Student Perspective

Today’s debates over health care and health insurance are analogous to the state of medicine. We spend too much time treating the symptoms, as opposed to finding a cure for the real sickness. Looking into the health industry over the past several years has led me to conclude that the solutions proposed to our problems are not truly aimed at the benefit of society.

Listening to the most recent national discussions on health insurance leaves most people, including members of Congress, scratching their heads. The Democrats seem to want to push whatever they can under the control of the Health & Human Services Department, former WI Governor Tommy Thompson’s former post. Whereas the Republicans, seem to be up in arms over pieces of the legislation that have been supported by Republican Presidents from Theodore Roosevelt to George W. Bush.

I, on the other hand, wish that the debates wouldn’t center on government controls and mandates, but patient choices and competition in the health care industry. To understand where we are, we must look from where we came.

The mid-19th century is where the foundation of today’s debate was laid. The 1860’s saw the removal of most regulations in health care which led to competition between the allopathic mainstream medicine with its eclectic and homeopathic counterparts. This was also a time when the schools of medicine were much more affordable, and much easier to access. The competition driven marketplace that existed kept prices low, and patients’ needs met. However, this was also the time that the American Medical Association(AMA), and Congress soon to follow, began to make its mark on the industry.

Health care providers were generally middle-income Americans, and had a more intimate relationship with patients that often led to working out prices that both parties could agree upon. This isn’t to say that doctors don’t deserve a high income, in fact, they deserve to make a killing, no pun intended. Also, to obtain an education in the medical field students didn’t have to invest an exorbitant amount of time and money, compared to the debt-ridden, over half-century long education necessary to enter the field today.

The 20th century saw the growth of power in organizations like the AMA and Health Management Organizations(HMO’s), and with insurance providers like Blue Cross and Blue Shield. The rise of these organizations was, unfortunately, not due to their positive impact on the patient, but rather on their support from unionized labor and legislation from Congress. The growth of accredited schools for medical practitioners was stymied, and entrance into practice became more and more difficult. This had the obvious impact of increasing the cost of education, and the limiting of growth in field. This shift pushed onto patients higher costs for care, and higher premiums for insurance.

Some ideas that I believe would push the industry in a positive direction for the patient is to reform insurance in several ways. Health insurance, like any other insurance, should not be linked to your employment, which could be accomplished by revising the tax code. The use of health insurance should also be examined. Most people have car insurance, but nobody uses it to get an oil change. This should apply to the outpatient when they receive minimal treatment, and/or purchase small amounts of pharmaceuticals. Leaving their health insurance to be used for the catastrophic events in life like cancer and heart attacks, similar to car crashes and flood damage to the house.

As a future member of the health care service industry I know that today’s problems don’t lie in the hands of providers, it lies in the foundation our industry is built on. The debates of today do not look to fix the sickness that is at the foundation of increased costs, but instead focuses on the symptoms of its superstructure.

When I ascend to the Presidency I will straighten it all out for us though, don’t you worry.

Bryce Chinault
University of Wisconsin School of Medicine and Public Health