By: Ron E. Peck

As I – like so many others – anxiously watched election day results on television, a commercial played more than once.  The advertisement displayed a mask (not a fun Halloween mask, but rather, one of the protective masks with which we have all become familiar).  The voice advises that this is a mask.  It protects the wearer and others around them.  It is not a political statement.  It is a mask.

The advertisement struck me, but not for the reasons they likely intended.  It moved me for two reasons.  First, I was saddened that the message even needs to be sent.  Second, I was even more saddened by the fact that the message was wrong.  Love it or hate it, masks – like so many other things – have become a political statement.

This is one example of what I fear; the politicizing of health. 

Many important decisions are made by politicians on a daily basis.  Yet, there are some decisions that transcend politics.  If a school is under siege by a shooter, police respond, rescuers do all that they can to save lives, and we all watch horror stricken.  Yes, in the aftermath people will politicize every aspect of the tragedy; debating mental health, gun control, and the like.  How did it happen?  How can we prevent it?  Yet, in the moment – as the emergency is unfolding – we set aside political rhetoric, unify, and act.

Today we are dealing with the COVID-19 pandemic.  As with a school shooting, there is an emergency that is presently in effect.  Some people question the numbers; how many people actually have the disease, how many fatalities are attributable to the disease, and so forth.  Yet, everyone agrees that there is a disease, it is fatal for some, and there are certain behaviors we can alter temporarily to potentially reduce the risk.  Whether you believe masks are effective or not, as an example, the cost of wearing one is small.  In other words, if you think there is – at best – a 10% chance masks are effective, isn’t it worth it – even then?  The point is that, when performing an objective cost-benefit analysis, the cost of engaging in some simple acts is so low, it’s worth engaging in those acts – even if you think the benefit is minimal.

Yet, once the act (or lack of action) is politicized, a thumb is applied to the scales and the cost is increased. 

Masks and COVID-19 are one example.  Looking at the bigger picture, health care in these United States of America is too expensive.  Insurance premiums or contributions to self-funded health plans are too expensive – in part because they need to pay for the excessive medical bills, but also in part because premiums and contributions have become a privatized tax, whereby we all pool our money to cover costs arising from inefficiencies or losses elsewhere.

I absolutely believe payers can do more to reduce costs without negatively impacting the consumer experience.  I absolutely believe providers can do more to reduce what they charge for care.  I absolutely believe patients can do more to limit damages and through proactive measures reduce the burden they place on both payers and providers.  Yet, as with masks, so too has health care – how it is accessed, administered, and paid – been politicized.  Demanding that everyone assess their behavior, processes, and implement changes that will improve care, improve benefits, and reduce costs should not be a political issue.  Yet, it has become one. 

I have always believed that, before we fight over the pie, we should first identify ways to make the pie larger.  Abraham Lincoln is credited with having said, “Discourage litigation.  Persuade your neighbors to compromise whenever you can.  As a peacemaker the lawyer has superior opportunity of being a good man.”  Certainly providers will need to sacrifice some revenue, if the cost of care is to be reduced.  How much profit can be salvaged, however, by first identifying and eliminating waste?  Likewise, payers will reduce their incoming revenue when they cap premiums or contributions, however, they too can recoup those losses by adjusting their procedures, coordinating benefits with other payers, and delivering their services in a more focused, effective fashion.  Lastly, patients need to be mindful of their own physical health, lest poor health should become financial crisis.  Just as routine $50 oil changes avoid a $4,000 engine replacement, so too can patients take action to reduce the financial burden placed on the system.

Ultimately, the question of “how” we pay for health care should be subservient to the question of what health care should cost… and to answer that question, we need to first consider all that goes into determining what the price ought to be.  The discussion of how we pay for health care may be political, just as deciding who will pay for dinner may be a matter for debate.  Before my father and I argue over who can pick up the tab, however, let’s first ensure we were not charged for a cheesecake we most certainly didn’t order!  That bit of common sense is certainly not political, nor should it be.