Healthcare affordability is not a topic for the faint of heart, or those seeking simple solutions.
With rapidly escalating costs for individuals, employers and government entities, the looming specter of worry about costs is never far from anyone's mind - or ledger sheet.
On March 10, 25 local, stalwart individuals faced the unwieldy beast head-on, by attending a free health care forum sponsored by the Gorge Ecumenical Ministries that was held at Riverside UCC in Hood River.
Two members of Bethel UCC of White Salmon, physician Dr. Paul Pennington and systems scientist Dr. Richard Davis joined together to present a half-day program of information and thought-provoking questions entitled "Healthcare reform: The urgent and unfinished business; a faith-inspired vision."
Designed to challenge listeners of differing faiths to consider both moral and financial aspects of healthcare from their faith perspectives, the duo began the day with a review of various religious teachings about caring for the sick and vulnerable.
Following a challenge to look toward a "platinum rule" instead of a golden rule, Davis pointed out that caring for others in order to be cared for similarly may not go far enough. His "platinum rule" outlined a higher vision, stating: "We are all one. When one is harmed, all are harmed. When one is helped, all are healed."
Following that vision, well-researched materials were presented to the attendees including a thorough examination of all the contributing factors leading to unsustainable cost escalations.
"We are here to present our perspectives, yes. But we are also here to present the important questions that need to be addressed, even if your response to those questions is different than ours," said Davis in his opening salvo.
Both Davis and Pennington decided to develop the workshop in an effort to start active and action-based dialogue within communities.
Pennington, as a physician, has seen the results of a "broken system" firsthand. Davis is trained to examine systems in order to create greater efficiency and effectiveness.
Both also believe that universally, every faith shares a core set of values which would call for healthcare to be: accessible to all and affordable to all while promoting accountability for those creating and using the system.
In contrast to what many believe, statistics reported by the duo showed that while the U.S. outspends every country in the world - with about one-sixth of our current GDP going to healthcare costs - many indicators show a less than top rank resulting from that spending. A sample of those sobering returns presented at the workshop follow:
The U.S. ranks 19th in deaths due to preventable diseases in developed countries. If advanced to the average on the list of countries, we could save 75,000 lives a year.
Sixty-two percent of all people who declare bankruptcy do so in conjunction with extreme medical bills. Of these, 80 percent had medical insurance at the onset of their illness.
Fifty-one million adults in the U.S. have no health insurance. Thirty million are under-insured. This equates to 44 percent of all U.S. adults and is an increase of 20 million people in just five years.
According to clinical data from physicians and patients, increasing numbers of people fail to fill needed prescriptions or forgo treatment due to costs they are unable to meet, leading to costlier interventions for advanced disease.
Medicare has a projected unfunded liability of around $35 trillion, if the current system continues as operating today.
With these examples within the current system, the pair also reviewed the plethora of stakeholders who must be at the table in any attempt for successful reform.
The premise of reform, according to Pennington, must begin with the question of whether healthcare is best handled as a "commodity" to be managed for profits.
As a for-profit enterprise, instead of a basic human right, many pressures come to bear on the system, producing skewed financial costs that result in no or limited overall improvement in health outcomes.
Examples from the presentation on the effects of multiple stakeholders follow:
New technology and new drugs are cited as the number one driver of increase for healthcare costs.
Patients pressure the system by demanding unnecessary treatments, instigating frivolous lawsuits, and using care without concern for costs.
Thirty-one percent of all health care dollars expended go to marketing, billing, administration costs and profits. Litigation, competition and lack of uniformity in billing practices pressure both providers and insurers while no improved health outcomes are produced as a result of the expenditures.
Families insist on invasive and extraordinary life-saving measures during end-of-life care without regard to cost.
The top 1 percent earners in the country generate 20 percent of annual healthcare costs.
Insurance companies, hoping to increase profits for shareholders, are pressured to select only the healthiest applicants, limit benefits, deny payments and maximize profits through expanding limitations and raising premiums.
Doctors are leaving primary care - the most cost-effective care - for specialty fields to increase salaries, pay off high medical school debts and reduce workloads.
The presenters went on to outline existing efforts to address the current healthcare crisis in the U.S., including a review of the recently passed Affordable Care Act and the burgeoning movement for a single-payer system.
Of note is the upcoming Supreme Court challenge, forwarded by 26 states, against the constitutionality of the "individual mandate" component of the Act. Results of that case will be determined in just over two weeks..