By Stan Friedman
CHICAGO, IL (October 25, 2010) – Politicians will be unable to solve the country’s healthcare crisis, but solutions need to be implemented soon to avoid economic collapse and live out our responsibilities to care for all citizens, ABC Senior Medical Editor Dr. G. Timothy Johnson told a breakfast gathering sponsored by North Park University.
Johnson, who is 74 years old and an alumnus of North Park University and North Park Theological Seminary, no longer provides regular reports for the network, but chooses the stories he wants to cover. “Now that I’m semi-retired and in the position of senior medical correspondent, I can speak my mind. And I will.”
Several times in his talk and in answering questions at the University Club of Chicago on Thursday morning, Johnson said he was disillusioned with politics practiced by both parties. “Don’t vote for any politician saying we have the best healthcare system in the world because they’re lying,” Johnson said.
They are lying, Johnson said, because, “We don’t have a system.” Instead, American healthcare is a hodgepodge of private and public insurance, varying rules, and is overly expensive, inefficient, and unequally accessible.
Fixing the out-of-control spending and bringing more cohesion to providing effective healthcare won’t happen until the crisis bankrupts the economy, which he said could happen within the next 10 years.
Johnson’s talk followed the outline of his new book, The Truth About Getting Sick in America: The Real Problems and What We Can Do, which currently is available only in electronic format.
He discussed: The Big Question, The Big Problem, The Big Fear, The Big Sermon, and The Big Prediction.
The United States must deal with the question of why it pays twice as much per person for healthcare than other western industrialized nations, and yet does not receive better outcomes, he says.
The public’s unrealistic desire for high-quality healthcare at little or no cost, and the medical community’s fee-for-service payment structure, are the biggest problems needing to be addressed if the crisis is to be solved, Johnson said.
“We want gourmet service for a blue plate special price,” Johnson said of consumers. The fee-for-service structure leads to more unnecessary procedures as well as a decline in the number of family physicians, who tend to be paid less than specialists and yet are more critical for ensuring proper care and prevention.
Johnson confessed his own culpability as well as the rest of the media in worsening the problem. He drew on his experience in the 1990s as an example. At that time, many physicians were touting bone marrow transplants as the treatment of choice for fighting late-stage breast cancer. The media cast insurance companies as villains, however, because the industry would not pay for what it considered an experimental procedure.
Patients and their families won millions of dollars from lawsuits against the insurance companies. But in 1999, three “gold-standard studies” showed that the treatment was ineffective and doctors immediately stopped doing the transplants.
“I was one of them who encouraged women to demand it from their doctors,” Johnson said. “I’ve been 20 times more careful since then.”
Although insurance companies again are being portrayed as the near equivalent of the evil empire in the political debate, Johnson said, “I actually have a lot of sympathy for insurance companies.” The companies are caught in the middle between consumers who want more for less and physicians’ rising costs, he explained.
The system . . . “is a mess, and it’s immoral.”
Johnson added that solutions also must include tort reform that would bring down medical malpractice costs and yet provide better safety for patients. He notes that currently some individuals receive large payouts, but the general public doesn’t benefit because the jury decisions don’t lead to widespread change and most people can’t afford to pursue a claim.
The system, he said, “is a mess, and it’s immoral.” Johnson advocates no-fault insurance, which is common in other industrialized nations, but which Democrats have blocked. “I think the Democrats are dead wrong in fighting this.”
Johnson said he understands the public’s big fear about government takeover of healthcare, but likened a possible solution to government regulation of the airline industry. The government sets strict national standards, but still allows for private competition. “Aren’t you glad it’s not up to each state to make it’s own rules,” he said.
He noted that the Veterans Administration (VA) medical system is considered the best in the country, and lessons could be learned from how it operates. A key difference is that the VA knows it will be caring for the entire life of each person, so it has added financial incentive and ability by using things like electronic records to take individual needs into account.
Johnson especially advocated for systems – including pay structures – that would enable more family physicians.
Johnson, who is an Evangelical Covenant Church minister and serves as assisting minister at Community Covenant Church in West Peabody, Massachusetts, stated that providing universal access to healthcare is more than an economic issue. “It is a moral imperative. How can we say we are pro-life and not be for this?”
Healthcare reform almost did not receive passage over concerns about possible federal funding of abortion. Johnson said, however, that providing universal coverage leads to fewer abortions because women know the care will be available.
“It will be impossible to pay for everything . . . that medical science can dream up.”
Johnson said the country’s attitude should be the same as that of the two Boston physicians who, in 1810, advocated starting a hospital for the indigent. They said, “When in distress, every man becomes our neighbor, not only if he be of the household of faith, but even though his misfortunes have been induced by transgressing the rules both of reason and religion.”
Those words are now over the entrance to what became Massachusetts General Hospital, where Johnson has practiced.
Johnson offered the big prediction that “it will be impossible to pay for everything for everyone at every age that medical science can dream up.”
None of the answers are easy and solutions can be difficult to achieve, he acknowledged. Johnson repeated throughout his talk, “It’s complicated.”
Johnson’s talk was part of the university’s Breakfast Series, which seeks to bring together the university’s faculty, staff, students, alumni and community to network and hear from industry leaders.