Meaningful health reform will fail. It will fail because of big bucks and fear. Outside the gun lobby, the biggest influence is the healthcare lobby. Big pharma, equipment and the hospital corporations pour millions a year into the election campaigns of Republicans and a handful of Democrats.
Further each year millions more is poured into a war chest to be used to buy television ads that are aimed to create, and fuel fears in the minds of the general public. Healthcare reform advocacy groups cannot hope to match such spending to counter the avalanche of spending and fear mongering that will be coming. For every dollar healthcare advocates can spend the healthcare lobby will be spending more than twenty-five dollars.
The healthcare lobby and the Republicans will talk about government inefficiency and the high costs of a public system. What will never be heard is that one out of five dollars goes to pay exorbitant salaries to the top executives and stockholders. The CEOs of the major healthcare systems and firms on average make more than $12 million a year. Those who note that one out of four dollars goes to insurance company bureaucracies will not be heard. What will not be heard is that insurance companies systematically deny a host of small claims they should pay with the hope that insured will pay the bill and not ask for cogent rationale and file petition for review (with the vast majority of such petitions being paid). What will not be understood by the public is their doctors and hospitals have to have a significantly larger staff than their Canadian or British counterparts just to help process all the different forms from the plethora of insurance companies and understanding what is covered and what is not covered, and what is the patient’s co-pay.
The healthcare lobby will talk about the rationing of healthcare in a public system. What will go unsaid is that for the average citizen, the American system has far more rationing of healthcare than any of their counterparts in the western world. The average citizen’s employer provided plan allows for the insured only to use a minority of doctors, clinics and hospitals in their area. What is not said is that though the hospital may be on the list, particular doctors who are assigned your case may not be on the insurance company’s approved list. To go off the approved lists means the insurance company pays less and the patient may carry the majority of the costs.
What will remain unheard and not comprehended by the average citizen is that they are paying more than 25% more on a per capita basis than their Canadian counterparts while having a higher infant mortality rate, a significantly shorter lifespan, and over 25% of the population uninsured or significantly underinsured.
In America, dollars not facts controls the public debate. When one party can outspend the other by more than ten to one is going to win the debate more often than not. In politics, if you outspend your the other side by more than twenty to one, your avalanch will bury them and the outcome is known.