The Best of Times and the Worst of Times, When It Comes to Healthcare

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In These Times

The Best of Times and the Worst of Times, When It Comes to Healthcare

by
Roger Bybee

With a raft of new Charles Dickens biographies hitting bookstores this fall, it is difficult not to quote the classic chronicler of the Victorian era's polarities when describing the state of America's healthcare system: "It was the best of times, it was the worst of times.”

The good times are concentrated among corporate executives. Healthcare, insurance and drug company CEOs have actually managed to displace bankers as the best-rewarded bosses in America. The Guardian archly reported recenty: "Pity Wall Street's bankers. Once the highest-paid bosses in the land, they are now also-rans. The real money is in healthcare and drugs, according to the latest survey of executive pay."

Among the big winners in healthcare listed by the UK-based newspaper:

  • John Hammergren, chief executive of McKesson Corporation, a pharmaceutical distribution corporation, took home a breathtaking $145,266,971 in 2010.
  • Joel Gemunder, outgoing president of Omnicare, a pharmacy company that dispenses drugs in nursing homes, benefited handsomely from s 2010 total pay package worth $98,283,242.
  • “CVS Caremark, which operates 7,000 pharmacies across the US, awarded chief executive Thomas Ryan $68,079,823 in 2010. 
  • Ronald Williams, boss of health insurance giant Aetna, made $57,787,786 in 2010. 

But for America’s healthcare consumers, the bad times got worse. Despite the slow-moving implementation of the 2010 Patient Protection and Affordable Care Act (PPACA), the system’s vital signs indicated critical condition:

  • 53 million Americans are now uninsured, up from 34 million in 1990.
  • As many as 82,000 Americans die annually due to a lack of access to healthcare, according to a new Commonwealth Fund study that roughly doubles the previous estimate.
  • 62% of personal bankruptcies are accounted for by an unaffordable stack of medical bills brought on by a family members’ health crisis.

Sweeping cuts in Medicaid by U.S. governors threaten to throw more people, including children, into icy uninsured waters. For example, Wisconsin Gov. Scott Walker is aiming to slice Medicaid rolls by 65,000, including 30,000 children.

Healthcare insurance has become so expensive that Americans have cut back on their visits to doctor’s offices by 17 percent, even as a growing share of Americans admit that they have skipped needed medical care because high-cost, high-deductible plans continue to proliferate.

But even with the implementation of state-level healthcare exchanges under the PPACA (aka, “Obamacare”), don’t expect much improvement except in curbing the most egregious abuses of insurers, warns Dr. Don McCanne, senior health policy fellow of the Physicians for a National Healthcare Programs.

Once the exchanges are in place in 2014, moderate-income Americans are certain to find themselves ensnarled in fights with the IRS over the proper level of subsidies they need to pay for a level of healthcare insurance that many doctors consider “skimpy."

Until the point where the inadequacy of PPACAA’s coverage becomes clear and Americans grow infuriated over fighting to pay for inadequate coverage., we seem destined for several more years of "unaffordable under-insurance," as McCanne told In These Times earlier this month. When frustration over the new status quo boils over, Americans will be ready to have a serious debate about the single-payer "Medicare for all” plan that replaces for-profit insurers.

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