- Chapter 6 -
- The Best Health Care for Every American -
nAmerican citizens are rightly up in arms about the
crisis in the U.S. health care system. Prices for
everything from medication to physician services are
soaring beyond the means of an increasingly
impoverished citizenry, while the cost of health
insurance is going sky high, forcing employers and
employees alike to drop coverage in order to stay
financially solvent. At the same time, health insurers,
led by Medicare and Medicaid, are covering fewer and
fewer categories of treatment, while paying medical
providers lower proportions of their costs and
demanding ever-higher premium payments. They are
forcing sick patients out of hospitals and financially
strapped hospitals out of business. The ones that
remain have had to limit or deny treatment for those
without insurance.
But the crisis in U.S. health care is not just one
of affordability. The fact is that our health care
system is in a {breakdown crisis,} caused by
the accelerating collapse of the entire U.S. economy
from nearly 30 years of incompetent economic policies
and financial swindles.
This breakdown is embodied by the now-evident
reality of the 1980s Reagan-Bush ``recovery'': the
surge in diseases like syphilis and hepatitis, the
epidemic emergence of new diseases--most notably
AIDS--and the re-emergence of long-dormant strains like
measles and turberculosis ({Figure 1}). The
failure to maintain basic public health screening and
treatment practices--especially in regard to AIDS--and
to provide elementary preventive medical services like
vaccinations, has put the United States on the verge of
a biological holocaust.
Furthermore, there is a dire shortage of hospitals
and hospital beds, by even normal standards. Up until
the ascendancy of Ronald Reagan and his bogus
free-market economics in 1980, the U.S.A. had steadily
increased the number of general hospital beds, to
attain 97% of the postwar standard of 4.5 beds per
1,000 population ({Figure 2}). By 1990, the
nation had only 83% of the beds needed; 761 hospitals
had been shut down.
While there is no doubt that improved medical
technologies have reduced hospital stays, the main
driver has been cost-cutting. In West Germany, which
arguably has the best overall health care in the world
today, there are more than 7.4 beds per 1,000 people,
which is nearly {double} that of the United
States.
Far worse is the inability to care for the growing
number of our aging citizens and for those who are
mentally disabled. Since 1950, the number of beds for
chronic long-term care patients has dropped by 65% to a
mere 25,000--barely 5% of the 500,000 needed.
Similarly, the number of beds in mental institutions
has dropped by 78% since 1960, to just 160,000 out of
the 1.25 million needed in 1990.
On top of this is the murderous closing of 65
trauma units, which have reduced the trauma death rate
by 64%. Lack of funds endangers the remaining 370
centers. In our largest cities, overwhelmed hospital
emergency rooms treated more than {twice} as
many patients in 1990 as in 1980. Each day, they are
besieged with AIDS victims, the homeless, the
chronically mentally ill, and drug-induced or
violence-related emergencies, as well as sick,
uninsured patients who lack access to primary care.
In California, where 56 hospitals have closed in
the last decade, more than a dozen other hospitals have
shut their emergency rooms permanently. Ambulances
carry patients to four or more hospitals before finding
an available bed. Los Angeles emergency room doctors
acknowledge that their patients have died on gurneys in
the halls while waiting for beds.
In 1989, while emergency room patients lined the
walls of New York City hospitals waiting for beds, over
1600 beds were certified and available but closed due
to lack of nurses. In a New York State Health
Department survey of city hospitals at midnight on Jan.
10, 1989, 599 emergency room patients admitted were
found waiting for a bed. One year later, on Jan. 10,
1990 at midnight, another state audit found 960
admitted patients waiting for beds.
- Prescription for Death -
Every candidate but LaRouche has ignored this
breakdown. Almost nowhere can one find even a mention
of the necessity for the enormous {expansion}
of our collapsing health care system. Instead, the
focus of the health crisis debate is on the form and
cost of insurance coverage that should be provided, the
means of reducing treatment in order to control costs,
and the measures for increasing ``cost efficiency'' of
the ``delivery system.'' {Every single one of these
so-called solutions--including the push for
``universal'' or ``national health care,'' ``managed
care,'' and so-called ``pay-or-play'' options for
employers--would only further wreck health care in the
United States.} They would actually
{worsen} the financial straits of hospitals and
medical providers, and precipitously lower the quality
and availability of medical treatment for the
population.
That in fact is the {intention} of George
Bush and the Bush Democrats.
It is the inevitable result of 30 years of pushing
the United States, and the world, into the New World
Order of ``post-industrial society,'' in which we have
failed to invest in the basic infrastructure and
industry that could have produced enough goods and
services to maintain an expanding population at
ever-higher standards of living. It is the result of
two decades of financial speculation in real estate,
commodities, and corporate mergers that have saddled
our industry and citizens with $25 trillion of
inflationary, unpayable debt, rendered our government
and banking system bankrupt, and turned us into a
debtor nation. Such a policy now deems much of this
population as ``expendable,'' especially the
depression's swelling ranks of unemployed who are
elderly, sick, or infirm--the targets for the growing
Right to Die euthanasia movement.
It wasn't always that way.
- Commitment to Life -
On the eve of America's victory over the Nazis,
Sen. Lister Hill of Alabama submitted legislation to
Congress that expressed the essence of the nation's
renewed commitment to the fundamental preservation and
enhancement of life. The Hill-Burton Hospital
Construction Act of 1946 embarked the United States on
a decade of unprecedented expansion of the nation's
hospital and public health system. Along with other
programs, such as upgrading nursing services and
locating veterans' hospitals near medical schools so
that medical students could both staff and train at
them, the U.S. health system became an integral feature
of the postwar economic expansion and a scientific
optimism that would soon enable man to soar into space.
The rising standard of living and solid gains in
productivity brought medical care within the budgets of
more and more Americans. In 1952, for the growing
number of people who purchased health insurance, the
combined premiums for Blue Cross/Blue Shield hospital,
surgical, and physician coverage was just $6.65 a
month, or $80 a year--just over one week's wages. Back
then, the average hospital stay cost just two weeks'
wages for such a production worker; now it costs
{12 weeks} pay, with much worse care
({Figure 3}).
The free-market insanity of the Reagan-Bush
administration has increasingly forced hospitals into
the arms of Wall Street financial wizards, who
increasingly moved in to run hospitals as a business
rather than as a dedicated professional service.
Far from augmenting ``efficiency,'' the
cost-control measures imposed by these bloodsuckers
have sent administrative costs soaring. The nitpicking
over each and every medical charge, the establishment
of legions of accountants and forms and financial
regulations, have resulted in an 8% annual increase in
administrative costs for both doctors and hospitals,
{above} the inflation rate! This is
{double} the average annual increase in overall
medical costs.
{Administrative costs now conservatively
comprise 25% of medical costs.} When combined with
the growing army of poor seeking medical care and
government cuts in Medicare and Medicaid payments,
hospitals and physicians have shifted more and more of
the costs onto the shrinking base of those with
insurance--to the point where the average hospital bill
now costs the equivalent of more than 11 weeks of a
manufacturing worker's wages.
- The LaRouche Program -
1. The prerequisite for restoring our health care
system is to commit the nation to LaRouche's program
for building our way out of the depression: the
creation of 6 million new productive jobs as the result
of federalizing the Federal Reserve, and pouring
low-interest credit into necessary public works. At the
top of the list will be the revitalization of the combined
public and private county hospital system, which once
adequately served the needs of our citizens, financed
from public funds garnered from an expanding tax base
of employed Americans.
2. We must build more hospitals and add hundreds of
thousands of beds, as part of this drive to revitalize
America's economic infrastructure. We must greatly expand the
number of intensive care beds, re-open closed emergency wards
and trauma centers, and build new ones. A new Hill-Burton
Commission shall be established to upgrade our health care
system, to oversee the construction of new hospitals and
medical centers and equipping them with the most advanced
technology.
3. We must launch an Apollo-style, crash research
program to fight degenerative diseases and epidemics
with the best technology available, especially
employing the frontier technology of optical biophysics
to find a cure for the species-threatening AIDS virus
and other infections now careening out of control.
4. Fourth, the federal government shall regulate
health insurance companies to ensure full payment of
medical costs and complete medical coverage for policy
holders, with premium prices based on an average cost
for entire communities, not on an individual's ``risk
factors.'' The federal government will also provide a
safety net for those without insurance, through both
Medicare and Medicaid and a new catastrophic health
insurance plan.
----
John Covici
[email protected]
