Sunday, July 15, 2007


Jul. 15, 2007 (McClatchy-Tribune Regional News delivered by Newstex) --
ADECADE of retirement, a comfortable pension and guaranteed benefits have done little to take Craig E. Zuber's mind off work.

In fact, they are exactly what's on his mind.

After more than 30 years as a welder at Dana Corp.'s (OOTC:DCNAQ) now-shuttered plant in Reading, Zuber said he suffers chronic back pain and relies on health insurance for his painkillers and medical care.

But with the bankrupt Ohio-based Dana planning to eliminate $1.5 billion in retiree health benefits, the 60-yearold Centerport resident may lose the benefits he worked half his life to get.

'Covered till we die, that's how it was supposed to be,' Zuber said. 'This isn't a good time in my life to be worrying about this.'

The worker lamented his dilemma.

'I'm too young for Social Security and too young for Medicare,' he said. 'But I'm too old to insure and too old to hire.'

In the 1960s and 1970s, nearly all large companies, especially manufacturers such as Dana, extended health insurance benefits to retired workers. Only a third of such companies still do. Executives increasingly face stark choices of benefits or bankruptcy.

The erosion of job-based health benefits is not limited to retirees. Those still in the work force have seen premiums soar and coverage cut.

Despite national health spending of more than $2 trillion a year, the numbers of uninsured Americans have reached more than 46 million, and another 57 million are enrolled in Medicaid, the government's low-income health insurance program.

But understanding the current dilemma means understanding the power structure of American health care -- a complex, costly system of government programs and competing private interests.

As costs continue to spiral, all of us -- providers, subscribers, employers, employees -- are strained under the increased burden.

As problems mount, calls for an overhaul of the health care system have grown louder. Most agree the system is broken, but the fix is far from easy and one of intense national debate often split along ideological lines, experts agree.

'The system is not just inefficient,' said John Morahan, president and chief executive officer of St. Joseph Medical Center. 'It's fragmented, dysfunctional and broken.'

Surging health care costs and the shift from benefit-laden heavy industry and manufacturing jobs to a largely lowwage, low-benefits service industry have helped fuel a more than 87 percent rise in employee premiums since 2000.

At the same time, another 8 million people have enrolled in Medicaid and another 6 million have become uninsured, according to the Henry J. Kaiser Family Foundation, a private foundation in Menlo Park, Calif., that researches, analyzes and reports on medical care policies.

But cost and access are not the only problems.

When compared with health systems in other Western countries, American quality and efficiency also are poor, said Karen Davis, president of The Commonwealth Fund health policy research center. The New York nonprofit advocates broad access to health care, including by low-income people.

In the latest in an ongoing comparison of six industrialized countries, the fund determined that on average each American spent at least twice as much on health care as a resident of Canada, Great Britain, Germany, Australia or New Zealand.

And, despite government health expenditures of roughly $6,500 per person -- more than double any other country -- Americans incurred at least twice the out-of-pocket costs for the most inefficient and least patient-centered system, according to the study.

Another indictment from the study was that despite America's massive medical technology industry, its health care system is dangerously out of date. Vital data, such as a patient's drug allergies, test results or history of diabetes, often do not get shared among providers due to a lack of investment in information technology.

'The score card is poor,' Davis said. 'We're not doing well on quality. We're not doing well on efficiency. We don't have quality standards and we don't have quality systems data.'

Davis said the poor performance is because the United States is the only nation in the study that does not have a universal, single-payer health system to guarantee equal, affordable and efficient care.

'It's become a major financial squeeze on employers and a major financial squeeze on middle-income families,' she said. 'This is a crisis that has reached a point where private business, which generally doesn't turn to government for solutions, is saying, 'We need to go in a different direction.' '

Not everyone agrees.

'Most people have insurance and pretty good insurance,' said Martin Gaynor, a professor of economics and health policy at Carnegie Mellon University, Pittsburgh.

'To change the status quo and move somewhere very different with a lot of uncertainty, we may be reluctant to do that,' he said. 'It's not an accident that we have not gone to universal care. No matter how you do it, it costs a lot of money. Every time it has been tried, it has failed.'

Many professionals in the health care industry believe the country should decide -- and decide soon -- about how to solve the problems.

'We have to decide in this country whether health care is a right or a commodity,' Morahan said. 'We need a coherent national policy, rather than being half-in or half-out, depending on who's in the White House.'

Newstex ID: KRTB-0172-18141869


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