November 15, 2009

A Personal Perspective on a Flawed Health Care System

Listed in: Women's Issues, Other Domestic Policy, NJDC News, Opinions

Originally published in JTA

By Ira N. Forman, CEO of The National Jewish Democratic Council

I am one lucky man, some might say blessed, as earlier this year I had a heart attack and survived—physically and financially.

I am fortunate to have a comprehensive health insurance plan. Yet even an American with good insurance cannot go through a serious medical calamity without getting at least a glimpse of what lies over the precipice of financial and medical disaster.

At a fund-raiser last March for my children’s Jewish day school, I found myself on the floor of a men’s room gasping for air as a result of blockage to one of the arteries to my heart. The emergency response personnel wanted to take me to the nearest hospital, but I was fortunate to have my wife, and advocate, by my side. She objected and demanded they take me to the hospital with a better cardiology department and where my medical records were readily available. The personnel reluctantly agreed and 70 minutes after I arrived at the hospital I had three stents implanted.

Ten days later I had successful bypass surgery and was on the road to recovery, thanks to the highly competent health professionals who diligently worked on my case.

Two weeks at the hospital resulted in a bill that was well into the six-figure range. After my discharge, I began receiving very large bills for my surgeries and hospital charges every few days—bills of $20,000 or $30,000 at a time. The notices on the bottom of the invoices indicated that my insurance carrier had refused to pay because the policy had been terminated and I was expected to pay the bill.

Thankfully my policy was still in effect and I was able to rectify the situation. However, not everyone is able to win a fight with the bureaucracies of insurance companies while also recovering from a life-threatening malady.

Millions of Americans are not so lucky. They may receive inadequate care or have their insurance company deny their claims. Considering the trouble I had with my health insurance claims, I can only imagine what happens with the millions of people who are uninsured or underinsured, or do not have the patience to persevere in a dispute with their insurance company.

More and more Americans are denied high-quality, affordable health care, and the insurance companies continue to refuse coverage when it is most needed. Unfortunately, with every day that passes, the problem gets worse and thousands more Americans lose their health insurance. Even for those with insurance, there is still no cap on what insurance companies can force patients to pay in out-of-pocket expenses, which leads many families into bankruptcy.

The expense of America’s health insurance is astronomical. According to an article that appeared in the New England Journal of Medicine earlier in this decade, administrative costs alone in the United States totaled $294 billion and accounted for 31 percent of total U.S. health care spending. By contrast, in Canada administrative expenses amounted only to 16.7 percent of health care spending.

If we do nothing now, health expenditures in the U.S. could grow from $2.5 trillion this year to more than $7 trillion in 2025. Our current system is not only a disgrace, it is a burden on our economy.

However, despite the astronomical amounts of money dedicated to health care in the United States, the life expectancy for individuals living in America is 75 years for a male and 80 for a female. According to the U.N.‘s World Health Organization, the figures are lower than Cuba, Israel, Japan and more than 30 other countries. Yet what may be most remarkable is that the U.S. manages to spend $6,714 per capita, while Israel and Japan each spend less than 40 percent of that amount.

In addition to these terrible inefficiencies, the inequity and injustice of our system leads many in the Jewish community to believe there is a moral component to health insurance reform. More than virtually any other issue, there is broad consensus for reform—from Agudath Israel of America to the Religious Action Center of Reform Judaism.

Stan Dorn, a National Jewish Democratic Council senior fellow, was right when he wrote, “The Torah contains more laws commanding justice and kindness towards the stranger … than it addresses to any other subject, including the Sabbath, the festivals, or even honoring G-d.” Dorn points out that our tradition “teaches that a society is measured in G-d’s sight largely by how its most vulnerable members fare.”

It is a matter of justice, no matter where you fall on the Jewish denominational spectrum.

I am lucky to be alive today. Moreover, I am doubly lucky that my medical emergency did not bankrupt my family. But I am reminded that my episode demonstrates just how broken our system is. After all, I am a Jewish organizational CEO with a high-quality health insurance plan and a master’s degree in business to figure out how to maneuver through private sector health insurance’s broken bureaucracy.

All of us, no matter which political party we are from or who we we voted for last November, are living with the consequences of this broken system. The passage of the health care bill out of the House of Representatives was a step toward fixing this system, but there is still much further to go. While we may not all agree on the exact solution, we must all agree that the time has finally come to comprehensive reform of our health insurance system.