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There were no anti-biotics and few complicated surgical procedures. You went to the doctor, or if you were too sick, the doctor came to see you. If you were really sick, or needed surgery, you went to the hospital and whatever happened, you were presented a bill which you paid out of your own pocket. Most hospitals had charity wards and most doctors treated patients they knew could not pay, but it was a direct doctor/ hospital to patient transaction.
A Little History
During World War II, the American government imposed wage and price controls, limiting what factories and companies could pay in salaries. Some large corporations began offering health insurance as a way of providing a benefit to workers while getting around the wage controls. This was simple hospitalization insurance. Most out-patient procedures were not covered. But it was a foot in the door for the insurance companies and marked the beginning of third-party financing of health care costs.
After the war, the men came home and with Europe's economy in ruins, the American manufacturing engine went full steam ahead. Business was booming during the 1950's and health insurance became a normal corporate job benefit and unionized worker perk. Hospitals began to depend on it and what was covered by it expanded. By the 1960's the system was in place, and since most people had health insurance, and were no longer paying their own medical bills, they began to abuse the system.
Since the only people who didn't have insurance were those who were not working, in the 1960's Medicare and Medicaid were passed into law as government run insurance programs for those over 65 and for poor families. Along with corporate profits, corruption and abuse of the system also grew.
By the 1980's, the system was out of control. Waste and corruption ran rampant as it always does when a third party pays the costs. Who cares if the cotton balls in the hospital cost $15. each if it's covered by insurance?
In an effort to control things, the current system was set up as a compromise after the failure of Bill and Hillary Clinton's 1993 attempt to reform the system. Like most compromises, it was a disaster. Insurance companies and HMO's got fat with profits while doctors, patients and hospitals suffered.
The Future of American Healthcare
Today, Americans have the world's highest health care costs as well as the highest infant mortality rate in the developed world and one of the lowest life expectancies. Families are paying health care premiums that are as high as their mortgage payments, and often find claims rejected or coverage denied when it is needed most.
In fact, 75% of all bankruptcies in America are related to healthcare costs. This is a shameful situation which if allowed to continue will bankrupt the nation financially as well as morally.
So, who killed American healthcare? We all did: irresponsible patients, insurance companies, and government bureaurocracy. If only we could return to a simpler time where we all paid our own bills --but since that is not possible, let's please pass some sort of health care reform soon.. Let's not kill American healthcare all over again.
9 comments:
clap clap clap clap clap. Excellent post. Thanks PP.
Thanks Frieda-- glad you like it. Could you get the message to Congress please? :-)
Great post.
To make health insurance affordable we need to address the increase in costs associated with the care that we are demanding from our service providers. As a health insurance broker we are perplexed how both bills do not focus more on cost containment, still some health care reform is better than what we have now.
True and we also need to have some way of controlling waste and fraud. This bill is far from perfect, but it is the best we can do and we absolutely MUST do something NOW. Thanks for your comment:-)
I really appreciate your post! It's very true. However, I would disagree, if I am understanding you correctly, that we need do something NOW (as in, shove it through hastily).
The president is trying to push his bill through after only one year in the White House, and I appreciate his desire to fulfill his promise of "change," but its wrong to fulfill that promise at the expense of prudence.
I think you would agree with me that the issue has become much more of a partisan tug-o-war, than the development of a bill that will help the people who REALLY are in need, maintain quality healthcare and allow physicians' and taxpayers' moral integrity to remain in tact.
Progress is good, but let us not sacrifice wisdom at the alter of progress.
Hi Dental and thanks for your comment. Actually,we don't agree on this. I think time is of the essence here and so do the millions of Americans who are uninsured or under-insured. The Health Insurance industry posted record profits this year and health insurance premiums are being raised by as much as 39% as I write. We don't have another year or two to debate this-- people are dying.
On top of that, President Obama has reached across the aisle with his recent health care summit( see my post on that) and has incorporated many of the opposition's ideas into the current bill. I am ashamed of the way that Congress has jumped into the pockets of the insurance and pharmaceutical lobbies and I applaud the skill and patience of those who are working to get some kind of compromise bill passed now. We need it desperately. The situation will not get better while we dither.
I wish we could pay directly and get some kind of discount for doing so. Right now, due to a 5 month illness (WITH employer subsidized health insurance) and several surgical procedures, we are getting bills from at least 20 different places and new ones each day. Even if we send everyone a little bit, that's still hundreds of dollars per month and then no one is happy--plus, we don't have hundreds of extra dollars per month. So we do what we can and are drowning in bills. Some bills are from people we've never heard of for stuff we don't remember. Nothing is centralized--it's all separate. No one wants to make arrangements, it's all due upon receipt.
It's insanity. I agree something has to be done ASAP, then we can tweak it later. My feeling is that this bill, while bad, will be better than nothing but will ultimately fail because it's still all private insurance based. We have to get the money out of it--medicine has to be based on treatment outcomes not on fee-for-service and on for-profit drugs and elective procedures. When even the 'lucky' people (who have insurance) can't afford to get sick, something is dreadfully wrong. Great post.
What part of 'no average citizen can afford health insurance premiums any more, let alone the inflated bills that "insurance" (what a joke) doesn't cover' does Congress not understand. At the very least, medical bills should automatically be written off if such bills force a home owner into bankruptcy.
How counter-productive to lose one's home to pay health care companies already awash in cash.
This is the AMERICAN way? Hello.
How about a revolution for change? Jefferson said we need a revolution every generation to protect the rights we THINK we have.
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