Professor and moderator Paul Bingham, of Stony Brook University’s Biochemistry department, opened Monday night’s Healthcare Reform debate by explaining that “we stand at a moment of transformative crisis, and the children that we have will look back on these times as brief windows where the world changed irrevocably.”
The crisis that Bingham alluded to is the problem of adequate health care insurance that exists in the United States, in the midst of economic recession. The solutions to these problems were the subject of the debate held in the Student Activities Center auditorium, an event hosted by the Stony Brook Patriot newspaper. As the debate began, it was clear that no one — in the audience or on stage — disagreed with Bingham’s statement. The differences in opinions were in how to bring about the changes that have to be made, namely creating a system of organized healthcare services that brings better quality care to more people.
Dr. David Brown, a cardiologist at Stony Brook University Medical Center, was arguing in favor of a government-run, single payer health insurance system. Mr. Michael Cannon, director of the CATO institute’s Health Policy studies, was arguing in favor of a for-profit, private insurance system. Brown spoke first, stating that he spoke not as a health care economist — as was his opponent — but as someone who was living through the health care crisis as a physician. He appealed to the frustration of seeing people in the hospital being denied the best care because of the way the insurance industry is currently run.
Cannon, however, began with a story about his father-in-law’s thyroid cancer, but was covered under Medicare. He emphasized that his father-in-law was allowed the best treatment in the world through Medicare. Though he acknowledged its benefits, he went on to say that the problems associated with Medicare were inherent in a government-run system and could only be improved by letting free market competition take over.
Brown associated our poor health care system with reduced life expectancies and increased infant mortalities on the failure of a greedy for-profit system.
The uninsured are mostly employed people who make too much for Medicaid, but not enough to afford their own health care. Of these uninsured, 25 percent of these are children — which he claimed was a crime in and of itself — and that only 5 percent are able to work but don’t. Brown also reminded us that we spend more money on health care than anyone else, but we don’t have the best health care because a large portion of what we spend on health care goes to administrative costs.
The fact is that although we pay enough to get the best health care in the world, countries like Canada have an additional three years of life expectancy.
He insisted that in the realm of access, quality, and cost — the principles health care should be based on — we are behind in comparison to the rest of the world.
Brown’s ideal insurance policy would be one that is government-financed, but not government-controlled — one where major decisions are left to patients and doctors. It would also be one where everyone had the same insurance, not merely some form of insurance. Cannon’s goals for restructuring of health care were similar, but he argued that it comes at too high a price. He also reinforced that a third of Medicare expenses are wasted and because of the way Medicare is run, hospitals and doctors are penalized for pursuing preventive care.
Cannon gave an example of a hospital in Washington where physicians worked to treat heart disease in patients with diabetes. Because patients are staying out of hospitals, however, they wind up losing money by losing patients and, as a consequence, doctors receive less pay. This wouldn’t happen in a private system because profits create incentives for providing preventative care while, in government systems these incentives don’t exist. He also gave an example of a doctor making a dosage error. Medicare would pay for the consequent hospital stay of the patient who took the wrong dosage, as well as the care to heal the patient — without penalizing the physician who gave the wrong dosage.
When Brown asked Cannon what his ideal health care system would look like, he responded with an emphasis on choice. Currently, we are tied into the same insurance as our employer so that when we lose our job, we lose our insurance. We also can’t change our insurance from the insurance of our employer. He also wants billing and payment that is simpler than it currently is, with better electronic systems that the free market comes up with, but is ignored by government systems.
Brown closed off his arguments by reminding us that we have to start somewhere. Both men agreed that the government is slow to respond, but that something must be done now.
Mr. Cannon’s closing statement was simple: Although his father-in-law was allowed the best treatment possible given his condition, he would have given that all up if his father-in-law had gotten just one preventative reminder to get his thyroid checked earlier, which could have happened in a privately run electronic alert system which government insurance doesn’t offer. The Patriot conducted a poll, asking audience members before and after the debate if they agreed with the debates proposition: “universal, single-payer, government-provided health insurance is the change we need.” 43.5 percent of the audience agreed, 30.4 percent disagreed while 26.1 percent were unsure. After the debate, some of the undecided chose a side: 57.1 percent agreed, 30.9 percent disagreed while 11.9 percent remained unsure.
