Koop discusses barriers to right to health care

Koop
discusses barriers to right to health care
…………………………………………………………………

BY KENT TERRELL
Special to the Rice News

While the United
States is one of the wealthiest nations in the world, the
right to universal health care is an elusive goal that may
never happen, said former Surgeon General C. Everett Koop.

Koop, a pediatric
surgeon, shared his enlightening views Nov. 16 as part of
Rice University’s Scientia lecture series. His talk
was Scientia’s annual Bochner Lecture.

Most Americans
believe that universal health care should be a right of
all citizens, but making that a reality is a much more complicated
task, said Koop, currently a professor at Dart-mouth College.

“Many Americans
were embarrassed and even outraged that of the industrial
world, only the United States and South Africa denied the
right to health care to their citizens,” said Koop,
who was surgeon-in-chief at Child-ren’s Hospital in
Philadelphia from 1948 to ’81.

“Just recently,
South Africa affirmed the right to health care of all of
its citizens, so the United States stands alone as the industrialized
nation that has not yet recognized this right for its people,”
he said.

The reason that
universal health care has not taken root in America, Koop
said, boils down to one main reason: the high costs of medical
care.

“Health
care costs, and these days health care costs a lot,”
said Koop, the recipient of more than 35 honorary doctorates.
“The right to health care will carry with it an enormous
price tag.”

In earlier decades,
Koop said health care “didn’t do very much and
therefore had very little value.” What’s more,
medicine may have killed more people than it cured, he said.

“Ironically,
many lives were therefore spared because there was no right
to health care,” said Koop, the author of more than
230 articles and books on the practice of medicine and surgery,
biomedical ethics and health policy.

But with advances
in health care, medicine began to help people to get well.
“As a result, medicine became more valuable and hence
it became more costly, not only to the individual but also
to society.”

Koop said a
look at Medicare provides a window into the issue of health
care as a right in the United States. Contrary to popular
belief, he said, Medicare does not provide for all the needs
of the elderly.

Medicare neither
provides money for nursing home costs, which average about
$40,000 a year, nor covers the cost of vital prescription
drugs, said Koop, who was awarded an Emmy in 1991 for his
five-part series on health care reform.

“Medicare
really covers only 45 percent of health care costs of America’s
elderly population,” he said. “It’s the closest
thing to health care as a right, or entitlement.”

Koop said 47
million Americans lack health insurance or are underinsured.
As a result, many uninsured people remain “in constant
fear of illness that will take everything they have. They
are more likely to be ill, to be sicker and to postpone
visits to the doctor.”

What’s
more, Koop said, the uninsured have a 3 percent higher mortality
rate than insured Americans.

“Most people
can be convinced that a reasonable right to health care
is OK,” Koop said. But he cautioned, “Someone
has to pay for it.”

“Even if
waste and fraud were removed from the health care equation,”
Koop said, “health care would still be costly.”
He noted that insurance premiums are 12 to 15 percent higher
this year with managed care.

Koop said it’s
important to find ways to help Americans who “fall
between the cracks” in coverage. A renewed commitment
of professionalism, where doctors place the interest of
patients over self-interests, is “long overdue in the
field of medicine,” he said.

Whichever approach
is taken in the debate over universal health care, Koop
said, one fact remains clear: “Health care reform is
a never-ending effort.”

Scientia is
an institute of Rice University founded in 1981 by mathematician
and science historian Salomon Bochner. Lectures in the series
provide an opportunity for scholarly discussion across disciplinary
boundaries.

— Kent
Terrell is a free-lance writer.