March 2, 2010

Speaking Out – How Much is Enough?


By Pam Brammann, R. N.

I was raised in Iowa, a city girl and an American. I have always been proud to be an American. That’s why it scares me when I see a possibility of America’s demise not too far off into the future, especially if we do not change our current path of greed and selfish acts.

For writing this article, I am sure that some people will feel it necessary to label me a socialist or unpatriotic, neither of which are true. I feel it is not only my right, but my duty as an American to observe, investigate and question our government and some aspects of our society. Failure to do so only serves to maintain the status quo and guarantee that nothing will get better.

It used to be that America was the strongest, most advanced country in the world with the highest standard of living. But guess what? Other nations are passing us up. I personally feel that a few countries may have surpassed America simply due to the fact that their philosophy is not so money driven. Don’t get me wrong, I do believe in capitalism. The desire to make money is a necessity for progress.

I also believe that capitalism promotes creativity, which can lead to success and economic growth. However we all have witnessed how often unrestrained capitalism and unlimited greed leads to poor ethical behavior, with massive financial gains for a few and financial ruin for countless others. This causes me to ask, how much is enough?

America is the only industrialized country in the world that implements for-profit health care insurance industries. For those who are not aware, Medicare and Medicaid are NOT for-profit entities; they are government run health care systems.

American for-profit health care insurance companies have a net profit margin of around 2% – 3%, which may not seem like much. However that’s their profit margin after paying their CEOs and other executives exorbitant salaries and bonuses of tens of millions (and sometimes hundreds of millions) of dollars, and these companies still have profits of hundreds of millions of dollars annually. These outrageous salaries of course contribute explanation as to why private health insurance companies have 25% to 30% total administrative costs compared to Medicare which only has about 3% in total administrative costs. Plus let’s not forget that private insurance companies make millions more in profits by finding reasons not to pay the medical expenses of people who faithfully paid their insurance premiums.

Since doctors and hospitals must play by the health care insurance rules to stay afloat financially, they must have a huge staff trained exclusively to deal with insurance bureaucracy. It has been estimated that the cost of health care administrative bureaucracy adds an additional 30% to the total health care dollars spent.

The pharmaceutical industries have a net profit margin of about 8% – 12% which results in the ballpark of thousands of millions of dollars. That’s not their total income – that’s just their profit over and above all operating costs. They are certainly entitled to make a profit, but billions of dollars left over as pure profit is a lot of money, period. Can you imagine if these companies charged less and made half their current profits? They would still be hugely profitable and their customers would be able keep more of their hard-earned cash which could really stimulate the economy! Plus more people could afford health care insurance.

I’m going to pick on the pharmaceutical companies for a moment longer because I often wonder why Americans are forced to pay such outrageous prices for a bottle of pills. Yet we can go to Canada or a European country and be charged far less for the same exact drug, from the same exact manufacturer. I sure wish that someone would offer me an explanation that is realistic and ethical, but I don’t think that such an explanation exists.

It’s true that the pharmaceutical industries must conduct expensive research in order to advance treatment and cures for disease and illness. But they recover all money spent on research and still have billions left over in profit. Also keep in mind that our government gives these companies grant money to conduct research. The key word here is give, not loan. When one company reports profits in the billions of dollars in one year, I have to ask, how much is enough?

We also blame doctors for the high cost of health care, because we believe that docs charge far too much money for an office visit. It’s also popular opinion that if we have a single payer health care plan, docs won’t reap the salary that they currently enjoy. There is a tiny bit of truth in this belief.

In so many other countries, if you want to become a physician, most if not all of your schooling is paid for by government dollars. Here in America, it’s not unusual for a new physician fresh from graduate school to owe $250,000 in student loans. On top of that, malpractice insurance may cost a doctor as much as a small house yearly. In other countries cost control measures are in place and physicians still enjoy a comfortable salary, just as they should. Anyone who is willing to sacrifice 10 – 12 years of a grueling education process, knowing they will never enjoy the average 40 hour per week schedule, in my opinion, is entitled to a comfortable salary as they now enjoy. If America implemented cost control options, we would see yet another reduction in health care cost.

Finally, the burden of financing insurance for health care is placed upon the employer. Today many companies can no longer afford to offer such benefits, and if they do, it’s one of their biggest expenses. Therefore this total cost is slowly being shifted to the average working family that is barely making ends meet. This is why so many Americans are forced to drop the health care insurance. It’s just getting too expensive.

In addition, forcing corporate America to pay for expensive health care benefits puts American corporations at a disadvantage when competing globally. As stated previously, other countries do not have for-profit health care systems. So those employers are not bogged down by such costs. Plus in America if you lose your job, you also lose your health care benefits. And many Americans are forced to stay in a job they don’t like because they have a pre-existing condition and can’t get covered by a new health plan. That’s just plain wrong.

Americans complain that they pay too much money for everything. In most instances I couldn’t agree more. I have personally gotten to know people from other countries and it’s always interesting to hear their thoughts concerning their perception of America. One thing I hear over and over again, “it’s very expensive to live here”. My friends are not from third world countries. They have never gone hungry and they have always had a roof over their head. If they get sick, they go to the doctor and they did not have to wait, despite the false rumors you may hear. They also received the proper medication, but at a fraction of the cost that Americans pay for the same drugs. The only difference is they live in countries that do not have profit-driven health care systems, that’s it. The longer these visitors remain in the United States of America, the more they ask, why do you have to pay so much money for things, why is everything so expensive?

America is perhaps the most prosperous and technologically advanced country in the world. But we are lagging farther behind other countries in certain areas like health care. I’m still proud to be an American, but I fear our country is being ruined by greed and a system that increasingly favors those who have the most money. Some day soon I hope our political representatives prove me wrong!

How Much is Enough?