Aug 25, 2008

Insanity: Doing the same thing over and over again and expecting different results. [Albert Einstein (attributed)]

Between 1988 and 2006, many states tried doing the same thing over and over again, with each of them consistently coming up with the same disappointing result. They were making the admirable attempt to insure that all of their citizens received adequate medical care when they needed it.

In a paper in a recent issue of the International Journal of Health Services entitled, “State Health Reform Flatlines,” the authors Steffie Woolhandler, Benjamin Day, and David U. Himmelstein relate the remarkably similar tales of seven states that thought they were instituting universal health care. In every case, the number of uninsured increased throughout the life of their plans. The paper was recently featured on the web site of Physicians for a National Health Plan (PNHP), an organization of physicians in favor of single-payer national health insurance.

Why the dismal results? The authors conclude that a combination of rising, uncontainable costs, and the flagging determination of legislators doomed the plans to failure. Their final word:

We remain convinced that more radical reforms can simultaneously expand coverage and control costs. A shift from our complex and fragmented payment system to a simple single-payer approach could save about 14.3 percent of total health spending—equivalent to $323 billion in 2007—on reimbursement-driven bureaucracy. Such administrative savings are unattainable with lesser reforms. A nonprofit national health insurance system could also curtail wasteful over-investment in medical technology (e.g., the proliferation of new cardiac care hospitals located near existing ones) and attenuate incentives for unnecessary and even harmful care.

What keeps our presidential candidates from taking the position that a solid majority of Americans and a growing number of physicians now favor?¹ What keeps our nation from investigating a system the rest of the civilized world has had in place now, in some instances, for well over a generation? Why are our per capita costs for health care per year twice what other countries are spending? Why are over 47 million Americans still uninsured, with the numbers growing rapidly every year?

We know why, of course. For the same reason the middle class is disappearing, suffering a net loss in income over the Bush 2 years while the richest one percent have become as wealthy as medieval royalty.² For the same reason we are in Iraq, where billions are being made by the few, while brave, if ignorant, Americans are being slaughtered every day. For the same reason famine has come knocking on the doors of over a billion of our fellow humans.

A great reckoning is at hand. We cannot persist in the same patterns and expect anything other than to continue on the downward path we tread. To expect anything different is, well, insanity.
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¹Sentiment shifts as primary season approaches, by The Associated Press, undated story on Yahoo News (Accessed August 20, 2008)
²Middle-Class Life Under Bush: Less Affordable and Less Secure (Accessed August 20, 2008)
tags: Health | Politics

Read the Press Release and Download the Paper