Switching to government-run national health insurance -- from insurance by private companies - could save every Utahn $828 a year by the year 2000, two consumer-advocacy groups say.
But some Utah health-care officials disagree. They maintain the groups are oversimplifying the complex health-care cost problem in America.Citizen Action and Families United for Senior Action released a report this week saying $274 billion a year nationally could be saved by 2000 by a switch to national health care similar to systems in Western Europe and Canada.
Their study said the savings would come by reducing the administrative costs of private insurance and by capping - through law - the inflation rate of health expenditures to 6.6 percent annually - still above the general inflation rate but 2 percent below projected health-care inflation.
The switch and its lower costs would still manage to expand health care to those who are now uninsured or underinsured. (Some 37 million Americans are uninsured; 250,000 are Utahns.)
Of the projected potential savings of $274 billion nationally in 2000, the study said $1.4 billion of it would come in Utah, the study reported.
Without national care, the study projected, total health-care bills in Utah would grow from $3.09 billion this year to $7.49 billion in 2000. With nationalized health care, the study predicts, cost could be held to $6.06 billion.
The study also said if the switch to national health care were made today, it would cut Utah's total health-care cost of $3.09 billion this year to $2.96 billion - for a savings of $73 for every Utahn.
"This study demonstrates why we desperately need a national health-care plan," said Citizen Action Vice President Robert M. Brandon. "It demonstrates the need for cost containment and for eliminating the inefficiency of private health insurance. . .. The time has come to get rid of an antiquated, inequitable system that delivers rhinestone health care at gemstone prices."
Michael J Stapley, vice president of Deseret Mutual Benefit Association, insists the groups' statements are an oversimplification of the health-care cost problem in America.
"The problem is multifaceted. It is true that health insurance and related administrative expenses are a component part of the problem," Stapley said. "However, to imply that such expenses are the major reason for higher expenses in America is a gross exaggeration. Our own direct administrative expenses are less than 8 percent of total premium."
According to the national study, other agencies have higher administrative expenses. In fact, the current U.S. health-care system "has the highest proportion of administrative costs in the world."
The study figures that by 2000, national health care could hold administrative costs to 2.7 percent. It said it may also allow doctors and hospitals to save on overhead costs for billing, although such savings were not included in the study.
The study also said health-care spending has increased at more than twice the rate of general inflation during the past decade. Stapley lists many reasons for the increase.
He said the other important parts of the health-care cost equation are:
- First, the quantity of health care consumed in America (i.e., number of surgeries, number of sore throats treated, etc.)
- Second, the volume of inputs required to provide a defined quantity of service (i.e., number of diagnostic procedures, hospital lengths of stay, etc.)
- Third, the price of the inputs.
"These are all major parts of the health-care cost problem and cannot be easily resolved simply by converting to a national health-care system," Stapley said. "We live in a highly pluralistic society. Our expectations of the health-care system are very different than expectations in Canada and Europe. Exaggerated claims with respect to what can be saved in one component do not represent a reasonable understanding upon which solutions can be based."
The national advocacy groups propose reforms to pay more for primary services and less for other procedures. They also want legislation to hold health-care inflation to about 6.6 percent a year.
The study also wants national health care to ensure all groups have access to doctors and hospitals. Expanding coverage to those now uninsured or underinsured would cost $24.3 billion in 2000 but could bring some savings by eliminating problems now resulting from lack of prenatal care or untreated chronic diseases, according to the study.
Steven D. Kohlert, senior vice president of Intermountain Health Care, is unconvinced.
"I think that any proposal that promises to make health care available to all those who are presently uninsured and save money at the same time clearly deserves a careful hearing," he said. "However, this seems like a deceptively easy and quick solution."
Kohlert says the key questions that need to be asked are: Does our experience in the United States indicate that a program run by the federal government can deliver those kinds of dramatic results? Would it provide a standard of care that the people would accept? Do we want the government to make decisions about what care we receive?
Congress recently proposed some steps in the general direction of national health care.
Senate Labor and Human Resources Committee Chairman Ted Kennedy, D-Mass., has proposed forcing all employers to provide health care for their workers.
The committee's ranking Republican, Orrin Hatch, R-Utah, has opposed that but has proposed expanding Medicare to allow employers to buy low-cost, basic coverage for workers.
Hatch has also proposed setting national standards of care for diseases.