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OPINIONS
Jeff Kessler: Current health care system crude, inefficient, broken
When it comes to health care, the best interests of our own pocketbooks and the interests and plight of the approximately 45 million uninsured Americans, including 250,000 uninsured West Virginians, are not inconsistent. The simple truth is that major health care reform will not only assist the uninsured, it will save Americans money.
In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA), which has proven to be an inefficient form of universal health care. This landmark legislation mandated that emergency rooms throughout the nation which receive government support may not turn away a patient who seeks necessary medical treatment. As a result, we have millions of Americans who seek their "primary" medical care in ERs. The cost of treating these uninsured patients are written off by the hospitals as "uncompensated care"."
However, as the truism goes, nothing in life is "free," and certainly no exception exists in the health care delivery system. All of the doctors, nurses, lab technicians, pharmacists and other health care providers who work in these facilities must, and will, be paid for the vital services they provide. The cost of treating the uninsured is merely passed on or shifted from the "non-payers" to the "payers" in order to support the system. This current crude form of universal health care which focuses on crisis and emergency treatment (at a significantly higher cost than services rendered for primary and preventive care) ultimately shifts billions of dollars in "hidden costs" to the final cost of obtaining health care insurance for those Americans who are insured.
Let's examine hidden costs with an all-too-common scenario. John Doe, a 45-year-old laborer for a small company, has adult onset diabetes, but does not know it. He does not have health care coverage and his diabetes goes untreated for years as he writes off the relatively mild symptoms as part of "growing older." He lets a small foot blister go untreated. Complicated by his diabetes, a serious infection develops. After the urging of his wife, he finally goes to the ER, but it's too late to save John's foot. It is amputated.
John is then told he has adult onset diabetes that has been untreated for years. He must immediately go on expensive medication, will have to get a prosthetic for his foot, and have a whole host of other problems the rest of his life, all related to diabetes.
John is devastated. He has no education higher than a high school degree and can no longer work his job because of his disability. He is facing medical debt that will bankrupt him and his family. He applies for Social Security Disability and gets it, and becomes qualified for Medicare.
This scenario happens every day across this country to countless Americans because they did not have the coverage for primary care and preventative treatment. Who pays for John's treatment? With no ability to work, the hospital and doctors will have to write off most of the bills for treatment provided to John. These written-off costs are in turn passed onto the medical consumer in the form of much higher fees by doctors and hospitals, resulting in much higher premiums for health care. Additionally, there are large federal grants that assist hospitals in paying for this written off "pauper" debt, and guess where this money comes from? You got it. We, the American taxpayers. Finally, John will eventually receive Social Security Disability and Medicaid, since he no longer is able to work. Once again, who pays? We do.
As you can see, for every tragic story similar to the one described above, there is another tragic story. Americans foot the bill, usually to the tunes of millions of dollars in hidden costs.
It's important to understand that as a result of this broken health care system, we are already paying for health care for all Americans. We are doing so through "shifted" costs and illusions rather than by every American paying an identifiable and affordable premium for coverage.
By creating a more cost-effective and efficient system, we could save Americans billions of dollars a year. What can you do? Call your elected U.S. representative and senators and tell them we cannot, and will not, wait any longer. Tell them we need a system of health care in the U.S. that eliminates cost shifting and instead gives hardworking Americans the ability to buy or obtain their own coverage.
Jeff Kessler has been a West Virginia state senator since 1997 and has served as chair of the Senate Judiciary Committee since 2003. He lives in Glen Dale.
