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Op-Ed: Reforming Healthcare While Saving Lives, Money, and a lot of Partisan Nonsense; Erin McClelland; Beaver Countian; October 30, 2014.
An editor’s note states, “Erin McClelland is the Democratic candidate for the United States House of Representatives in Pennsylvania’s 12th Congressional District, running against incumbent Republican Congressman Keith Rothfus. She is a healthcare professional and entrepreneur.”
Below are some comments about parts of the subject opinion piece.
“Today, we elect people who, for the most part, see our nation and our problems the way we see them. We elect ideologies and platforms that are based on an unrealistic, fantastical view of what our society should look like instead of a realistic, pragmatic view of what our problems look like. If you examine the gridlock in our government on any issue, from healthcare to immigration; from job creation to tax reform, you see a constant ideological push and pull that fails to present a comprehensive view of the problem and never considers an actual solution to solve it. What you do see is an abstract target condition that will likely turn the system upside down, creating more problems and providing no solutions. This notion will continue to gridlock our government, fester hate and resentment in our society, and deteriorate our nation’s systems more and more.
“As someone trained extensively in systems level problem-solving, I am hopeful that we can change the focus of the American voter toward a realistic understanding of our problems that incorporates systemic attributions as opposed to blaming elected officials, parties or administrations. But doing this will require a great deal of support, an open-minded electorate and the assumption that the majority of Americans, regardless of their political affiliation, are good people that want this nation to be better.”
[RWC] As an engineer by education and experience, I too am “someone trained extensively in systems level problem-solving.” Most of my comments in this critique come from my paper “Healthcare.”
“But let’s start with an open mind and the example I know best – health care.”
[RWC] You will find in the next paragraph Mrs. McClelland does not “start with an open mind.”
“The debate rages on regarding reform of our healthcare system; the left advocating for a single payer system, the right advocating that the system remain unchanged from its structure prior to passing the ACA. My response to each is simple: what problem are you trying to solve? Let’s examine this simply, step by step.”
[RWC] “The right advocating that the system remain unchanged from its structure prior to passing the ACA?” This is untrue and an example of the straw man tactic. Regardless of how many times you state you support a free market healthcare approach over the status quo, nationalized (aka “single payer”) healthcare proponents claim your opposition to their plan is support of the status quo. In their “defense,” though, lefties tend to believe anything not 100% controlled by the government is a free market. Nationalized healthcare proponents assert our current approach is “mainly a private enterprise operation” and “most of it’s [sic] coverage [is] in the private sector.” These folks want us to believe “private enterprise” and “private sector” are synonyms for “free market.”
“What is the problem? Healthcare costs are growing, and include approximately $60 trillion in future required payments that we cannot afford. This condition is not sustainable and requires a solution.
“What is the root cause of growing healthcare costs? There are a number of factors that are contributing to health care cost growth, including the incentive structure of the payer system. But since we cannot agree on how to address that problem, we should look for major issues that significantly contribute to cost growth on which we do agree. So why not start with medical errors and hospital acquired infections, which even the most extreme in each party can agree should be resolved?
“A 2011 study found that process improvement efforts reduced hospital-acquired infections via central venous catheters by 85% and saved $5.1 million dollars over two years. That was just the savings incurred from reducing infections only through central lines.
“A number of studies, including one in the Journal of Patient Safety, have demonstrated that every year our health care system kills enough people to fill two to three jumbo jets. We experience 300 million medical errors every year. The cost of these errors amount to $1 trillion dollars each year.”
[RWC] While addressing the issues Mrs. McClelland mentioned is good, she ducked “the root cause of growing healthcare costs.”
“How do we solve the root cause of the problem at the policy level? This is actually simpler than most would imagine, and does not require a massive health reform bill. We could simply use the same industrial engineering principles used by manufacturers and NASA to solve problems, and initially implement them in the VA health system. This would address issues like the Legionnaires infections that killed six veterans and infected 22 others. It would also increase effectiveness and efficiency, reducing costs and providing better, faster, and more effective care for our veterans. Once this program is well-established and demonstrating results in the VA, it could be implemented in every hospital in the nation as a condition to receive Medicare and Medicaid reimbursement. Every 10% reduction we experience in medical errors and infections would provide an additional $100 billion in savings, which can then be used to cover the cost of the uninsured via either a government system or a third-party payer system. This will streamline more people into the primary care setting, instead of the emergency room where care is most expensive.”
[RWC] While improving procedures is always a good thing, it’s dishonest to imply these things represent “the root cause of growing healthcare costs.” I believe the free market is the best approach to providing the best combination of healthcare accessibility, choice, price, quality, timeliness of treatment, et cetera. No, the Obamacare “marketplace” is not a free market.
As a reminder, the VA health system is a “single payer system,” the kind of system Mrs. McClelland conceded above she – as a member of “the left” – favors. “Government systems” like Medicare and Medicaid are “third-party payer systems.” As it applies to medical care, “a third-party payer system” is one in which someone (government, private insurer, charity) other than the patient pays the bill from the healthcare provider. An unfortunate side-effect of “a third-party payer system” is it makes patients price insensitive.
“What could have been? If they had focused solely on the problem instead of the ideology, Democrats and Republicans could have easily reached an agreement on these facts:
“– Healthcare now constitutes $2.5 trillion in domestic spending or 18% of GDP. This growth in healthcare costs is unsustainable and hurting our economy. Reform must be done in order for our healthcare system to be sustainable and not a burden to economic growth.
“– Medical errors and infections cost this country nearly $1 trillion a year in injured patients, lost lives and wasted money.
“– We need to stop hurting people, and start saving money.
“If these inarguable goals would have been considered instead of the ideological stalemate that yielded the ACA, healthcare reform would have been much simpler and more streamlined, the rollout would not have been so disastrous, and the GOP may not have shut down the government, cost us $24 billion for nothing, sued the president, and spent millions of dollars attempting to repeal the ACA. (The GOP really messed up on these issues, abandoning a golden opportunity to demonstrate real fiscal conservatism, the value of a free-market driven provider and payer system, and an unconditional appreciation for life.)”
[RWC] This paragraph is one falsehood after another.
“Ideological stalemate that yielded the ACA?” What “ideological stalemate?” Democrats controlled both houses of Congress and the White House and enacted the ACA (Obamacare) without a single Republican vote.
Mrs. McClelland blames the GOP for shutting down the government for two weeks in 2013, but ignores the roles of President Obama and the Democrat-majority Senate. If you want to assign guilt, all three are responsible. The “$24 billion for nothing” is bogus. Standard & Poors estimated the shutdown cost the economy $24 billion. A Forbes story countered, “There Will Be No $24B Economic Loss From The Government Shutdown.”
The GOP did not sue President Obama.
Obamacare is not “a golden opportunity to demonstrate real fiscal conservatism,” “a free-market driven provider and payer system,” or a demonstration of “an unconditional appreciation for life.”
“The fact that we have members of Congress who still argue that healthcare reform wasn’t even necessary is embarrassing for this nation; but its sting is truly felt when you consider the costs in blood and treasure this problem has yielded. To keep the partisanship going as costs grow and people die demonstrates how awful politicians are willing to be in the interest of partisanship.”
[RWC] Once again Mrs. McClelland falsely claims “we have members of Congress who still argue that healthcare reform wasn’t even necessary.” Then again, Mrs. McClelland may define “healthcare reform” to mean Obamacare and/or more government control of the healthcare system.
“What can we do about it? We as the electorate need to stop voting for the person that presents a fantasy for the United States that we just so happen to agree with and instead vote for the person that presents a sound knowledge of the problem and an understanding of how to solve it. Only then do we have a chance to save another generation of Americans from being doomed to inherit a world worse off than their parents. ”
[RWC] Based on this piece, Mrs. McClelland does not “present a sound knowledge of the problem and an understanding of how to solve it.” Given her own advice, voters should not vote for Mrs. McClelland and her “fantasy for the United States that we just so happen [NOT] to agree with.”
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