The Alternative Press

I am now in bed waiting for surgery on my back. The same surgeon who repaired my back twenty years ago will perform the upcoming procedure and I expect an excellent outcome.

I am fortunate to have a great group of doctors taking care of me. I believe they are people who are proud to BE doctors, rather than those who just DO doctoring for a living. It is too bad that in the U.S. we have too few of the former and too many of the latter.

My need for complex surgery comes at the time our Supreme Court is deliberating the constitutionality of the new healthcare law. I don’t know whether the law will improve healthcare in the U.S. or not, but I do know something needs to be done. In the last World Health Organization listing of healthcare quality and cost, the U.S.ranked 37 among all nations in overall healthcare and number one in per-capita expense. Our country’s quality of care is right behind Costa Rica, but Costa Rica is number 50 in per-capita spending. 

For every other industry (healthcare is a $1.5 trillion industry) there are market checks and balances either at the consumer level or by government.  No consumer market checks exist for healthcare.  If you ask a doctor how much a procedure will cost or how much an insurance company will reimburse for a procedure, the typical answer is to ask the business manager or delay the procedure until the office staff can get a price.  The doctors themselves can’t comprehend their pricing system.

In any other transaction, whether buying a house, a share of stock or an oil change, consumers can get the price beforehand, comparison shop and, if necessary, negotiate a better deal. These elements of capitalistic consumerism are predominantly absent from the healthcare arena. You go to a doctor, get no advance pricing, get treated and hope you can afford the bill you get afterward.

Politicians and pundits continue to argue over the cost of Medicare. Medicare is not the cause of the problem, it is the symptom of the problem. Medicare spending can be documented, added up and the bill sent to Congress.  It is much more difficult to compute commercial healthcare costs.

We, the healthcare customers, are not the only ones to suffer from this dysfunctional system.  Doctors pay extraordinary amounts to manage their accounts receivable and to interface with government and private insurance entities. Hospitals are faced with such heavy financial problems that finance is the number one concern of hospital CEOs while quality of patient care is number three.  Pharmaceutical companies are facing increasing financial pressures from the cost of drug development, expiration of exclusivity on name-brand drugs and the complexity of the drug approval process.

The entire healthcare system needs to be reformulated.  We will not know for years whether or not the healthcare bill will begin fixing the system.  For the sake of the medical and financial health of the nation and its people, I hope the law is upheld by the Supreme Court, not because it is such a good law, but because it is an attempt to improve a terrible situation.  As I learned a long time ago, there are times when “you must do something, even if it is right.”.  That axiom applies to the health of the healthcare system in the U.S. today.  Taking action, even if it is wrong action is preferable to doing nothing.

So, as I sit here with my aching back, waiting for an opening in a surgical schedule, I am appreciative of the dedicated healthcare professionals -  doctors, nurses, pharmacists, drug developers, and thousands of others who daily work to the best of their ability to deliver the best medical care they can, in spite of a system that encourages them to do otherwise.

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Henry Bassman has lived in Summit, NJ for 37 years, has been married for more than 40 years and has three daughters who graduated from Summit High School.  Henry was a Captain in the U.S. Army, retired from AT&T where he wrote about high-technology science and engineering and is now affiliated with a small investment bank that specializes in biotechnology, medical devices and healthcare issues, about which he often writes.  Articles by Henry can be seen on ABCNews.com and other business Web sites.  He can be contacted at hbassman@comcast.net