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Kai Ryssdal: For today's installment of our election series, Interested Parties, Sarah Gardner looked into what people in the health care trenches want from Washington.
Tape of hospital page: Kelly Clarr to the central work area, please. Kelly to the central work area, please.
Sarah Gardner: It's mid-morning in the ER at UCLA Medical Center in Los Angeles. This is one of the best hospitals in the country, according to U.S. News and World Report. It's also one of the busiest. The staff here treats over 70,000 patients each year. Everybody from surgeons to technicians is ready to spring into action. A few, literally.
David White: Everybody's always experimenting with footwear, because we are, you know, on the go.
Emergency medical technician David White wears shoes with springy coils on the soles. He's on his feet 12 hours a day and the shoes help. White does everything from meeting patients on the helipad to doing CPR. He says the ER here can be as clogged as an LA freeway, in part, because many of their walk-ins aren't emergencies. They're ordinary folks using the ER for ordinary health care problems, like flu or stomach troubles.
White: Y'know we're fortunate, you know, on a bad day our wait here might be six or seven hours. You go to some of the other county hospitals, if you're there less than 12 hours you don't even bother going up to ask: Am I next?
Here's the surprise. White says the people seeking basic care here in the ER aren't just uninsured immigrants or Hollywood freelancers. They're also professionals with plenty of coverage who've run into another traffic jam trying to get an appointment to see their doctors. They either wait or give up and end up in a health crisis. White believes the U.S. needs universal health coverage, with an emphasis on preventive care.
White: And I don't know that totally socialized medicine is necessarily the answer; I do think that it's kind of a basic right that everyone should have access to health care and have access to good health care.
White's view is a common one here. He envisions a system where everybody's covered somehow, whether totally through the government or a combination of public and private insurance. And Washington would have to figure out the details. fast. But everybody's skeptical. Nurse Patty Taylor says the first thing Congress should do is, quote, "get the pharmacy lobby out of Washington D.C." But does she believes Congress will do it?
Patty Taylor: No, I think a lot of Washington is bought out by lobbyists. I truly believe that.
Taylor started as a nurse 44 years ago, treating wounded soldiers in Viet Nam. Her army career took her all over the world, and she says she admires Western Europe's health care system the most.
Taylor: They may have a waiting list to get a certain type of procedure, you know, whatever, but they're doing very well.
Tom Rosenthal: There's absolutely no doubt in my mind that we're not ready for that.
That's Tom Rosenthal, a kidney transplant surgeon at UCLA.
Rosenthal: Hi, guys. How's everything goin'? It looks pretty busy here.
As Rosenthal walks through the surgical recovery area, he says, yes, a European health care system is probably more equitable but it's not perfect. He wants both the presidential candidates to start grappling with the economics of health care reform. Take Obama, he says.
Rosenthal: He said in front of some rally that we need to cover everybody and we need to do so at lower cost. I don't know how you do that. It's kind of like it's not a serious dialogue.
Covering everybody, say the experts, won't come cheap. Between all our pharmaceuticals, new technologies and longer living, health care's just getting more expensive. And taxpayers can only afford so much. But the hospital's CEO David Feinberg says when he talks about the need for rationing care, people look at him like he's crazy.
David Feinberg: Everyone wants low health care cost. But when your grandma is sick, you want her in the best intensive care unit, you want a 150 specialists to see her, and if they say, well, we could do this last procedure and it may help her; many people say, oh, let's go for it.
Feinberg says if he could talk to the president, he'd tell him we need to start thinking about rationed care, even if it's controversial. He'd also tell him the incentives in health care are all backwards. Doctors and hospitals don't make big bucks practicing preventive care or promoting healthy lifestyles. Meanwhile, he says, Americans should look themselves in the mirror.
Feinberg: You know, we make up 5 percent of the world's population and consume 50 percent of the illegal drugs. This is a country that takes things to excess.
Half our health care costs would disappear, Feinberg insists, if we stopped smoking, ate less, exercised more and consumed less drugs and alcohol. In Los Angeles, I'm Sarah Gardner for Marketplace.