Reckless approach to health care in Kansas
Published on -12/14/2012, 9:21 AM
I'm trying to sort out facets of the debates over health care.
Our current health care system started in the 1970s, when Nixon re-jiggered the definition and intent of comprehensive health care to give us health maintenance organizations. Consider this the beginning of the economic spiral we call American health care.
The current system rose from the nonprofit facilities that used to be run by both secular and religious organizations that had oversight from state and federal authorities. There were caps on costs. There was a clear accounting of everything, audited for accuracy.
Until someone figured out there would be a never-ending supply of sick people. Maybe they didn't think that exactly, when moves were made to give the management of health care to the blossoming HMOs. The larger interests of the insurance companies and Wall Street outweighed the ethic of any person's right to health care.
In short, there was money to be made, and lots of it, by the idea that The Market is capable of delivering quality health care, that the Invisible Hand would control costs and allow more innovation. These were the selling points at the time.
The industry is enormous. Health care was 17.9 percent of the gross domestic product in 2011, and estimated to rise to 20 percent of GDP by 2014. In 1980, we spent 9 percent of GDP in health care. Deregulation of the industry accounts for most of the inflation of costs.
The system as it has evolved is not about health care at all. Health care has become the equivalent of "product," that generic term used for whatever is being sold. It's about money, profit and shareholders.
By the standards of capitalism, this growth is appreciable. Big business would say that's the way it works, and it's working very well, because money is being made, people are employed, and the system has allowed for growth, research and development.
But that's not true. The inaccuracy lies in the profit motives. When health care went from being a social institution to an industry, Americans became consumers, not individuals.
These are important definitions in the debate.
Consumers are categorized by their disposable income, their socioeconomic status, their ability to pay. "People" is an all-inclusive term that hinders profit, since it addresses those without the means or status to pay.
Which brings us to today, when we have a system breaking under these mutually exclusive influences -- those who can pay for health care and those who can't afford it.
Wall Street says the system works because these companies are making great profits in the market. The business model of insurance works with material things but not with health care. You can replace a house, but aging has only one end and disability is generally a continuous state.
In the never-ending cycle of sickness and health, we have created the perpetual profit machine. We somehow justify 44 million uninsured and another 38 million without enough coverage. The market answers this deficiency by promoting policy that demands everyone have insurance.
The profit machine only gets bigger, not more effective.
People on Medicare and Medicaid are given to an adjunct system, creating a new profit sector in the administration of taxpayer funds.
Gov. Sam Brownback is a leading proponent of the market-driven health care policy.
He invited three companies into the state to provide oversight of the distribution of taxes to Medicare and Medicaid and the implementation of health care service administration statewide. He was only following the neo-conservative principle that everything gets better when business is allowed free rein.
He began a reconfiguration of health care funding with a rushed timeline and hindered the work of our elected insurance commissioner to bargain with companies seeking the contracts with the state. In an impetuous act of defiance he refused federal funds for implementation. He was more interested in running his end game of tea party politics.
That's not conservative, it's reckless and a rookie mistake in administration.
It was announced last week that the Jan. 1 deadline still will take place, when almost all of the 380,000 Kansans on Medicare and Medicaid will be moved into this new system, with oversight from the Kansas Department of Health.
There are discrepancies from the state and in the plans concerning the care of the disabled and the homebound, and officials have refused to push back the deadline to give people a chance to learn about the new plans.
Giving a choice of three companies is not a choice at all. The real choice would be giving every Kansan the care they need, when they need it, for as long as they need it, as opposed to care received as part of a business plan.
No policy devised places the needs of people over the need for profit.
Mary Hart-Detrixhe is a lifelong resident of the prairie and Ellis county. Her work can be found at www.janeQaverage.com.