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Our Sick Health-Care System

Don Rose 13 January 2009 7 Comments

On my way to another chapter in the oddball Odyssey of Burris and Blago—which could be outdated instantly—a friend sent the sad story of the University of Chicago Hospital.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

7 Comments »

  • Dan Kelley said:

    The subject of this article is an important one and needs to be debated thoroughly.

    Some random observations:

    I am personally acquainted with some Canadians who have told me about their friends and family members who have traveled to the USA to receive surgical treatment which they chose to pay for using private funds rather than wait for their numbers to be called several years hence in the Dominion of Canada.

    Michelle Obama has not been licensed to practice law since 1993. All told, brilliant and talented or not, she held her law license for less than five years.

    Many people are going to continue to question whether or not her position at the University of Chicago Hospital was a sinecure created for the same reason that Hillary R. Clinton was encouraged to begin speculating in cattle futures. I suspect that these questions are not going to be answered nor are they going to abate.

  • Goobs! said:

    Don,
    First of all, excellent article on an important subject. Your patronizing tone of the First Lady to be’s qualifications is extremely poitically delicate. You would do well in the Blagoiovich Cabinet.

    So you agree and want single payer health insurance? Is this so people like myself, that have some small pittance of self discipline and do not drink a quart of Coke/Pepsi/Poison a day, nor eat delicious Big Macs on a regular basis, can be forced to cover for all of the fat and lazy folks that do not relish being healthy and active, but instead can rely on us to lift them up – and pay for their healthcare?

    And $300,000 for Mrs. Obama’s help in meeting with some of the less fortunate? This is clearly Pay to Play, and perhaps the CHicago Way will help the old USA now that it has invaded Washington.

    Nope, I like the insurance company and its transparancy, so that I can now see what is paid for my healthcare, along with the high monthly nut that I choose to pay, for insurance, instead of spending that $12,000 er year on HDTV’s and overpriced Bears games.

    Admisnistrative costs reduced how? By a un-incentivized Bureaucrat stamping the paperwork during his slow moving 8 hour shift? I have seen the lack of interest in working in Washington, and Bureaucracy does not work!

    Not sure what you did in the past to get to this point of disilusionment, but I think you should get out in the world a bit more and see what you can do to improve it.

  • Brian said:

    Single payer imposed by the government will REDUCE administrative costs?

    How\’s that, when most of the administration is the result of onerous government requirements?

    Do you know why Medicaid and Medicare cost so little to administrate?

    Because they are fraud ridden. Just wait until \"mental health\" is covered, we\’ll have people flocking to hucksters, claiming a visit and walking out in a minute with a $10.00 bill.

    Uncle Sugar ALWAYS gets fleeced.

    The feds will ham handedly try and \"fix\" health care by reducing reimbursement.

    No one\’s going to go to medical school to make $75K a year. Soon we\’ll be chalk full of quacks from Indonesia, just like the UK.

  • James Hovland said:

    Dan Kelly,

    Have those Canadian friends of yours get you an insurance quote next time their here. Then ask them what they would rather have. Their system, but with what America spends? Or.. Our system with their budget? Do they really think they can get affordable insurance here?

    Why neglect the fact that we spend more and have better equipment? This isn’t Canada. If they spent what we do, they wouldn’t have to wait for anything. It would be like Les Schwab where the guy runs out to meet you. We pay that much more.

    I suppose that doesn’t feed your fear or support your conditioned opposition though does it? Why look to Canada? Their system is not the greatest. I understand that paid propagandists like Devon Herrick have said to only look to the North, but why do you listen? Why not examine France? Norway? Or? Why is it always the bad example that you want to use?

  • James Hovland said:

    Brian,
    Do you honestly expect people to believe what you say? That fraud is why Medicare costs so little to administrate?

    Or, did you not foresee that people would catch that enormous gap in logic in the “Do you know why” lead in to your “fraud ridden” “Just wait” promotion of fear and disinformation?

    You’re either sucking up lot of propaganda, or expecting us too. Either way it’s very sad.

  • James Hovland said:

    Goobs!

    Back up a minute, Single Payer has nothing to do with you paying for someone else’s bad habits. Which by the way, you already do. Your not going to win any debates by stereo typing the opposition as something it isn’t. In fact we have the heath nuts, and the doctors on our side.

    Both systems provide a structure for holding our money until we need care. Single Payer is a very streamline structure.

    With Insurance you pay for… lobbyists, political contributions, anti-government propaganda, Multi million dollar CEO salaries, multi million dollar bonuses, corporate jets, marketing, and…

    …A six figure individual who reviews your request for treatment, in a free market competition where bonuses and advancements are based denial rates. That’s who makes your health care decisions.

    …Another expensive individual reviews applications to determine if people are healthy enough to insure at a profit. They don’t want you if you might get sick, and it’s a big “no way” if you actually need care.

    …There is this Lawyer guy too. He costs us a bundle every time someones bills get expensive, because, if there is any way for the insurance company to get out of paying, that’s the plan.

    Single Payer doesn’t include those problems or expenses and every doctor is in the network.

    For everyone in America to get the Health Care they need, we need more doctors and probably more hospitals. That fact is independent of any system we pick to accomplish universal coverage. More doctors are easy to get. You simply talk about the “doctor shortages” and college bound kids see an opportunity. Society has been shaped like this for a very long time. Make a big issue about it and we’ll end up with too many doctors. Society is not that complex, you just have to know where the strings are pulled from.

  • James Hovland said:

    Don,
    They say: Democracy requires a vigilant public. I think we are starting to get there. Thanks for contributing. I too, liked the plan Kucinich supported. HR 676 would be an excellent place to start, but I think we need ongoing reform to really get it right. Our Democracy needs to be more flexible and maybe not so opposed to each other. For some reason I’m kinda bent on Congress working together as a team, you know, for America rather than for their parties. But our real problems start with Congress being out to lunch with the lobbyists and public opinion being shaped as a for profit service.

    I was promised a government of, by, and for the people. What we have is the governing of the people, by the media, mostly for the corporations. Read this quote from the 1928 book Propaganda, and think about how this effects our Democracy.

    “The conscious and intelligent manipulation of the organized habits and opinions of the masses is an important element in democratic society. Those who manipulate this unseen mechanism of society constitute an invisible government which is the true ruling power of our government.” ~ Edward Bernays

    It worked very well back when TV was high tech, too well, to be exact. We have been held back and kept blind for generations, but not anymore. The world has clearly changed. People are more knowledgeable now than at any point in history. We have access to information like never before, search engines, news archives, global communication, social networks, blogs, and a comment section on every corner. Welcome to the information era, where the people have a voice, and Democracy is rising.

    James Hovland, a product of freedom

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