The fallacy of the McCain/Obama proposed healthcare coverage
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| CV consultant breaks down the current state of U.S. healthcare system. Image source: www.wcbstv.com |
Specifically, half of the states within the U.S. require Certificate of Need approval to open or expand new services. On the other hand, the remainder of the states are free to allow providers to deliver whatever care they deem necessary. Even Medicare must work through local intermediaries, i.e., insurance companies or third party entities, to attempt to implement the National Medicare Plan, which varies greatly as to care allowed and amounts paid to providers within different states.
The greatest fallacy of the proposals by Senators McCain and Obama is they do not touch the biggest issue facing the U.S. population and its governmental leaders, which is the severe shortage of physicians, registered nurses, licensed practical nurses, and nurse and home health aides.
McCain’s vision primarily focuses on providing individuals and families a tax credit toward the cost of insurance. McCain does not recognize a radically aging population and our severely acute shortage of all healthcare provider types, including physicians and hospitals. For example, an individual may have insurance, but may not be able to find physicians who will provide care.
Currently, I see this problem existing in many areas of the U.S. today and see no plan to address the catastrophic shortages that are projected between now and 2020. Simply put, if you have ten dollars, but no place to purchase food, then your ten dollars does not help with potential starvation.
By contrast, Obama proposes to cover all uninsured Americans by providing affordable healthcare coverage similar to the plan available to members of Congress. Obama proposes a high-tech insurance approach, i.e., simplified paperwork, establishment of a national health insurance exchange and lowering costs by modernizing the U.S. healthcare system.
Once again, Obama has completely missed the mark and overlooked the supply versus demand factor in the U.S. Obama does not acknowledge an aging population with increased healthcare demands, an existing severe shortage of all levels of healthcare providers and the significant state variances as they relate to healthcare as previously discussed under the section for McCain.
In addition, neither presidential candidate acknowledges the complexity of healthcare provided in the U.S. today.
First, neither seems to be aware that each of their proposals would only address providers of healthcare, i.e., hospitals and physicians. Neither of their proposals addresses the fact that there are no controls on the costs of pharmaceuticals, the costs of intermediaries who manage Medicare’s money and who would manage any national plan, and the costs of expanding technology.
It should be noted that pharmaceutical costs, intermediary charges, and technological costs represent in excess of 50 percent and in many areas of the country 60 percent of our total healthcare expenditures.
Finally, it is noteworthy to point out that our physician shortage in 2020 in just the field of cardiology is projected to be 45 percent. A 58.4 percent increase in the number of cardiologists would be required to meet the 2020-projected demand. Once again, you cannot purchase healthcare services where there is no work force to provide care irrespective of how you play with the insurance companies.
In summary, we are currently in an out-of-control healthcare crisis that has the potential of becoming catastrophic during the next eight years. If the future selected president does not take the time to appropriately address all of the issues that the healthcare environment requires, it is very possible that our citizenry will have some form of insurance or other healthcare, but no place to obtain the healthcare.
Alternatively, we could end up in a much-tiered system where the wealthy are able to obtain care, but the middle-class insured are excluded due to the shortage of healthcare providers and the high cost of drugs. The facts are clear – neither candidate’s plan would address our healthcare crisis.
Mr. Goodman is President/CEO of J O Goodman Associates in Las Vegas. He can be reached at jgoodman@jogoodmanassociates.com