Practicing medicine has become a frustrating vocation. While physicians continue to learn new therapies and advanced surgical techniques to improve the lives of their patients, a constant drumbeat by both the government and the private sector to control costs is turning medicine from the art of healing to the art of battling byzantine bureaucracies. Meanwhile, more and more patients are falling through the cracks—even in supposedly good economic times—as health insurance costs escalate. Forty-one million Americans, 17.6% of the under 65 population, are uninsured, the highest in recent history. (1) The primary response of the medical community to this disturbing trend has been either to fight the bureaucratic excesses of managed care or to attempt to organize health insurance plans controlled exclusively by physicians. Neither of these approaches will address the underlying reason for the unaffordability of health insurance: the wages of workers have not kept pace with the escalation in health-care costs. Per capita health-care costs have increased 23-fold since 1970 while wages have increased only 4-fold. The problem is further compounded by increasing disparities of … [Read more...]

The rollout of the Affordable Care Act is one of the most dismal policy failures ever to take place at the federal level. The ACA has resulted in the cancellation of millions of existing policies and rapidly rising health insurance costs. The mostly inoperable website has become a symbol of an overly complex, unworkable law. The Congressional Budget Office now estimates that 31 million Americans will be left uninsured when the ACA is fully in place. By definition it will have failed in its primary mission. The President’s plan does recognize, however, that there is a health care problem. The United States is the only industrialized democracy that allows its citizens to go bankrupt from health care bills. Millions of Americans are without health insurance (those that would like to see the true figures for the uninsured, which are substantially lower than the “official” figure should see Beyond Those Healthcare Numbers, by Gregory Mankiw, New York Times, November 4, 2007). Many millions more fear that a job loss or sudden illness will result in bankruptcy. If the Republican Party plans to recapture the middle class and working poor, this problem must be addressed. The … [Read more...]