On Monday evening, we spoke to a packed house of 270 people at the Historic Nevada Theater, where Samuel Clemens performed long ago. No fooling.
As usual, it was an enthusiastic crowd of single payer supporters with scattered skeptics. One of the local docs asked my favorite question, “Wait, if we spend twice as much as the rest of the world and we only waste 20-25% of our health care dollars servicing the insurance industry, what about the rest of it?” The video Health, Money and Fear systematically illuminates the multitude of other perverse incentives that drive up cost. They include the abuse and overuse of technology, fear of liability, pressures for profits, near-criminal behavior of Big Pharma, chaos in medical records, primary care shortage, and frequent poor choices near the end of life, when far too often we spend unimaginable amounts of money keeping people alive to suffer longer. Until we understand that we are all paying for everybody, put everybody in the same risk pool and manage our health care money to maximize health, we are never going to be able to get a handle on all those other cost drivers.
Disallowing the insurance companies to reek havoc by segregating us into favorable and unfavorable risk pools is the first necessary, but not sufficient, step to creating a real health care system focused on earning real value for our health care dollars.
Last night, we lodged in the Swan Levine House in Grass Valley, formerly a hospital from 1906-1968. My bed is in a quaint room that used to be the operating room. No fooling.