The Affordable Care Act, take two

Do you believe that people in this country should have universal, affordable health care? Something similar to what most people in industrialized countries have? If so, this column is for you.

If you don’t care that millions of your fellow citizens do not have health care or that 18 million Americans will lose their health care if the Affordable Care Act is repealed, please go see your doctor. Clearly, you are having some heart problems.

With the Senate confirmation of ACA and Medicare critic Rep. Tom Price, of Georgia, as the next Health and Human Services secretary, the battle lines are being drawn for another epic fight about health care.

What should progressives do? First, we need to protect the positive achievements of the ACA, such as the 18 million previously uninsured people who now have health care; the ability of people with preexisting conditions to get health care; the increased availability of mental health and birth control coverage.

But, the ACA was a compromise bill. While we were able to expand coverage, we were unable, due largely to Republican obstructionism, to rein in health care costs.

The stupidity of the United States health care system is unbelievable. We are the only first-world country without a publicly financed universal healthcare system. Even prior to the ACA, we paid 17.1 percent of our gross domestic product on health care. This is roughly 50 percent more than France, the second highest spender. Despite the high costs, millions of Americans still do not have health care.

At the same time that we fight to save the positive aspects of the ACA, we also need to address the faults in the health care system. Progressives need to take on the vested interests that are getting rich off our screwed-up system.

Let’s start with Price and his fellow orthopedic surgeons. In America, the average orthopedic surgeon makes $500,000 a year. This is two or three times more than what a similar surgeon makes in Europe. Physicians’ salaries, and especially medical specialists’ salaries, are way out of control.

A bigger problem: One out of every four dollars Americans spend on health care goes to administrative costs. This is far greater than what European countries, Canada and Japan spend on administration. Our insurance companies, while inefficient administrators, are efficient at applying political pressure. If these for-profit insurance companies cannot compete on price and service, then we need to move to a government-run system.

Our prescription drug prices are the highest among industrialized countries. The fact that our government can’t negotiate with pharmaceutical companies to reduce prices is absurd. We need to change this. If the drug companies hadn’t helped to write our laws, this hold-up would be illegal.

We need to change our thinking about end-of-life decisions. Much of the care that people receive in their final months of life is unnecessary, inhumane and expensive. With education and extended palliative care, we can change that.

In the upcoming health care battle, we need to address universal health access as well as out-of-control costs. A more efficient system with lower physician and administrative costs, pharmaceutical drug cost controls and a more humane and less costly end-of-life care can be embraced by Americans who care for their fellow citizens as well as Americans who care about their pocketbooks.