Americans have long known that our healthcare system is rigged against the consumer. The horror stories of people living in debt for the rest of their lives because of an accident or illness have become so commonplace that many have become numb to them.
In large measure, the frequency with which Americans have to choose between medical care and being able to put food on the table or keep their homes was the impetus behind President Obama’s landmark Affordable Care Act. The President saw – as the rest of us have – that we desperately needed to increase the quality and availability of affordable health insurance.
The last year has shown how flawed the ACA is in both construction and implementation. And we find ourselves as a nation still struggling with a hugely costly and unfair healthcare system.
Fundamentally, what makes healthcare costly is a wildly unregulated and noncompetitive insurance and payment system that is rigged against the average American. ObamaCare and its regulations has only made the system less competitive and, in the process, even more obscure for the average person.
As a result, we are further from the goal of getting Americans better healthcare that we set out to achieve.
Healthcare needs to get back to its roots: healing the sick. That’s what pharmaceutical companies and doctors do. Most of the problems and unfair cost overruns are a result of big corporate hospitals and greedy insurers who make it nearly impossible to effectively and affordably deliver high quality healthcare.
Indeed, it’s an open secret that insurers are more concerned with their bottom line than getting patients the best possible medicine.
Elliott Antman, professor of medicine at Harvard Medical School and president of the American Heart Association, spoke to this troubling reality. He said, “[U]nfortunately, many insurance companies focus strictly on the cost of the pill. But if we only look at the per-pill cost we have blinders on. We have to think about the impact on the health-delivery system overall – and if a more expensive new drug reduces symptoms to the extent that patients aren’t hospitalized as much, then that has enormous economic impact.”
This trade-off between higher costs upfront for lower costs later on is a difficult one to grapple with and, more to the point, afford.
High deductible plans are becoming more and more commonplace. For instance, Kaiser estimates that 20% of workers are enrolled in high deducible plans with a savings account option in 2013, up from 8% in 2009, meaning that consumers will have to evaluate their options more closely.
Paul Ginsburg, a professor of health policy and management at the University of Southern California’s Sol Price School of Public Policy told the New York Times that many workers may not have a choice but to have a high deductible plan.
“If the deductible is very high, all of a sudden the financial protection part of insurance, you are losing that,” he said. “You still have protection against very high claims, but you have people who may have to pay $5,000 during one year toward the cost of their care or more. And a lot of people don’t have that kind of savings.”
It’s under these tough circumstances that Americans are being forced to make the difficult decisions between getting the care that they or a family member needs and facing a lifetime of financial strain.
At this point, we know that doctors and drug researchers are in it to save lives and help people. Everyone knows someone who has had their lives dramatically improved by a talented doctor or breakthrough drug. But corporate hospitals and insurers are rigging the system to make sure they get paid – and little else.
As a result, pharmaceutical companies and doctors have no choice but to play by the rules and work with insurers, even though the system is broken and everyone knows it.
That’s why big Pharma has pushed for major pro-consumer rule laws like Medicare Part D, which is arguably the most successful aspect of today’s healthcare system.
Nevertheless, we all know that much more can be done. ObamaCare is certainly a step in the right direction, but it is a law that needs serious reform in order to be effective in accomplishing its goals.
In the meantime, it’s the consumer that will continue to suffer while legislators bicker and insurers line their pockets.