The new GOP-controlled House should take a second look at their promises to roll back the healthcare reforms initiated and pushed by U.S. President Barack Obama and passed by the last Congress. Why? Because such moves may end up hurting individuals, businesses (like contact centers) and the economy--contrary to these elected officials' claims that dismantling “Obamacare” will "help".

(Full disclosure here: my stepson is a paramedic crew chief for a major New Jersey hospital; my wife is a retired IS/IT manager for one of the United States’ largest healthcare providers)

The private-sector-based American health system is riddled with corporate administrative inefficiencies. Resources poured into plan setups, marketing, test and treatment approvals, customer service, billing and collections, the back-and-forthing between physicians and insurers (my old doctor in Manhattan cursed nearly every one of them) take away from providing timely, quality and compassionate care. While human beings don’t change when they change physicians and providers the standards of care do; there is no uniformity of treatment.

[Update: While the U.S. spends more on healthcare compared with other nations a huge chunk is wasted on administration. A 2003 article in the New England Journal of Medicine “Costs of Health Care Administration in the United States and Canada” reported that in 1999 the U.S. paid $1,059 per capita for bureaucracy compared with $307 in Canada. After exclusions it said administration accounted for 31 percent of health care expenditures in the United States but just 16.7 percent of health care expenditures in Canada The trend has been increasing and widening. The share of the U.S. health care labor force accounted for by administrative workers escalated from 18.2 percent in 1969 to 27.3 percent in 1999. In contrast the same expenses in Canada climbed from 16 percent in 1971 to just 19.1 percent in 1996.  Both nations’ figures exclude insurance- industry personnel.

(Contrary to myth Canada’s system is not national but provincially managed but with partial national funding and reports Wikipedia is not “socialized medicine” but more like social insurance: doctors are private and bill the provincial governments.)

“A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system,” said the report.

I can vouch for that; I have lived in both countries. In some provinces you are billed monthly for premiums, in Ontario it is taken from your taxes but in both instances you show your card and that’s it. No messing about with HMOs and PPOs and provider networks.

No wonder the American health insurance lobby fought against “Obamacare” and its failed predecessor “Clintoncare”. The business of sickness and dying is booming as the Baby Boomers creak and totter into oblivion. As a media type and political scientist I admire how this industry cynically manipulated the American rugged individualism ideology to convince many Americans to oppose such care—especially those who would benefit the most, like the famous sign “government get your hands off my Medicare”. Hello, and who is providing Medicare??? ]

What is truly obnoxious about the U.S. health system is its malevolence to those most in need. The words “pre-existing condition” strikes fear into anyone if they or their loved ones have life-endangering illnesses: cancer, diabetes, M/S, muscular dystrophy, et al. There is nothing more bottom-line greedy yet unimaginatively cruel than for insurers--and by extension the employers who selected and dictated the terms of the plans offered--to deny or limit coverage to someone or their family members who are most in need. I know of Americans who have moved to Canada but who cannot return because they have these diseases though they can continue to work and pay taxes, because they are unable to obtain insurance.

Ranking next to this are the medical bills and in them are the rapidly changing lists of what patients must shell out. At a time when most households are living paycheck to paycheck, facing the specter of foreclosures by a predatory financial industry—one that has profited handsomely from creating, abetting and from the collapse of the mortgage Ponzi scheme that has ruined the economy—they cannot cope with the added burdens of these expenses. Americans are facing having to make the wretched choices of what to sacrifice and suffer from the lack of or getting nasty calls about not paying for food, shelter and health: with no room to cut back on either of these costs.

The U.S. health “system” has another built-in inefficiency; it limits labor productivity by forcing workers to stay, select or switch employers and locations based on their healthcare plans not because the jobs or the employers are better suited to them and their skills. Employees who work for companies primarily because of the benefits—and the fear of losing them will not generate as much wealth for them and for the economy compared with being at organizations where they can excel at. It also limits them from wanting to work part-time or themselves. One of the biggest fears in households is being forced part-time or into self-employment because the breadwinners lose their benefits.

Where the healthcare issues come to the fore is in the low-paid service work, such as contact centers. It is in such sectors that employees feel the most stress from the badly-performing economy yet because they are on the bottom rungs they get the worst benefits. Yet it is here where the meanness really shows. Outfits that choose to cut costs by slicing benefits and by dispensing with in-house centers, only to have their employees hired by outsourcers with little if no coverage pass the burden onto overburdened hospitals who are often forced take those who have no coverage on a charity basis. So much for responsibility.

So what happens to employee i.e. contact center agent performance, absenteeism and turnover when the agents can’t get treated until their health gets so bad they have to throw themselves on the mercy of others, resulting in hours spent in ERs? When they have to work extra jobs to pay their bills, only to come in with very little sleep? Or spread communicable diseases because they can’t afford to see a doctor?

President Obama’s plan has to its considerable credit, and though not perfect within the confines of a narrow American ideology that rejects more efficient single-payer (private or public) programs adopted elsewhere in the world is making a start in addressing the healthcare woes. Rolling it back will tear back the stitches that are now taking hold, re-exposing the wounds and letting the bleeding and dangerous infections that it was designed to stop and prevent occur again.

In many ways “Obamacare” is akin to Social Security, which was brought in by a president at a time of great economic distress, who was vilified by the right wing for it, and paid dearly in a mid-term election. A president is now revered as one of the greatest the country has ever known. His name is Franklin Delano Roosevelt…

If the GOP wants to go after a more fitting target for waste it should target the financial services industry. It should demand a moratorium on home foreclosures; Canadians and others are snapping up distressed houses and threatening to displace families. It should hold hearings into what led to the financial system’s collapse, find out who was responsible for creating, not stopping and stomping on the whistleblowers who pointed out that burying mortgage risk was generating a pyramid scheme and publicly flog them; too bad the laws can’t be changed retroactively to padlock the perps. Finally it should demand reforms to insure stability so that this mess would never happen again.

Financial services is services--it doesn’t create true wealth for it doesn’t produce anything—instead it enables wealth.  One of the biggest mistakes ever made—and both parties are guilty of it—is dismantling the financial reforms enacted in the 1930s that were made with the collapse of the stock-driven Ponzi scheme that underwrote the economy in the late 1920s. Guess we haven’t learned much since then…

And if President Obama wants to have his legacy like the healthcare system ensured he should take a page from FDR’s playbook and go after the financial services industry from his most effective tool: his bully pulpit, and bring the American people with him.

And if anyone wants to see what will happen if we don’t stabilize our economy and look after our people: in short arresting the slide into a nation of a few haves surrounded by a growing army of have-nots they need only to look over the border…to Mexico.

(A better view is north: to Canada, whose superior economic management—enabled by the previous Liberal government that sliced a massive deficit left by a previous Conservative regime, more stable and less predatory financial service industry and yes a more affordable and accessible healthcare system lies in sharp contrast to the U.S. It is the better-heeled Canadian shoppers that are helping to keep many American communities alive: witness the license plates in the parking lots of malls in Michigan, New York State, Vermont and Washington State, to name a few).

For only with stability, enabled by citizenry and workforce who are healthy and productive can we have a truly prosperous economy, one that enables the greatest good for the greatest number, not just for a select few.