The health-care crisis: Are the candidates really concerned?
The Political Pulpit
Object:
Recent reports indicate that 47 million Americans were without health insurance in the summer of 2007. That is up from 44.8 million in 2006, which according to the US Census Bureau was 15.3% of the population. Meanwhile the costs of drugs, hospitalization, and doctors' visits spiral. Times are tough for the sick or for those trying to stay healthy. But the drug companies are doing well. Johnson and Johnson reportedly earned $10 billion in 2005, and Phizer with $8 billion in profits did not lag far behind.
Most recent figures for a 2003 Physician Compensation and Production Report indicate times have been good financially for medical doctors (contrary to all the difficulties they would have us believe they have). In 2002, family practice doctors averaged compensation of $150,267, pediatricians $152,690, and specialists or surgeons as high as $306,964. CEOs of the drug companies do even better. The 2006 compensation package for the Johnson and Johnson CEO was $28 million. William McGuire, the CEO of the insurance company UnitedHealth group, made $124 million. It is hardly surprising that times would be good for these people and companies. Drug companies, hospitals, insurance companies, and doctors' organizations have made sure that there would be no significant changes in the system. In 2005 and 2006 they collectively spent $400 million lobbying Congress. Little wonder our present health-care system remains pretty much in place.
By the time you get this column and are ready to use it, the presidential primaries will have been winding down, and we'll have a good idea of who will be the parties' choices for the general election. At press time, when the field was still filled with viable candidates, polls suggested that the health-care crisis was the #2 or #3 issue on the minds of voters (trailing behind the war in Iraq and/or the economy).
Even if the winners and final contenders don't make health care the issue, most Americans seem to want it to be, the flaws in our health-care delivery system still warrant the American church's attention. The third and fourth months of the New Year provide you with ample opportunity to address the concerns. Among the assigned biblical texts inviting a sermon on the topic include the first lesson for March 2 and the gospel lesson for March 16 (as Samuel and Jesus respectively stand up to the government status quo). Others reflecting appropriate themes for a sermon on health care include the first lessons for March 9 (Ezekiel 37:1-14, testifying to the resurrection of the bones made dry by oppression), March 21 (the Good Friday lesson drawn from Isaiah 52:13--53:12, which refers to the Messiah's identification with the oppressed and afflicted), and March 23 (the Easter Day lesson drawn from Acts 1:34-43 proclaiming that God shows no partiality). Best of all for those of us committed to universal health coverage for all Americans in the first lesson for April 13 (Acts 2:42-47), which tells the story of how the first apostles shared all things in common. Can those of us blessed with jobs that afford medical insurance or with enough money to purchase it do any less?
Americans, like all human beings, are not likely to call for change as long as they believe that the status quo is working for them. But although the medical establishment and our politicians extol our medical system, it ain't that good. The World Health Organization ranks US health care 37th in world, well below most of Europe and even trailing Chile and Costa Rica. No wonder. Life expectancy in the States is shorter than in 27 other countries. Our infant mortality rate ties with Malta, Slovokia, and Hungary. We may have more nurses than France (though we trail the United Kingdom and Canada on that score), but France has more doctors than we do.
Our other problems include the costly character of our system. Based on 2004 statistics, we spend more per capita than any other country (nearly twice the next most expensive system). That is 16% of the American economy. One trillion dollars of the $1.89 trillion spent on health care (53%) was paid for by individuals. While in Canada, France, and Britain only 30%, 24%, and 16% respectively of the costs came out of private pockets. It seems you get more for less in these single-payer socialized medicine systems.
Of course, the media and our politicians sometimes spin stories of the unhappiness Canadians have with their single-payer system. Many of your parishioners have likely been convinced that this is the reality. A June 1993 Gallup poll revealed that only 2% of Canadians preferred the US health-care system to their own. A more recent 2004 Harris Interactive Poll revealed that only 10% of the Europeans, with single-payer, universal coverage systems, would prefer the American system to their own. Hardly surprising. The myth spun by our politicians and their media handlers that citizens of socialized medicine nations have long wait-times to receive care neglects the reality that 2004 statistics reveal that American patients waited 36 million days for appointments. And a 2006 report of The New England Journal of Medicine reported that almost 50% of the time American patients do not receive the care they need!
Who are the culprits? How can we fix our broken system? True, the middlemen do raise the costs of American medicine. An estimated 15 cents of each private US health-care dollar goes simply to administrative costs. Our HMO system and insurance company costs eat up much of our health-care costs. But don't let the medical guild convince you that this is the whole story in a system that is jeopardizing medical treatment for the disadvantaged. Never forget that there is a long history of doctors fighting efforts to socialize medicine. It was the American Medical Association that stopped Harry Truman's efforts to establish a kind of European-like single-payer system in 1949. Even with their six-figure annual incomes today, doctors are complaining about the fees they can gain from the elderly in the socialized Medicare system we already have in operation (Bill Novelli, "Where We Stand," AARP Bulletin, November, 2007, p. 28).
Given the realities of campaign funding we lamented in the November-December column, it is hardly surprising, as Wes' column indicates, that all the viable candidates left (save John Edwards) have avoided espousing the single-payer, government subsidized universal health coverage. Their real concern is not to provide a system guaranteeing coverage, but to get elected without changing the system too radically. In other words, they are just planning on tinkering with the present system, leaving all the potential donors from the American Medical Association, as well as the drug and health insurance companies, free to keep opening up their wallets for campaign contributions. The idea of most of the candidates who are speaking of health-care reform is to create tax incentives for employers to offer health insurance and to mandate that citizens purchase their own health insurance and have government subsidize those too poor to do so. This is essentially what Mitt Romney did in Massachusetts during his administration. But the "middlemen" who contribute to running up the costs of American medicine will still remain in the picture with this plan. And the doctors are unlikely to receive the kind of pay-cut to put them more in line with their European counterparts in their single-payer system.
What can we do about it? Start lobbying and voting accordingly for our representatives. Enough sermons by all of us on this topic, stressing the biblical themes of challenging the status quo, grappling with poverty, sharing all our goods, and sharing the information you have been reading might at least plant seeds to begin making a difference. If you want a more economical, efficient medical system, one that also might nudge some members of the medical establishment back into the middle class where they are more likely to start identifying with their patients, the single-payer socialized medical system might be the way for you and our nation to go.
Mark Ellingsen is a tenured associate professor on the faculty of the Interdenominational Theological Center in Atlanta and the author of hundreds of articles and thirteen books, including "When Did Jesus Become Republican? Rescuing Our Country and Our Values from the Right" (Rowman & Littlefield).
Most recent figures for a 2003 Physician Compensation and Production Report indicate times have been good financially for medical doctors (contrary to all the difficulties they would have us believe they have). In 2002, family practice doctors averaged compensation of $150,267, pediatricians $152,690, and specialists or surgeons as high as $306,964. CEOs of the drug companies do even better. The 2006 compensation package for the Johnson and Johnson CEO was $28 million. William McGuire, the CEO of the insurance company UnitedHealth group, made $124 million. It is hardly surprising that times would be good for these people and companies. Drug companies, hospitals, insurance companies, and doctors' organizations have made sure that there would be no significant changes in the system. In 2005 and 2006 they collectively spent $400 million lobbying Congress. Little wonder our present health-care system remains pretty much in place.
By the time you get this column and are ready to use it, the presidential primaries will have been winding down, and we'll have a good idea of who will be the parties' choices for the general election. At press time, when the field was still filled with viable candidates, polls suggested that the health-care crisis was the #2 or #3 issue on the minds of voters (trailing behind the war in Iraq and/or the economy).
Even if the winners and final contenders don't make health care the issue, most Americans seem to want it to be, the flaws in our health-care delivery system still warrant the American church's attention. The third and fourth months of the New Year provide you with ample opportunity to address the concerns. Among the assigned biblical texts inviting a sermon on the topic include the first lesson for March 2 and the gospel lesson for March 16 (as Samuel and Jesus respectively stand up to the government status quo). Others reflecting appropriate themes for a sermon on health care include the first lessons for March 9 (Ezekiel 37:1-14, testifying to the resurrection of the bones made dry by oppression), March 21 (the Good Friday lesson drawn from Isaiah 52:13--53:12, which refers to the Messiah's identification with the oppressed and afflicted), and March 23 (the Easter Day lesson drawn from Acts 1:34-43 proclaiming that God shows no partiality). Best of all for those of us committed to universal health coverage for all Americans in the first lesson for April 13 (Acts 2:42-47), which tells the story of how the first apostles shared all things in common. Can those of us blessed with jobs that afford medical insurance or with enough money to purchase it do any less?
Americans, like all human beings, are not likely to call for change as long as they believe that the status quo is working for them. But although the medical establishment and our politicians extol our medical system, it ain't that good. The World Health Organization ranks US health care 37th in world, well below most of Europe and even trailing Chile and Costa Rica. No wonder. Life expectancy in the States is shorter than in 27 other countries. Our infant mortality rate ties with Malta, Slovokia, and Hungary. We may have more nurses than France (though we trail the United Kingdom and Canada on that score), but France has more doctors than we do.
Our other problems include the costly character of our system. Based on 2004 statistics, we spend more per capita than any other country (nearly twice the next most expensive system). That is 16% of the American economy. One trillion dollars of the $1.89 trillion spent on health care (53%) was paid for by individuals. While in Canada, France, and Britain only 30%, 24%, and 16% respectively of the costs came out of private pockets. It seems you get more for less in these single-payer socialized medicine systems.
Of course, the media and our politicians sometimes spin stories of the unhappiness Canadians have with their single-payer system. Many of your parishioners have likely been convinced that this is the reality. A June 1993 Gallup poll revealed that only 2% of Canadians preferred the US health-care system to their own. A more recent 2004 Harris Interactive Poll revealed that only 10% of the Europeans, with single-payer, universal coverage systems, would prefer the American system to their own. Hardly surprising. The myth spun by our politicians and their media handlers that citizens of socialized medicine nations have long wait-times to receive care neglects the reality that 2004 statistics reveal that American patients waited 36 million days for appointments. And a 2006 report of The New England Journal of Medicine reported that almost 50% of the time American patients do not receive the care they need!
Who are the culprits? How can we fix our broken system? True, the middlemen do raise the costs of American medicine. An estimated 15 cents of each private US health-care dollar goes simply to administrative costs. Our HMO system and insurance company costs eat up much of our health-care costs. But don't let the medical guild convince you that this is the whole story in a system that is jeopardizing medical treatment for the disadvantaged. Never forget that there is a long history of doctors fighting efforts to socialize medicine. It was the American Medical Association that stopped Harry Truman's efforts to establish a kind of European-like single-payer system in 1949. Even with their six-figure annual incomes today, doctors are complaining about the fees they can gain from the elderly in the socialized Medicare system we already have in operation (Bill Novelli, "Where We Stand," AARP Bulletin, November, 2007, p. 28).
Given the realities of campaign funding we lamented in the November-December column, it is hardly surprising, as Wes' column indicates, that all the viable candidates left (save John Edwards) have avoided espousing the single-payer, government subsidized universal health coverage. Their real concern is not to provide a system guaranteeing coverage, but to get elected without changing the system too radically. In other words, they are just planning on tinkering with the present system, leaving all the potential donors from the American Medical Association, as well as the drug and health insurance companies, free to keep opening up their wallets for campaign contributions. The idea of most of the candidates who are speaking of health-care reform is to create tax incentives for employers to offer health insurance and to mandate that citizens purchase their own health insurance and have government subsidize those too poor to do so. This is essentially what Mitt Romney did in Massachusetts during his administration. But the "middlemen" who contribute to running up the costs of American medicine will still remain in the picture with this plan. And the doctors are unlikely to receive the kind of pay-cut to put them more in line with their European counterparts in their single-payer system.
What can we do about it? Start lobbying and voting accordingly for our representatives. Enough sermons by all of us on this topic, stressing the biblical themes of challenging the status quo, grappling with poverty, sharing all our goods, and sharing the information you have been reading might at least plant seeds to begin making a difference. If you want a more economical, efficient medical system, one that also might nudge some members of the medical establishment back into the middle class where they are more likely to start identifying with their patients, the single-payer socialized medical system might be the way for you and our nation to go.
Mark Ellingsen is a tenured associate professor on the faculty of the Interdenominational Theological Center in Atlanta and the author of hundreds of articles and thirteen books, including "When Did Jesus Become Republican? Rescuing Our Country and Our Values from the Right" (Rowman & Littlefield).
