Many people imagine hospitals with kindly doctors and compassionate nurses that deliver unfalteringly excellent medical care in which their patients always get better. These hospitals exist only on television. Miracles do happen, life is snatched back from death, and there are dedicated people who act with supreme unselfishness. People often die in hospitals too and not only because of the illnesses that brought them there. Many times infections, unnecessary operations, overdoses of medicine, misdiagnoses and other instances of shoddy care is the cause of some of these deaths. Five to fifteen percent of hospital patients can expect some blunder to impair their health or recovery.

Health experts who once worried that Americans got too much health care now fear that some will not get enough. Center Magazine reports that there are thirty-three million Americans who are not poor enough to qualify for Medicaid and cannot afford private health insurance. Another fifteen million have inadequate coverage. Since hospitals cannot afford to do much charity care, patient dumping from private to public hospitals often results. U.S. News and World Report says the Albert Einstein Medical Center in Philadelphia has turned away as many as one hundred hospital patients each month because Medicare would not foot the bill for such common items as physical therapy and regular checks of heart rate and lung conditions.

In addition to all this, there is also an acute shortage of health personnel. Thousands of communities throughout the nation have no doctor. Yet, each year, thousands of qualified applicants are denied admission to overcrowded medical schools. The system itself is filled with inefficiencies. It attracts doctors where they are needed least and treats patients where it costs the most. Worst of all the system shows no signs of being able to respond to the crisis. Another area that needs improvement is the performance both at the scene of the accident and in emergency room treatment. It is estimated that between fifty and seventy-five thousand lives could be saved each year if our ambulances were better equipped and staffed with properly trained personnel.

On top of all these problems in the health care system, there is the soaring cost of health care. A great number of resources are spent on costly equipment which saves few lives but deprives many more people of either medical treatment or preventive care that might have saved their lives. Too often, the premiums we pay insurance companies go into new towers on their office buildings, instead of into more health benefits for the people. The insurance companies are so preoccupied with writing up new policies that they have written off any responsibility for the health system. We have paid an enormous price to continue this system, most of which goes to support highly paid professionals and to amortize mortgages on our hospitals.

An overriding aspect of our health care crisis---and the key to all others---is the absence of any effective role of the citizen. The people pay the piper, but they never call the tune. For too long, the health care system has been operating for those who provide the services---the doctors, the hospitals, and their agents, the insurance companies---rather than for the benefit of those who receive the services, the people of America. The consumers have been ignored too long. They have the biggest stake in the health system and have had the smallest voice.

There are solutions to some of these problems that exist in the health care system. The current system should put more funds to improve emergency care and prevention care. Some studies have found that money spent for prevention and disease detection programs are effective, especially when compared with the cost of results of medical treatment. For example, fluoridation programs costing ten million dollars reduce carries in three-hundred thousand children. The same money spent on treatment of caries would only help less than fifty-thousand children, reports Center Magazine.

In sum, what should the government's role in health care be? I think the Federal Government should have the leading role in health care. In order to bring real reform to every aspect of the health care system, the government needs to create a national health insurance. The government would affect controls on costs, efficiency and quality of care. I t could also increase the resources available to supply health care to the poor and needy. Moreover, the focus of regulation should be on the outcome of medical care, with full and open disclosure of information to the public.

BACK