Ahmed: A sick nation can’t be a great nation

Dr. Nasir Ahmed is a professor of Public Adminstration at Grambling State University.

When I came to America 40 years ago as a graduate student, I paid less than $100 per year for my health insurance. Today, as a gainfully employed professor, I pay $8,000 from my paycheck and my employer pays another $8,000 for all my insurance needs for my family of four. 

A few months ago, per my doctor’s recommendation, I went to have an MRI done on my heart. I was shocked to hear that they demanded $1,100 down payment from my pocket to get the MRI done. So, I did not do the necessary MRI. 

Considering the fact that sixty percent of American families do not have $1,000 saved for any emergency, my assumption is that at least sixty percent of Americans cannot afford an MRI if they need one.

 Without making the health care issue too personal, I must say most people think our healthcare system sucks. The ‘USA Today’ newspaper in the Feb. 7-9, 2020 issue sadly proclaimed: “The nation’s health care system needs fixing.”

It goes without saying that our healthcare system is a big headache for all of us: decades of neglect and lack of proper public policies have led us to a system where everyone dreads getting sick.  Insurance premiums, copay for doctors’ visits, procedures and drug prices make us almost insane. Without insurance, the scenario is much worse.

First, hospitals charge according to their will and wishes. There are no federal and state regulations on hospital charges. Every hospital has a chargemaster sheet, where they make up a price for each procedure¸ which has no rational connection to the real cost of a procedure. Of course, insurance providers negotiate down from the chargemaster price, but the benchmark is so high, even a fifty percent discount gives the hospitals excessive profits. Many hospitals run under the guise of a nonprofit organization, but their high executive salaries do not resemble anything nonprofit. 

Second is the insurance industry. Even the Affordable Health Care Act (Obamacare) could not force the insurance industry under any kind of federal oversight in regulating insurance premiums or copays. Yes, the Affordable Health Care Act has increased health care access for poor and low income people, however, this act did not address the cost issue in any meaningful manner. Americans will pay more for insurance premiums and copayments – with or without Obamacare.

Third, the pharmaceutical companies’ lobby power is very strong. America is the only industrial democracy where there is no regulating body to oversee the price of medicine. Not only that, federal laws prohibit Medicare and Medicaid to even negotiate drug prices with drug makers. Can you imagine? Congress enacted a law that prohibits government agencies from negotiating drug prices with the pharmaceutical industry. 

No negotiation is equal to no liberty. So naturally, they are at liberty to ask whatever drug price they want. No advanced country allows it. 

The health equipment industry is also a powerful factor in the health care equation. New equipment and technologies are very conducive to hefty profits. They keep no stone unturned to make an insane return of their bucks.

Fourth, our healthcare system does not have enough doctors. Doctors are always in short supply. Federal and state governments can easily fund medical colleges to produce more doctors. Of course, doctors’ associations are also reluctant in this matter as more doctors may bring more competition – hence less compensation. 

Fifth, the current Trump administration is not interested in enacting any meaningful reform in the healthcare system. Rather, the administration is doing whatever they can to weaken Obamacare. The uninsured rate is increasing under the current administration, and they are looking for ways and means to cut funding for Medicaid and Medicare. 

I am not expecting any meaningful policy option coming out of the Trump administration.

In America, almost 18%  of the gross domestic product is spent on health care, compared with about half in most developed countries. Yet the results in our health care system are no better; rather at some level it is worse than other developed countries.  This is not acceptable. 

National policies should be produced by maintaining a balance between efficiency and equity. It is not a zero sum game. For the past half century, the healthcare industry was able to set the tone of health policies where people’s needs were not addressed appropriately. Health care lobbyists are more interested in protecting their profits and benefits than the people they are supposed to take care of. 

We cannot blame them only. As citizens, we all share the blame. We need alert and activist citizens. Health care is a right like speech and religion. The whole industrial democracy (Europe to Japan to Australia to Canada) introduced Universal Health Care for their citizens in some form or shape. 

I call upon young men and women across the country to start intellectual and political activism to bring some transformational change in our healthcare system. It is the call of our time – particularly for educated youth. A sick nation cannot be a great nation.