On Health Care in the United States

by Tor Dahl

Many years ago I submitted an paper to a respected journal, HOSPITAL FINANCIAL MANAGEMENT. It was accepted and published, and a couple of years later, it was awarded a prize for the best paper submitted to that journal in 25 years.

I wrote about the best way of providing health insurance to all Americans.

When the Affordable Care Act was passed, every Republican in Congress voted against the bill. They also tried to abolish it some 60 times without success. Prior to passage, hundreds of amendments were added to the bill in order to win Republican support. Some of them barred price negotiations between Medicare and drug providers--thereby making Big Pharma the most profitable industry in the US. They also made it illegal to import drugs from Canada--the very same drugs that was made in the US but that were sold for a fraction of US prices in Canada.

But there was more. The public option, an opportunity for people to seek insurance like Medicare for themselves, was also forbidden, although Medicare has become the most popular and affordable insurance in the USA. 

What became possible, was removal of preexisting conditions that would often make insurance impossible for a large segment of the population, removal of providers's options cancelling one's health insurance at will, or putting caps on annual and life long insurance coverage. At the time the cost of coverage increased by about 8.5% per year, every year, and if that were to continue, the health sector would consume ALL income in America in 2060.

I estimated that the plan I had submitted in my paper would insure everyone at approximately half the cost, all health care personnel would be paid the same, and with added increases to pay and pensions in the future that they had been paid in the past.

At that time any private insurance in the US would not cover people who were too poor, or too sick, to afford insurance. Their only option was to seek care in an emergency room. That was the most expensive care of all, and would produce 2/3 of all the bankruptcies in the US every year.

We know precisely what must be done to produce universal health insurance in the US. And we know how it could be done quickly, privately AND publicly, at low cost and with better outcomes, and we know how we could become the healthiest nation in the world in less than that.