Column by Rita Hillmann Olson
Originally published in the Faribault Daily News
Sept 28, 2019
Recently, I spent eight hours with a family member in a rural hospital’s ER. The only attending physician practiced in a hospital 50 miles away and was helping out. The staff repeatedly apologized for the wait time as they kept the patient comfortable. While waiting, a statistician’s cold number became a living fact. A 2018 survey by the Physicians Foundation found that 80% of physicians claim to be “at capacity or fully overextended.”

Combined with 2017 survey results from the American Association of Medical Colleges we can expect a U.S. doctor shortage of up to 120,000 physicians by 2030. Waiting line warnings are brightly flashing!

We all have stories that mold our healthcare opinions. Friends of my family recently welcomed their first baby. They have good health insurance which required them to go 45 miles-past two hospitals-for delivery at the hospital “in their plan” Baby’s mom had a different doctor since hers did not practice at that hospital. This family soon discovered having health insurance does not mean better access to needed medical care.

We can agree on wanting increased access to medical care and consumer choice. But can we have both?

The U.S. spends more than twice the average of other developed countries – over $10,000 per capita – on medical costs.  Before you sing the praises of socialized medicine as a solution, ask if other countries really have “socialized” plans – complete government control of the delivery of medical care. In comparing the Swiss system to the current U.S. system, we find that Switzerland’s structure includes high copays and deductibles. It is an entirely individual health insurance market: no employer-based health plans.  Prices are public, so the consumer has more transparency-both in purchasing their medical care and coverage.

The most cost-efficient healthcare system in the world-yet seldom cited by reformers-is Singapore’s. The U.S. spends more than triple (17%) its gross domestic product compared to Singapore. Instead of mandatory health insurance plans, Singapore has mandatory health savings accounts. Depending upon age, individuals contribute 8-10.5% of wages-tax-free, interest-bearing and inheritable-into a savings account.  Once the account is considered full, the savings can be used for other goals, such as retirement or housing.

Singapore’s consumers are in command of their medical cost and purchases because it is their money: no third party-not insurance companies or the government-making the buying decision. For those who don’t earn enough to cover basic medical costs, there is a government safety net called Medifund.

 If the U.S. has the courage to opt for a patient-centered healthcare system, then patients and providers must partner in medical decisions. The consumer can not afford to be passive-to take orders from the insurance companies or government planners.  Competition and having pricing options for care and coverage will put the consumer back in control of life-changing and life-saving decisions.