Better care, lower costs abroad

BY CLARE HOWARD

John Parks has no hesitancy labeling himself a conservative, but he’s adamant the current health care system in this country is broken, and the best solution is a single-payer plan providing universal coverage.

Parks, 70, has the personal experience and analytical understanding to support his contention. He has no recent health issues, but an experience nine years ago informed his opinion.

After a career at General Motors and Caterpillar Inc., he left the corporate world and became self-employed working on the design of an electric car. With his departure from the corporate workforce, he lost group health insurance. He bought his own individual health insurance, but he’s always been healthy so he bought a plan with a high, $5,000 deductible.

In 2008, his doctor told him he should probably have a hernia operation.

“So I thought I’d call around and get prices,” he said.

One local hospital quoted him $20,000 for the room alone and the surgery was an additional cost. Parks decided to expand his research.

He found Shouldice Hernia Centre in Ontario, Canada. The hospital is a world leader in hernia repair. Founded in 1945, the hospital has a success rate of 99.5 percent.

Complete cost for room, surgery and related expenses was $3,900.

“That was less than my $5,000 deductible,” said Parks, who also had enough frequent flyer miles to cover the round trip airfare.

“John Travolta went to Shouldice. People go there from around the world for excellent treatment,” Parks said. “The day after my surgery, I was encouraged to walk around the grounds of the hospital. Beautiful gardens.”

He said the Canadian patients he spoke with were enthusiastic about their national health care system. Some had to wait up to five weeks for their surgery, but they were not upset. Parks, however, was scheduled quickly.

“Our system is so screwed up,” he said. “We need a system more like Canada. Single-payer, universal coverage. More like Medicare for all.”

He said universal health care reflects American values.

“When people are financially destroyed and lose their life savings and declare bankruptcy because of medical costs, that’s un-American,” he said.

Parks was drafted during the Vietnam War and went to Fort Knox and Korea. He is eligible for V.A. care.

“All veterans should just be given a Medicare card,” rather than having to access separate V.A. care, he said.

One complaint he has, however, is that the Affordable Care Act is too complicated.

A major reason for that complication was trying to meld private and government funding in a way to gain political support. However, even when the ACA was crafted to reimburse states for added costs of expanding Medicaid, 19 states declined the subsidy and chose instead to leave low-income people unable to access coverage.

Retired pediatric cardiologist William Albers has been a student of the American health care system for decades. He supports single-payer plans.

“No country is able to provide universal access to health care without some government involvement,” he said. ”Switzerland comes closest, but it has the individual mandate. We are the only industrialized country without universal care.”

The individual mandate is necessary to require that everyone enroll in a health insurance plan so risks can be spread among the entire population. Without an individual mandate, risk is concentrated among groups of sick people, creating a financial burden that destroys the concept of insurance.

One conservative Republican legislator railed against the individual mandate and praised the proposed Republican replacement plan because it would give people “freedom to go without health insurance.”

Albers said a significant portion of American health care, nearly $600 billion a year, is the cost of marketing, administrative expenses and profits. Even not-for-profit health care providers need to focus on the bottom line, he said.

The Canadian system is based on private physicians and hospitals but public financing.

Albers said he was very disappointed that insurance companies made huge profits under the Affordable Care Act but then pulled out of the exchanges rather than trying to fix portions of the program that did not work.

He cited basic fallacies in the proposed Republican plan including inadequate coverage and cost shifting.

“If I worked in a department store and a line of clothing was not selling, I’d lower prices,” Albers said. “But insurance companies raised prices or pulled out. Result was adverse selection. I never heard a health insurance company say they were responsible for the health of the nation, but they are responsible for the profit for their shareholders.”

Before the Affordable Care Act, there were health insurance plans in this country with low lifetime benefit caps, some as low as $20,000. Some plans excluded coverage for opioid addiction treatment. Between the 45 million uninsured and 45 million underinsured, about 90 million Americans had inadequate access to health care before the Affordable Care Act, Albers said.

The ACA has not been completely repealed, he noted, because many important aspects remain including no exclusion for pre-existing conditions, no benefit caps on essential benefits and coverage of a family plan for children up to age 26.

Albers sees “slogans” and “fallacies” behind the proposed Republican plan, and views it primarily as cost shifting rather than a comprehensive plan to expand access to health care for all Americans.

He said when American auto manufacturers pay more per car in health care costs for employees than steel costs, it becomes obvious why manufacturing is moving from the United States to Canada and other countries with public-private partnerships to provide universal health care.

“I’m basically a pessimist,” Parks said. “Unless government provides universal health care, we will continue to see people destroy their life savings because of medical costs. That’s un-American.”

Clare Howard

Clare Howard is the editor of the Community Word. She can be reached at communityword@yahoo.com



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