I worked as a pediatrician for 37 years and I have become concerned about how health care is financed in America. There are fundamental flaws in our health care system and I don’t mean what doctors and nurses do.

In a nutshell, our system is too expensive, too hard to access and the payment system is too complex. 

Because of these problems, many people find it very difficult to access care, leading some to simply choose not to get care. Thus, despite being by far the most expensive health care system in the world (double the average cost of other advanced countries), our health care quality, as measured by preventable deaths and preventable disease, is only mediocre compared to other advanced nations. Also, we Americans actually receive significantly less care than the average citizen of other developed countries. 

Why? 

The control of our system is too much about the profits of insurance companies and other large businesses and is not focused enough on the needs of the patient and society. The health insurance industry holds the purse strings of health care and they are accountable to their shareholders and not accountable to the patient nor to the public. 

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Let’s compare our health care system to our highway system. Despite occasional congestion on our roads, all of us are able to drive as needed without fear of financial ruin or lack of access to good roads. If, however, the highways were like the health care system, some people who are elderly, impoverished or who work for the government (tax-supported, government-run health care programs) would be allowed to use our highway system more freely than others.

Meanwhile, those who are privately employed, before they could use the highways, would have to pay another monthly “premium” toll of about $1,000-$2,000 for a family of five that is deducted from their income, even though they paid their share of the taxes that built the highway system just like the government workers. Then, with proof in hand that they paid their monthly premium, they might try to get onto the highway. But they would be stopped at the toll booth yet again to pay another toll. This is a “deductible” toll which is paid every time they get on the freeway until they have paid out about $5,000 each year. Even if they pay their full $5,000 each year, they still need to pay yet another “copay” toll of about $30 every time they use the highway.  

Health care is not something that should be controlled by companies who are motivated to make profits off the people who are already paying for their care and the care of all Americans, by taxes, premiums, deductibles and copays. The health care insurance companies clearly benefit tremendously from the taxpayer’s contribution, but does the taxpayer benefit from the insurance company? 

An acceptable system is already available to large segments of our society, i.e., those eligible for tax-supported, government-run health care programs. It should be available to all American patients. After all, they paid their fair share of taxes that pay for those programs.

The control of our health care should be wrested from the health insurance industry and realigned to focus on the needs of patients and of society. Health care and its financing should be accountable to the patient, the people, the taxpayer and the care should be available to all.  

We should all be allowed to drive on the good roads that we pay for. We should all have access to and coverage by the health care system that we already pay for with our taxes. Common Sense Health Care for Utah is a nonprofit organization that is working to bring this kind of fairness and accountability to Utah’s health system.

George Groberg, M.D., is a retired pediatrician with 37 years of experience in America’s increasingly dysfunctional health care system.