Doc shortages to deficits: Reform reality check

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Health care videos

Public option a barrier to reform?
Nov. 25: Is a proposed government health insurance option getting in the way of landmark health care legislation? Sen. Thomas Carper, D-Del., and guest host Chuck Todd, discuss.

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Negating Lieberman’s vote

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Dose of reality
Do health care reform headlines leave you saying “huh?” Visit msnbc.com's guide to health reform and send us claims you'd like fact-checked.

Video

Health care reform: Too fast, too soon?
July 22: Sen. Bob Bennett, R-Utah, discusses why Republican senators want a delay for the health care reform legislation.

MSNBC

Reality check: The chairman of the Republican Party Michael Steele has been comparing President Obama’s health care overhaul to socialism.

This complaint is not worth five seconds of your time. Quick — name the biggest government-run health care system in the world. If you said the Veterans Administration health system, you would be correct. Yet, instead of calling to dismantle the VA, most Republicans want to see more money spent on the system.

Claim: Health care reform will create a mind-boggling web of bureaucracy.

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Reality check: Reform critics have taken to trotting out a complicated-to-follow flow chart showing the complexity of the Democratic proposal, a tactic meant to turn Americans against the reform plan. But bureaucracy is already choking health care in the United States. There could not be a more complex, inefficient, frustrating and absurd bureaucracy than the system we have now.

Have you looked at a hospital bill lately? Have you talked to your doctor about the amount of paperwork that needs to get done simply to get paid? Ask any hospital staffer about drowning in bureaucracy.

Compare the costs of administering health care in Medicare or the Veteran's Administration: They have a single payment form without a lot of back-and-forth on the billing. On the other hand, doctors have to deal with multiple payers. Major insurance companies like Aetna, Cigna and United Health have high administrative costs, sometimes don’t pay the bill properly, or will put up obstacles to stop payment — forcing the consumer to track them down.

Claim: Health reform will empower Washington — not doctors and patients — to make health care decisions.

Reality check: No one in Congress or Washington wants to play doctor. They are too busy to have any time for prescribing medication for your allergies or to tell you what surgeon to see for your gall bladder operation. With the Obama team taking a cue from the Clinton administration, there will not be any single government-run health plan.

Claim: Health reform is the end of innovation in health care.

Reality check: It is true that innovation is in trouble in an age of cost-containment. There is no way, health reform or not, that we can continue to pay for medical research and innovation the way we have done so in the past. But the way we have done so in the past is crazy.

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Basically, Americans have paid for the cost of developing and marketing new drugs and devices from laboratories to hospitals and pharmacies by paying two to three times as much as the rest of the world. This is not the way to pay for medical innovation. In the future we need to take the cost of innovating out of the insurance side of the system and put it firmly into the research side, where we can all then decide how much we really want to pay to innovate.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.

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