For The Record

As for providers–hospitals, medical technicians, doctors, nurses–what can you say? Last week one of my neighbors had a hip replacement. One hour after the operation, he was on his feet and 2 days later, he was home. In 1934, when I had my appendix removed at St. Vincent’s Hospital in New York City, I was in the hospital 3 weeks and out of school a month. Many operations and procedures that formerly required hospitalization are now done on an outpatient basis.

Progress in this area has been an enormous boost to the nation’s productivity. Expensive, you bet, but then the new Ford I bought for $1,100 in 1947 costs a great deal more today. You can argue that the Ford of today has many more features than the one bought in 1947. True, but then, so is the quality of health care today. What was life like before the MRI, CAT scan, open heart surgery and stents? The answer was often debilitating illness, disability or death and, not so minor an issue, loss of productivity.

And finally, those real bad guys so often painted as the worst villains by candidates–the insurance companies. Most people living today have not experienced what life was like before the advent of health insurance, particularly group insurance. I remember it vividly and witnessed it first hand what illness did to the family finances. On two occasions, my in-laws were reduced to poverty because of medical bills to treat my brother-in-law. There was no insurance available and my father-in-law worked years for doctors just to pay off their bills.

Health insurance enables people to finance the ultimate in healthcare–no matter how expensive. This has enabled millions to access care that was formerly beyond their reach. This financing has also helped to pay for the wonderful advances in medicine that we often take for granted. But then, the audience for this column is as aware as I am as to what insurance has done and is doing to help people access the best healthcare in the world–so I will not belabor the point.

As to profit, the last figure that I saw indicated insurers were realizing only 2% or 3%–certainly not unreasonable. Additionally, some companies have exited the business because it was unprofitable.

Despite all the progress, is there still room for improvement? Of course there is, but as you get closer to perfection, improvements are harder to come by. The most often cited area for improvement is the plight of 40-plus million people who are uninsured (voluntarily or otherwise). But being uninsured does not necessarily mean a person does not have access to the health care system. Medicaid and state and county initiatives regularly provide excellent care for those who cannot pay for such services.

There are indeed opportunities for improvement, but my guess is that they will more likely come from the 4 targeted areas I noted than from some “secret” plan being touted for votes.