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To: mohd.imad@hotmail.com
Subject: Health Care Reform - Why Are People So Worked Up?
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Date: Thu, 23 Nov 2017 04:40:53 +0300
From: Williamemeds <mohd.imad@hotmail.com>
Reply-To: Williamemeds <codydavis3434@yahoo.com>
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Name: Williamemeds<br>=0AEmail address: codydavis3434@yahoo.com<br>=0AMessa=
ge: First, let&#039;s get a little historical perspective on American healt=
h care. This is not intended to be an exhausted look into that history but =
it will give us an appreciation of how the health care system and our expec=
tations for it developed. What drove costs higher and higher?=20
=20
To begin, let&#039;s turn to the American civil war. In that war, dated tac=
tics and the carnage inflicted by modern weapons of the era combined to cau=
se ghastly results. Not generally known is that most of the deaths on both =
sides of that war were not the result of actual combat but to what happened=
 after a battlefield wound was inflicted. To begin with, evacuation of the =
wounded moved at a snail&#039;s pace and this caused severe delays in treat=
ing the wounded. Secondly, many wounds were subjected to wound care, relate=
d surgeries and/or amputations of the affected limbs and this often resulte=
d in the onset of massive infection. So you might survive a battle wound on=
ly to die at the hands of medical care providers who although well-intentio=
ned, their interventions were often quite lethal. High death tolls can also=
 be ascribed to everyday sicknesses and diseases in a time when no antibiot=
ics existed. In total something like 600,000 deaths occurred from all cause=
s, over 2% of the U.S. population at the time!=20
=20
Let&#039;s skip to the first half of the 20th century for some additional p=
erspective and to bring us up to more modern times. After the civil war the=
re were steady improvements in American medicine in both the understanding =
and treatment of certain diseases, new surgical techniques and in physician=
 education and training. But for the most part the best that doctors could =
offer their patients was a &quot;wait and see&quot; approach. Medicine coul=
d handle bone fractures and increasingly attempt risky surgeries (now large=
ly performed in sterile surgical environments) but medicines were not yet a=
vailable to handle serious illnesses. The majority of deaths remained the r=
esult of untreatable conditions such as tuberculosis, pneumonia, scarlet fe=
ver and measles and/or related complications. Doctors were increasingly awa=
re of heart and vascular conditions, and cancer but they had almost nothing=
 with which to treat these conditions.=20
=20
This very basic review of American medical history helps us to understand t=
hat until quite recently (around the 1950&#039;s) we had virtually no techn=
ologies with which to treat serious or even minor ailments. Here is a criti=
cal point we need to understand; &quot;nothing to treat you with means that=
 visits to the doctor if at all were relegated to emergencies so in such a =
scenario costs are curtailed. The simple fact is that there was little for =
doctors to offer and therefore virtually nothing to drive health care spend=
ing. A second factor holding down costs was that medical treatments that we=
re provided were paid for out-of-pocket, meaning by way of an individuals p=
ersonal resources. There was no such thing as health insurance and certainl=
y not health insurance paid by an employer. Except for the very destitute w=
ho were lucky to find their way into a charity hospital, health care costs =
were the responsibility of the individual.=20
=20
What does health care insurance have to do with health care costs? Its impa=
ct on health care costs has been, and remains to this day, absolutely enorm=
ous. When health insurance for individuals and families emerged as a means =
for corporations to escape wage freezes and to attract and retain employees=
 after World War II, almost overnight a great pool of money became availabl=
e to pay for health care. Money, as a result of the availability of billion=
s of dollars from health insurance pools, encouraged an innovative America =
to increase medical research efforts. More Americans became insured not onl=
y through private, employer sponsored health insurance but through increase=
d government funding that created Medicare and Medicaid (1965). In addition=
 funding became available for expanded veterans health care benefits. Findi=
ng a cure for almost anything has consequently become very lucrative. This =
is also the primary reason for the vast array of treatments we have availab=
le today.=20
=20
I do not wish to convey that medical innovations are a bad thing. Think of =
the tens of millions of lives that have been saved, extended, enhanced and =
made more productive as a result. But with a funding source grown to its cu=
rrent magnitude (hundreds of billions of dollars annually) upward pressure =
on health care costs are inevitable. Doctor&#039;s offer and most of us dem=
and and get access to the latest available health care technology in the fo=
rm of pharmaceuticals, medical devices, diagnostic tools and surgical proce=
dures. So the result is that there is more health care to spend our money o=
n and until very recently most of us were insured and the costs were largel=
y covered by a third-party (government, employers). Add an insatiable and u=
nrealistic public demand for access and treatment and we have the &quot;per=
fect storm&quot; for higher and h<br>=0A