Health Care System Left In Shambles

It’s probably safe to say that Dr. George Schneider knows as much or more than anybody else on this side of the state about the delivery of health care in Washington.

For the past several years, he has served on the State Health Services Commission, charged with implementing the landmark reforms of 1993, and subsequently on the State Health Care Policy Board, which presided over the dismantling of the reforms.

At a recent meeting of the Senior Legislation Coalition for Eastern Washington, the former physician from Spokane offered a personal perspective on where health care is headed. The prognosis?

Not good. Not, at least, for subscribers to the good doctor’s point of view, which holds:

“Government’s basic responsibility is to provide for the safety and well-being of its people. That’s why we band together as a society. Health care incorporates what government is all about.”

“Enactment of Medicare and Medicaid (in the 1960s) expressed the concept that no matter who you are - wealthy or poor - health is a right of society. This is a powerful policy statement - a commitment to a fundamental concept. We take care of those who are less fortunate and in need.”

“Sadly, our society also has come to value money as the most important measure of an individual. Health has become secondary to the accumulation of wealth. It is unfortunate, and we will have to deal with that.”

“The individual is important. All individuals.”

Coming from this basis, Schneider said Washington’s Health Services Act of 1993 was the most enlightened and forward-looking program of health care ever enacted. It may take 15 or 20 years for the pendulum to swing back, but this nation eventually will end up with such a system.

“The insurance companies will find that they can’t compete on a global basis at a low enough level and still get the returns they want,” Schneider foresees. “So they will abandon health care.

“Americans will demand a system that ensures reliable health care. We will go to a single-payer or single-source system, run by government because that is more efficient and cost-effective than the existing fragmented method of delivery.

“Meantime,” Schneider says, “there is no health care system in this country.”

It was shredded by the insurance companies. Insurance works well if the risks are widely shared, Schneider says. But it is more profitable for insurance companies if “barriers” and “gimmicks” are used to “divide” and “isolate” people.

“With that approach,” says Schneider, “the costs escalated two or three times the Cost of Living Index.” This was the spreading cancer that health reformers sought to bring under control early in the decade by creating an orderly system of health care for all.

But, says Schneider, “The far-reaching reforms of 1993 in this state came to near-total defeat, because corporate giants realized that in health care, fast approaching a trillion-dollar industry in the United States, there was a great deal of money to be arbitraged. They could come in and take a lot of money out of health care services, as they had in transportation systems, in steel, in oil.

“They waged a huge campaign, and our state’s health services act went down to defeat, along with effort’s to establish a similar national health care system.”

Now, once again, he says, “There is no system of caring for a person’s or people’s health. It is hodgepodge. Hit and miss.”

Difficulties lie ahead for health care. “I think we have peaked,” Schneider says.

“Our leadership,” says the policy expert, “does not even have a policy that deals with health care. I have never heard a policy articulated in a broad sense.”

That’s all the more frightening, says Schneider, considering that a large body of new knowledge points to the conclusion that a normal lifespan is about 120 years. Yet, workers get booted at age 50.

“We shouldn’t have to apologize for living 120 years,” says the physician. “That bothers me.”

, DataTimes MEMO: Associate Editor Frank Bartel writes on retirement issues each Sunday. He can be reached with ideas for future columns at 459-5467 or fax 459-5482.

The following fields overflowed: CREDIT = Frank Bartel The Spokesman-Review