This is the second of two stories about 10 important myths in the Great American Health Care Debate.
There are so many fantastical myths out there in the great debate about reforming the American health care system that Disney Studios appears to be running the show. In my last column I tried to kill five on my list of the top ten biggest myths in health care. Today I will try to kill the other five on that list.
Myth No. 6 on my Top Ten list is that Americans don’t think health insurance is a right. Surveys suggest at least two thirds of us think it is, and half of Americans say they would pay more in taxes if necessary to insure us all. We also act as though it’s a right: we have made it a right for our poorest residents (Medicaid), all Americans over 65 (Medicare), members of our armed services and most veterans (the Veterans Administration Health System), most government workers and members of the U.S. Congress (who ought to be embarrassed about being insured). We expect it with any good job, and 140 million of us get it through our employer. Health insurance is functionally a right for most, we have just not figured out how to guarantee to all.
The 7th myth almost makes me laugh when I hear it: “We have to keep the government out of health care because government cannot run anything well.” Never mind that government is already the biggest provider of health care and health insurance in America, so it will never be “out of health care.” But the idea it cannot do anything well in health care is refuted by facts on the ground. It runs Medicare, America’s biggest and most popular health insurance program. It runs the VA Health System, felt by many to provide some of the best health care in America. That’s not to argue for or against a government role in the system, or that Medicare and the VA System are perfect. It’s just to point out that a government role in running our health system is not only required but may offer good options that should not automatically be dismissed because of the source.
That myth’s partner is the 8th myth, that unfettered free market competition in health care can produce affordable health care and health insurance for all. Study after study suggests competition in health care has added costs to the system. No other country in the world has found a way for the free market to successfully run a health system. What passes for a free market in health care has resulted in some of the system’s most odious features, such as denial of insurance coverage for pre-existing conditions. The free market has not and cannot save us here.
On the flip side, the 9th myth is that a viable, affordable health care system has no role for private enterprise. Large parts of the world’s successful health care systems — German, French, etc. — are private, including health insurance companies in several countries. The key is that the private parts of the system must function in a way that supports a sustainable whole, not solely for their own benefit.
Finally, the last and most important myth of all is that, if you and I resist change in our health insurances and this health care system, that change will not come. The truth is that dramatic change is underway regardless of whether we resist. Employer-based health insurance is eroding under 140 million pairs of feet and most of us cannot afford to buy that health insurance on our own. The federal budget cannot be made affordable unless Medicare is changed. Change is happening; get used to it.
There they are: ten myths that have deluded and paralyzed us with wasted debate of useless issues. Memorize the ten, then do your part to kill them when you hear them, and to get us focused on the real issues.
Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.