To the Editor:
Imagine for one minute that the repair shop to which you take your car has 2 mechanics who work on the cars, but 20 people who work in the office making appointments, creating work orders, et cetera. How much would it cost to get a simple tune up or oil change? Now imagine that this situation existed in the healthcare field.
Surprise! You don’t have to imagine, that’s the reality in American healthcare. There are now 10 healthcare administrators for every doctor: “The ratio of doctors to other healthcare workers is now 1:16, up from 1:14 two decades ago. Of those 16 workers for every doctor, only six are involved in caring for patients—nurses and home health aids, for example. The other 10 are in purely administrative roles.”
How does this insanity come to pass? It’s what happens when a healthcare system is fractured into several discrete and competing interests. Each zealously pursues its own interests—insurers, drug companies, PBMs, device manufacturers, for profit providers, private equity shark investors….where are the patients? They have no organization similar to America’s Health Insurance Plans [AHIP], The Pharmaceutical Research and Manufacturers of America [PhRMA], or The Partnership for America’s Health Care Future [PAHCF]. The PAHCF alone includes over 100 individual organizations. The combined financial power of these organizations, all of which profit greatly from the current 10-to-1 system, puts the resources of individual patients to shame. It is always these organizations that are the “players” who get “a seat at the table.”
All of which has gotten us to this point where the cost of healthcare is crushing people. A veteran healthcare journalist reports that “I’ve seen patients’ faith shaken. They’re tired of shocking medical bills they didn’t expect and can’t afford. And they’re disgusted by the collection notices, the threatening phone calls, and the appointments they can’t get because they owe money.”
A practicing doctor writes in the New York Times that “There’s nobody measuring the time spent on the phone plus lost wages plus complications from delayed care for every single patient in the United States” And certainly no one even attempts to identify/quantify the psychological and emotional toll of the anxiety that all this causes people trying to navigate the labyrinth while sick and worrying that the delays will kill them…..
Again: Ten administrators for every doctor. None of the current healthcare “reform” proposals addresses this problem except for Medicare for All. And despite the fact that the problem affects everybody, the executive director of the Vermont Democratic party told me not long ago that healthcare was not a hot topic for voters when candidates speak to them.
If true, we have to make it a hot topic. Tell people: 10-to-1. Tell everyone you know. Tell your legislators over and over again until they really understand how disastrous this is.