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Practical Realities
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The National Coalition on Health Care (NCHC), a broad-based organization with a diverse membership working to find solutions to the health care crisis, says well-meaning but incremental attempts to address institutional shortcomings in the health care delivery system amount to Band-Aid approaches that will make little difference in the end.

The NCHC, which includes the IBEW among its membership, says the system is broken, plagued by quality control problems, administrative waste and inadequate technology assessment and information dissemination systems. Such inefficiency and duplication of efforts translates into the waste of $500 billion each year, or between 30 and 50 percent of the total amount spent on health care.

Red tape, restrictions and legal and regulatory requirements make directing a health plan a challenging exercise. New forms and procedures regularly add to the administrative burden. Confusing new laws governing the minutiae of health care administration divert money from health care to hiring experts to write legal policies.

And trying to price policies and coverage for comparative purposes proves impossible, said Local 271 Business Manager Davis. "It seems like in the health insurance industry, you dont know what anything costs," he said. "It just doesnt make sense."

The NCHC calls the health care system the worlds most complex, least friendly system, so complicated that it costs between $50 and $100 billion each year just to push papers through.

Industry Resists Change

In the past four years of the Bush administration, 4 million more Americans lost their health insurance, average health care costs have increased by 50 percent and premiums have gone up more than three times faster than average wages.

But a Republican president, Senate and House of Representatives have been reluctant to press for comprehensive reform.

As the single biggest industry in the country, the health care industry spends millions preserving the status quo. By the end of the first quarter of 2004, organizations representing health professionals, hospitals, nursing homes, HMOs and pharmaceutical companies reported giving more than $15.3 million to candidates seeking federal office according to figures reported to the Federal Election Commission. Republicans were the overwhelming beneficiaries of the largesse, receiving 65 percent of the total contributed.

Medicare prescription drug reform amounted to the only significant health care legislation that has become law under Bush. Not surprisingly, the bill was favored by pharmaceuticals and the HMOs and only addresses a piece of the problem: the high cost of prescription drugs. When the full program is implemented in January 2006, it is expected to open the door to privatization of Medicare. As for the prescription drug discount cards that were introduced this summer as the initial stage of Medicare drug reform, AARP and Families USA predict that rapidly rising drug costs will render the cost savings meaningless.

The president has done little else to ease the crisis; and indeed some of his proposals could make things even worse. President Bushs proposed 2005 budget calls for reducing Medicaid funding by $1 billion and nearly $16 billion over the next 10 years, just as budget shortfalls have caused states to reduce their low-income health insurance programs. The Bush budget also calls for $1.1 billion in cuts to non-Medicare/Medicaid programs such as grants for the uninsured, according to the American Association of Family Physicians. White House budget guidelines for next year seek to cut spending on many health care-related programs, including the Department of Veterans Affairs and nutrition for women, infants and children.

A Colossal Challenge

Ten years ago, the health care industry and Congress rejected comprehensive changes to the system proposed by President Clinton in favor of piecemeal solutions. Today, the problem is worse than ever, but the challenges are not insurmountable. Other developed countries spend one half to two-thirds less than we do per capita while achieving health care outcomes at least as good and sometimes better, with a population far more satisfied with their system, said Simmons of the NCHC. But Congress will only act when public pressure for action overwhelms the intransigence that the industry buys with political contributions.

"We need change to understand and address the enormity of the problem with health care in this country," President Hill said. "Momentum for a change will not come from the insurance companies or the pharmaceuticals who are profiting from this chaotic system. It must come from the grassroots, from people like IBEW members, who can help convince our elected officials that we need to take action now."

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