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Dramatic Reform in Store for U.S. Health Care
CHICAGO, IL (May 7, 2001) - By Bob Smietana
The health care system in the United States will undergo dramatic changes in the next 10 years, according to Dr. G. Timothy Johnson, medical correspondent for ABC News Good Morning America.
Johnson, who is also an ordained Covenant pastor, was in Chicago Saturday to present a lecture for the Anderson Kim Bioethics Lecture series at North Park University. His topic was "Reforming Health Care: Who? What? Why? When? Where? Why?"
In the years since 1950, "medicine was transformed from a cottage industry into the industry known as managed health care," Johnson said. In 1950, the cost for health care in the United States was $12.7 billion, or 4.4 percent of the gross domestic product (GDP). Today, those costs have risen to $1.25 trillion, or 15 percent of the GDP. Those costs were driven up by three factors, according to Johnson: a growing population, an aging population and the explosion of high technology. "Those forces spell disaster for the health care system," said Johnson.
"There is no industrialized society on the planet that will be able to do everything for everyone, at every time, that modern science can provide," Johnson said. "The question is not whether we will have to make hard choices - the question is who, what, where, when and why those choices will be made. Our generation will not have to bear the brunt of [those choices], but our children and our children's children will."
Any change in the U.S. health care system has to deal realistically with the public's expectations, Johnson believes. "The public wants health care that is convenient, competent, compassionate and cost-free," he said. What Johnson describes as the unique history of employer-based health insurance programs in the United States illustrates his point. Hospitals were looking for guaranteed sources of income in the 1930s and 1940s. In 1939, Johnson says, Baylor Hospital started offering a pre-paid insurance plan to teachers in Dallas, Texas. Other hospitals picked up on the idea, leading to the formation of Blue Cross. Following World War II, employers had to operate under a strict wage control system. The only exception was that employers could offer benefits. Now, the majority of Americans (approximately 160 million) get their health care through their employers.
Employers will stop providing health insurance as a benefit within the next five years, Johnson predicts. Within ten years, that will lead to a system like the Canadian health-care system, where the government finances health care. Private doctors and hospitals would still deliver health care. "Nobody else will want to pay the bills," says Johnson.
During his lecture, Johnson showed a segment he did for ABC's World News Tonight that compared the Canadian and U.S. health care systems. In the video, Johnson looked at a typical family at a small practice in New York State and in the province of Ontario. In the New York example, a young family with two children had no health insurance (the father was self-employed). When one of their daughters was born, the family was not allowed into the hospital until they arranged a $500 deposit to apply towards the delivery costs. The father negotiated the terms of payment while his wife was in labor.
In the Canadian example, the family just showed their medical card and were "whisked into their hospital room." While saying that he has concerns about the Canadian system, Johnson said that "they have very good basic coverage and have better health indices."
A nursing student asked Johnson what advice he would give to those just starting their careers in health care. "Despite all of the problems that I am talking about," he said, " I believe that being a health care provider is a wonderful way to live your life. It is intellectually challenging and it's a wonderful way to live your life and to be of service."
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