are ready for change in the way they receive and pay for health
care. Surprisingly, it may not be the changes that most politicians,
big businesses, insurance companies and special interests are pushing.
Americans are ready to take back control of their health care. They
are ready for a change from unaffordable insurance that comes only
from an employer they may prefer to leave – insurance that
seems to provide more of a hassle than convenient protection from
unexpected expenses. They are sick of sitting for an hour to see
a doctor, then seeing a nurse for 10 minutes and the doctor for
three and often left to wonder about what happened. They are burdened
by high taxes for government programs that seem to provide health
benefits for everyone but them while the same government clamors
to cover even more in financially unsustainable programs. They have
heard enough of empty promises from politicians who care only about
getting re-elected and having more power. Yet even with all these
and other problems, many Americans have given up and figure that
it is up to the government to solve the problem. They wonder if
the government solution will still allow them rapid access to high
quality health care they deserve.
proposals for reform are cloaked as big changes, but as it turns
out, they are actually more of the same. They can be summed up in
this way: turn more control over to the government and insurance
companies while politicians and special interests jockey for credit
and work behind the scenes to benefit – at the expense of individual
Americans. Albert Einstein once defined insanity as doing the same
thing over and over and expecting different results – but that
is what is being proposed today. While most American want more individual
control over their own lives, the health reform proposals will expand
the control over health care held by third-party payers (insurance
companies and government). This would make matters worse for Americans.
story of how we got to where we are today is long but has its roots
in the World War II–era policy that stated that a tax deduction
could only be applied to health insurance provided through a job.
That lead to employers’ control of health insurance purchase and
removed the consumer from the decision – decisions they make
every day for auto, homeowners and life insurance (products that
are affordable). Insurance companies then sold to employers –
not to consumers. Insurance products then began to expand from "accident
and sickness" policies, to "health" insurance. Thus
they cover every minor expense except for a token deductible from
patients. While this seems desirable on the surface, in the end
it leads to little control over demand for medical tests and treatments
and drives up the cost of health care and insurance for all. Instead
of asking your doctor, "Do I really need another pill"
or an MRI, or a surgery, consumers take the "free" benefit.
Unfortunately, doctors often do more tests and treatments to survive
government-fixed prices through high-volume services and to protect
themselves from lawsuits. This leads to what the government and
insurance companies call "over-utilization," the boogeyman
they seek to kill by having more control over what kind of care
every patient can be authorized to receive. Authorized by someone
else besides the patient through cookbook medicine and rationing
of care. That is the same thing that happens in socialized medicine
in other countries.
McKalip is a Solo Practice Neurosurgeon in St. Petersburg Florida
and President of the Florida