68.05, as they would any insurance company.
Something here tugs at what remains of my sanity.
If I were an ordinary working person without insurance—earning too much to qualify for Medicaid—I would have been screwed financially.
But I have one of the best government programs ever—along with Social Security. The government is not my doctor—it is my insurance company and a damn good one at that. I happened to rack up a lot of medical bills last year—halfway to six figures in “official” billings—but actually paid only a pittance. (I’m just fine now—thanks for asking.)
All of which gets me around to argue again for a single-payer national health insurance program for everyone, not just old farts like me. It’s a system akin to Canada’s and Sweden’s—not the British plan where the government employs your doctors.
The bloated budget of the UC hospital—which is cited only as an example—is one reason why the administrative costs of American health care run at least 30 percent, compared to Canada’s 17 percent.
Under single-payer, hospitals would receive a global budget annually and have to stick to it—eliminating all or most of those cushy administrative jobs. Everyone would have to stick to the business of caring for the sick.
Doctors would earn their pay one of several ways, ranging from fee-for-service to working for a hospital to being part of a health-care group.
Administrative costs would be reduced dramatically and further savings realized because of centralized administration.
Getting rid of employer-based health insurance would make a lot of industries very happy. In Detroit it would reduce the cost of making a car by more than a thousand bucks. Yes, there would be higher taxes—but spread more equitably.
Unfortunately the health plan Barack Obama outlined in the campaign was weak and employer based; Hillary Clinton’s was barely better. Dennis Kucinich got it right from the start. (I mentioned this earlier.)
Considering the current economic upheaval, perhaps the Obamans will rethink it all. It’s long past time to stand up to the insurance companies and their allies in Big Pharma.
Never too late to get it right, Mr. President Elect.
Don Rose is a regular contributor to the Chicago Daily Observer