Opinion | The Coronavirus Has Laid Bare the Inequality of America's Health Care - The N... - 0 views
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The notion of price control is anathema to health care companies. It threatens their basic business model, in which the government grants them approvals and patents, pays whatever they ask, and works hand in hand with them as they deliver the worst health outcomes at the highest costs in the rich world.
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The American health care industry is not good at promoting health, but it excels at taking money from all of us for its benefit. It is an engine of inequality.
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the virus also provides an opportunity for systemic change. The United States spends more than any other nation on health care, and yet we have the lowest life expectancy among rich countries. And although perhaps no system can prepare for such an event, we were no better prepared for the pandemic than countries that spend far less.
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One way or another, everyone pays for health care. It accounts for about 18 percent of G.D.P. — nearly $11,000 per person. Individuals directly pay about a quarter, the federal and state governments pay nearly half, and most of the rest is paid by employers.
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Many Americans think their health insurance is a gift from their employers — a “benefit” bestowed on lucky workers by benevolent corporations. It would be more accurate to think of employer-provided health insurance as a tax.
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Rising health care costs account for much of the half-century decline in the earnings of men without a college degree, and contribute to the decline in the number of less-skilled jobs.
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Employer-based health insurance is a wrecking ball, destroying the labor market for less-educated workers and contributing to the rise in “deaths of despair.”
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We face a looming trillion-dollar federal deficit caused almost entirely by the rising costs of Medicaid and Medicare, even without the recent coronavirus relief bill.
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Rising costs are an untenable burden on our government, too. States’ payments for Medicaid have risen from 20.5 percent of their spending in 2008 to 28.9 percent in 2019. To meet those rising costs, states have cut their financing for roads, bridges and state universities. Without those crucial investments, the path to success for many Americans is cut off
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executives at hospitals, medical device makers and pharmaceutical companies, and some physicians, are very well paid.
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American doctors control access to their profession through a system that limits medical school admissions and the entry of doctors trained abroad — an imbalance that was clear even before the pandemic
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Hospitals, many of them classified as nonprofits, have consolidated, with monopolies over health care in many cities, and they have used that monopoly power to raise prices
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The health care industry has armored itself, employing five lobbyists for each elected member of Congress. But public anger has been building — over drug prices, co-payments, surprise medical bills — and now, over the fragility of our health care system, which has been laid bare by the pandemic
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A single-payer system is just one possibility. There are many systems in wealthy countries to choose from, with and without insurance companies, with and without government-run hospitals. But all have two key characteristics: universal coverage — ideally from birth — and cost control.
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In the United States, public funding is likely to play a significant role in any treatments or vaccines that are eventually developed for Covid-19. Americans should demand that they be available at a reasonable price to everyone — not in the sole interest of drug companies.
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We are believers in free-market capitalism, but health care is not something it can deliver in a socially tolerable way.
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They choose not to. And so we Americans have too few doctors, too few beds and too few ventilators — but lots of income for providers
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America is a rich country that can afford a world-class health care system. We should be spending a lot of money on care and on new drugs. But we need to spend to save lives and reduce sickness, not on expensive, income-generating procedures that do little to improve health. Or worst of all, on enriching pharma companies that feed the opioid epidemic.
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Medical device manufacturers have also consolidated, in some cases using a “catch and kill” strategy to swallow up nimbler start-ups and keep the prices of their products high.
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Ambulance services and emergency departments that don’t accept insurance have become favorites of private equity investors because of their high profits
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Britain, for example, has the National Institute for Health and Care Excellence, which vets drugs, devices and procedures for their benefit relative to cost
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At the very least, America must stop financing health care through employer-based insurance, which encourages some people to work but it eliminates jobs for less-skilled workers
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The industry might emerge as a superhero of the war against Covid-19, like the Royal Air Force in the Battle of Britain during World War II.