Health care system needs surgery |

Health care system needs surgery

Mel Hawkins

Year after year, we try to fix the system with reforms that are initiated to broaden access to care, control cost, reduce complexity and otherwise improve the manner in which the system meets the needs of Americans.

In spite of these efforts, estimates suggest that 45 million Americans lack access to health care or coverage. Millions more risk losing their health coverage because their jobs are in jeopardy.

The senior citizens who struggle each month to pay for the prescription drugs they so urgently require number in the millions.

Experts predict double-digit annual increases in aggregate health-care expenditures over the next decade, driving the total cost of care from $1.25 trillion to nearly $3 trillion by 2010.

In the midst of these headlines, the system grows more complicated and physicians see an erosion of the control they exert over their medical practices.

How long will this continue? The answer: As long as it takes us to alter the way we think about health care in America. In my book, “Radical Surgery: Reconstructing the American Health Care System,” the reader is guided through a process that examines the American health-care system as an integral whole and that leads us to a solution.

What one learns is that the reforms of the last half-century have been initiated in response to symptoms and not the root causes of the system’s failures. Over the last century, health care has evolved into a system that we do not understand and that will not bend to our will. The problem stems from our basic assumptions about health care in the United States.

At home or at our jobs, we will fiddle with a tool or process for only so long before we conclude there must be a better way. We then step back to re-examine our purpose and we construct a new tool, one designed to serve our specific objectives. We must apply this same approach to resolve the health care dilemma in our nation.

The root causes of the system’s failure begin with an acknowledgement that the system was constructed on a false premise. We must first acknowledge that the system in place today was never intended to provide universal health care and no amount of tinkering will change this basic truth.

The second thing we must do is to declare, unequivocally, that all Americans deserve health care. Contrary to those who insist that we lack such a consensus, public sentiment appears strong.

The obstacle is that few think it is possible to provide universal care without turning to some form of socialized medicine and, for many Americans, this is untenable. What we need to understand is that providing universal care, without government, is possible if we are willing to use a little imagination.

The final thing we must do is clear up the misconception that the problems of health care are the result of the free-market system run amok. As it turns out, just the opposite is true. The problem with health care is that the logic of the current system is so convoluted that free market forces are unable to exert their influence.

More simply stated, the problem is not that doctors make too much money. The problem is that incentives in health care reward the wrong behavior.

The problem is not that the health insurance and managed-care industries are driven by an insatiable hunger for profits. The problem is that these entities exist at all.

Think about it! If we want to provide universal care, what value does heath insurance and managed care contribute? What value do Medicare and Medicaid provide?

Don’t these organizations exist to restrict access to care to those who are eligible? Don’t these entities exist to limit care to only those procedures to which the enrollee is entitled and for which they have paid?

Everything we have in this wonderful country, including our freedom, is made possible by our free market economy. Why are we so quick to think that free market forces are bad for health care?

The challenge for Americans is to believe that a solution is possible if we focus on the objective and begin anew.

What we will discover is that we can have a system that provides universal health care and prescription drugs to all Americans. We can have a system that gives the patient the freedom to choose their doctor. We can have a system that returns control of the practice of medicine to physicians and that frees them from the interference of public and private bureaucrats.

We can have a system that reduces the growth of aggregate health expenditures by billions of dollars each year.

We can have a system that relies on free-market forces to drive quality and accountability. We can enjoy a system without health insurance, managed care, Medicare or Medicaid.

Finally, we can have a system that limits the role of government to the very few things government does well.

Mel Hawkins lives in Waynedale and is the author of a new book, “Radical Surgery: Reconstructing the American Health Care System,” available at or,, or through your local bookstore.

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