Posted 10/17/11 on The Doctor Weighs In
Today marks the one month anniversary of a movement that pundits initially thought had little chance of lasting. Instead of fading away, the Occupy protests are metastasizing across the globe with demonstrations in London, Rome, Chicago, Tokyo and even in Paraguay…Paraguay, for God’s sake. Some people are saying the Occupy movements are the “Arab Spring” of the West. People, empowered by technology, are refusing to accept the status quo that protects the interests of a few.
So how does this relate to health care? Well, right now, it doesn’t…but it should. Health care, in the US at least, seems to serve everyone well but the people who need it. For profit segments of the industry are by and large doing just fine. Insurers are raking in record profits – in part because utilization is down, many think, because of the recession. Doctors, primary care excepted, are probably mostly in the 1% or, if not, in the 5%. Device companies, drug companies, and other health care services companies – are making oodles of money.
But patients – the 99% – well, they are paying more, getting less, and waiting longer. Why the heck aren’t they mad as hell?
Some are, of course. If you didn’t get a chance to read Jane Gross’ terrific opinion piece in the New York Times, here’s the link. Even people with Medicare, like her elderly mother, end up destitute if they have the misfortune of taking a long time to die.
You rarely hear anyone saying America has the best health care in the world anymore. If they do say it, it is qualified: America has the best health care in the world if you have the money to buy it. It is within our power to fix what is broken – if we have the will. But that means the 99% will have to stand up to the 1% and demand a change to the status quo. It is not going to happen on its own – those who are profiting from the existing system simply have too much to lose.
- We need universal coverage – get everyone in the insurance pool so we eliminate cost-shifting related to the un- or underinsured.
- We need to get serious about waste. It is not ok to have our collective dollars spent on care with limited benefits (e.g., hip replacements in people with advanced Alzheimers disease or liver transplants for an alcoholic who is still drinking).
- We need to LEAN our delivery systems to make them more efficient and more affordable.
- We need to much more rapidly incorporate the new technologies into every day medical practices—why do we still have to make an appointment, drive, park, and wait for a 15 minute office visit? Technology is available now to transform many physical office visits into low cost, convenient virtual ones.
I could go on and on with potential solutions, but that would not be in the spirit of the Occupy movement. They are galvanizing opposition to the status quo, not proposing specific solutions…yet. I think we need to do the same in health care. Let’s agree IT IS NOT WORKING before jumping to a solution. We need every one who is, will be, or cares for a patient to first agree that there is a problem – a big problem – that has resulted in inequities that negatively impact the lives of folks every day – ranging from “job lock”(you stay in an unsatisfying job in order to keep your health insurance) to delays in care (not going to the hospital when you have chest pain, for example) to financial catastrophe (health care bills are the cause of ~60% of bankruptcies). Let’s get mad as hell and demand a health care system that serves the 99%. Occupy Health Care.
Pat Salber MD, MBA is a former Emergency Physician and large health plan Chief Medical Officer. She writes at The Doctor Weighs In.