Johnson: ‘It makes sense to have basic health insurance for everybody’

Brian Smith | Staff Photographer
Dr. Timothy Johnson, former chief medical editor for ABC News, delivers Monday afternoon’s Interfaith Lecture in the Hall of Philosophy.

The United States spends almost twice as much per person on health care as any other developed country.

“ ‘Where is this money going?’ is the question that ought to haunt us,” Dr. Timothy Johnson said, “and will be hanging over our heads the rest of this afternoon.”

Johnson was the first to speak on Week Nine’s Interfaith Lecture Series theme of “Faith, Hope and Healing.” His lecture was titled “The Truth about Getting Sick in America” and was delivered at 2 p.m. Monday in the Hall of Philosophy. Johnson was the chief medical editor for ABC News for 25 years, providing medical analysis for “Good Morning America,” “World News,” “Nightline” and “20/20.” He is also an ordained minister of the Evangelical Covenant Church.

“There are two big problems,” he said, “and when you put them together, it’s a formula for financial disaster. On one side is the problem of unrealistic expectations that we Americans have when it comes to health care.”

Johnson said that Americans want health care that is cheap, coordinated with their personal schedules and on the cutting edge.

“We Americans worship at the altar of high technology,” he said. “We … have come to believe that the newest is automatically the best, even if it’s the most expensive.”

The other problem facing U.S. health care is that it has what Dr. Arnold Relman called a “medical-industrial complex,” Johnson said; it is a massive industry that produces technologies, drugs and devices to make a profit — not necessarily to improve people’s health.

“In the early 1990s, some experts in … the field of breast cancer treatment started to advocate the use of bone marrow transplant with high-dose chemotherapy as the preferred treatment for advanced breast cancer,” he said.

After it received intense coverage by the media, women began to demand this new treatment, Johnson said. Insurance companies wouldn’t pay for the treatment because of its experimental status, and some women sued, often winning large sums of money.

This went on for about 8 years, Johnson said. In 1999, three studies were presented at the American Society of Clinical Oncology’s annual meeting showing that bone marrow treatment for advanced breast cancer was no better than standard chemotherapy.

“In the meantime, we had treated hundreds of thousands  — probably into the millions … of women with this treatment that was not only far more expensive,” Johnson said, “but … far more dangerous. And we do that all the time in this country.”

Many Americans are unreasonably fearful of the “government takeover” of health care, Johnson said.

“We leave all the safety regulations pretty much up to the hospitals —  or the states, at best,” he said, “and that’s why the Institute of Medicine many years ago came up with an estimate of 99,000 deaths from medical errors every year in this country.”

Though he admitted that he doesn’t know exactly how, Johnson believes that the federal government should play an essential role in health care. This is the case for nearly every other developed country in the world, and yet those countries still have more affordable and effective health care systems than the U.S.

“A fairly recent Harvard-based study estimated … that about 45,000 Americans die every year in this country, prematurely, because they have no health insurance,” he said. “How can anyone call themselves pro-life and live with those numbers in the richest country in [the world]?”

Restricting basic health insurance doesn’t make financial sense, Johnson said. When poor people don’t have insurance, they tend to not go to the hospital when they’re sick. Instead, they wait and go only when they’re very ill and in need of emergency care, which is expensive and can be dangerous.

“Ultimately, it makes sense to have basic health insurance for everybody,” he said, “rather than rely on the emergency room as the primary care doctor for so many people without insurance.”

As a Christian, Johnson also believes that there is a moral imperative for universal access to basic health insurance. He said that the teachings of Jesus, such as in the parable of the good Samaritan, point toward caring for the sick and injured.

Johnson ended his lecture by suggesting four components of health care that should be reformed in the United States. First, the payment system needs to be changed; the monetary incentive for doctors to prescribe as many tests and treatments as possible needs to be eliminated. Second, there should be electronic health records that are transferable from one hospital system to another. Third, along with the electronic records, there should be a way for health care providers to digitally register a patient’s data and access relevant studies to inform their treatment recommendations. And fourth, there need to be more primary-care doctors, nurses and assistants.

“And all of that will work only if we have universally available primary care,” he said.

Johnson expects that health care costs will continue rising until the nation faces bankruptcy. At that point, he said, officials will probably vote to expand Medicare to cover every citizen and form a single-payer health care system. But he hopes he’s wrong.

“The state of Massachusetts — my home state — is really a kind of beacon in terms of what you can do if the the politicians and the industry and the doctors and the hospitals … sit down and try to talk with each other,” he said.