Why reform health care in the United States? The question has never been more timely. Those opposed to health care reform have many reasons for not wanting to change the system: it will cost too much money, the system is working just fine for the “good” citizens who have jobs that provide health care insurance, the Democrats just want to socialize medicine, the Democrats just love to throw money at things, and the ubiquitous “I won’t get to choose my own doctor.”

The first two reasons not to reform health care are rational and therefore can be debated in terms of a business model. Thinking of health care in America as a business that affects each and every American citizen, consider these facts, taken from the Democratic Party Platform. “We spend more on health care than any other country, but we’re ranked 47th in life expectancy and 43rd in child mortality.”

As people with a stake in this business, American citizens hearing such facts should be very concerned about the huge gap between money spent and results achieved. They should be asking, “What are the other countries doing? Is it working?” But when the other countries are France and Canada and what they are doing is providing universal health care, many Americans move out of the business model zone and into the “America as we perceive it” zone, which precludes anything that sounds like socialism.

Here is another fact for the stakeholders in the American health care business to consider. According to an article in the March 17, 2009 edition of Central Pennsylvania’s Patriot-News, the Hospital and Healthcare Association of Pennsylvania conducted a survey of 126 area hospitals and found that many of them are experiencing an increase in emergency room visits by patients without health insurance combined with a decrease in hospital admissions for routine procedures (e.g., colonoscopies) and elective surgeries (e.g., knee replacements). To put this situation in business model terms, when customers are coming in on “free ice cream cone day” but not coming in to buy ice cream cones, your business is in trouble.

So, hospitals are spending more money caring for the uninsured and receiving less money from the insured. Also, due to the recession and massive layoffs, many of those who were insured through their employers are no longer insured. Therefore, many “good” citizens – not illegal aliens or welfare abusers or drug addicts -- are among the people waiting until simple illnesses become emergencies, and then going to their local ERs because they can not afford to visit their primary care physicians.

The survey also states that 84 percent of the hospitals queried have already cut staff or are very inclined to do so, as a means of dealing with their loss of revenue. That means fewer personnel and more customers. Again, this is not a recipe for good business. Dr. Ann S. O’Malley, a senior researcher for Studying Health Care System Change, stated in the New York Times that “Emergency departments are a kind of barometer of the general health of the rest of the system.” The system, then, is obviously failing, and its stakeholders need to sit up and take notice.

How does a business owner improve his business? He looks at where he is and where he wants to be. Then he carefully devises a plan that will get him to his goal. How can the American people improve their health care business? They can do the same thing. It’s called health care reform, it’s on President Obama’s agenda, and it will turn a bad business into one that all Americans can patronize and be proud to call their own.