An Opinion

Healthcare – the Past and the Future

Tuesday, 23 June 2009 16:59

One of President Barack Obama’s campaign pledges was to provide healthcare coverage for every American. Some 47 million of us do not have healthcare insurance. Healthcare is our nation’s largest industry - $2.4 trillion and expected to double in the next ten years. Before getting into where the current debate will take us. Look with me at the past.

First of all, in 1900, Americans had a projected life expectancy of 47 years. Today, we can expect to live until we are around 80 years of age. What made this possible?

There are many reasons, but the most important have been technological developments which can diagnose and treat health issues along with medical education which produced the fine physicians who care for us when we are ill. Other elements certainly include healthcare lifestyles, pharmaceuticals, and preventative care.

As for efforts to provide healthcare coverage, the first Presidential candidate calling for universal coverage was Theodore Roosevelt in 1912 when he was running on the Bull Moose Party. Later, Richard Nixon, as President, proposed coverage for all Americans in 1973. Subsequently, “Watergate” put healthcare on a back burner.

One advancement in coverage came during World War II. With a wage and price freeze, unions and businesses came up with healthcare insurance as a way to provide additional funds for the pockets of employees. And that was really the start of insurance coverage for a large segment of the American public.

With expanding technology, longer life expectancy, and more people having access to healthcare, the costs continue to escalate. For example, the cost of steel in the manufacturing of an automobile is less than the cost of healthcare insurance for the workers who make the cars. Also, for the average American, healthcare costs more per week than the cost of meals for a family of four.

The main challenge faced by the Congress is who pays the bill? With total healthcare expenditures four times the military budget in 2009, you can see the difficulties.

President Obama has outlined a sketchy program about what action he would like to see in the Congress. He has proposed spending $634 billion over the next ten years to cover the uninsured. The math is difficult, because to cover all of the more than 45 million uninsured could be as high as $100 billion per year. At any rate, the cost is high.

The President has left the details up to the Congress. Yet, up to now, there has been mostly talk about what steps should be taken. That is no wonder when you consider who is at the negotiating table – doctors, patients, hospitals, insurance companies, pharmaceutical companies, unions, employers, nurses, assisted living homes, medical equipment manufacturers, and 240 million of us with coverage.

A few weeks ago, some of the leadership organizations in healthcare pledged to cut spending by $2 trillion over the next ten years. No doubt they are trying, but the plan is again short on details.

Assuming that some plan passes the Congress, there will be another challenge – a critical shortage of physicians and nurses. As the baby boomers age and retire, the challenge becomes greater. It is estimated that there will be a shortage of some 800 thousand nurses by 2020 with a shortage of physicians at around 110 thousand. The hardest hit areas of the country are rural and inner city areas.

This debate will not end soon. Even if a law passes, the implementation will not be easy. Based on these thoughts, I have one suggestion – stay well!