Dear Sir or Madam,
It troubles me when I hear endless discussions about little things that don’t really matter that much while avoiding the most fundamental problem.
Here is what I think it is:
It is a well known fact that At 16+% of GDP or 2.2 trillion dollars per year American healthcare costs twice as much as healthcare in any other developed country, while the outcomes (morbidity and mortality) are worse and 15% of the population (45 million) is not covered. Unfortunately the debate at this point focuses only on the 45 million people that are not covered and how to find even more money to cover them. In addition an argument is frequently made that American healthcare is the best in the world, without any evidence to prove it, and thus needs to be preserved. At the end of the discussion a passing reference is usually made to the need to do something about the rising costs.
What about the costs that are already there?
Unfortunately, not a single person said this – by doing simple arithmetic, based on the above facts, one can easily arrive at the following – If this extra 8% of GDP isn’t producing any improvement in the health of this nation, then it is a WASTE?
In other terms, more than 1 trillion dollars per year goes to the “Medical industrial complex” without producing any benefit for the country. Clearly this amounts to massive and systematic wealth transfer, comparable to the Wall Street deeds over the last few years. This astronomical amount of waste exceeds the GDP of the most countries in the world. And there is nothing to show for it.
So this trillion dollars is either stolen or wasted every year and it is rising at the rate of 12-15%per year.
Who pays for it? We, the taxpayers, through lower wages, higher taxes and insurance premiums.
Some of this extra $1trillion/yr cost is illegal (like overbilling, etc), some is borderline, although should be illegal (like price fixing by the providers in the particular part of the country), some has to do with plain mismanagement, but most of it is probably legal and done “by commission or by omission”. In other words, it had to be intentionally designed into the system.
This system is designed to “be best at being the most expensive”. One can only imagine the amount of influence the stakeholders on a receiving side can afford to buy with just 5 percent of this extra trillion dollars per year.
One can also imagine that if this waste were to be eliminated, assuming that the government had the courage to do it (and no one else can even try to handle this task), the savings to the economy would be sufficient not only to cover the 45 million people (this would cost less than 100 billion dollars per year), but also, enough to rebuild the whole American industrial and transport infrastructure within just a few years.
If so, then the whole different set of issues has to be discussed:
1. Why is this 1 trillion dollars continues to be wasted? Why is this allowed to go on? How do we as a nation get our 1 trillion dollars/year back?
2. Who are the main beneficiaries of this 1 trillion/yr of national wealth transfer and who allowed them to do this to us? Where specifically is all this money going, to whom?
3. Why do the lawmakers, the law enforcement, federal and state governments allows this to go on? Who and why allowed this to happen?
4. how do we get the healthcare cost down to 8% of GDP? How and when will this nation get its 1 trillion dollars/year back
5. Who will be responsible to stop this “heist of the millennium”?

Even Pres. Obama hinted in one of his earlier speeches that this problem is so bad that it might bring this country to bankruptcy (and as such is a matter of national security).

Unless we address these issues, rather than talk around them, we don’t stand a chance as a nation.

The Honest Doctor