UNIVERSAL HEALTH CARE – WE NEED IT RIGHT NOW!
Illness can be frightening wherever you live, but medical bills in the USA can financially wipe out your family. About half of all bankruptcies in the United States are caused by a health crisis, and in about half of these medical bankruptcies the sick person had some type of health insurance. There is no other advanced nation where citizens have to worry that the cost of medical treatment will take their life savings. Every other advanced country cares enough about its citizens to make certain they have health care.In the USA we spend far more money on health care than anywhere else. Health care has jumped to 16% of our Gross Domestic Product (up from 7% in 1960). This is at least 50% more than any other nation and is about twice the cost of health care in Japan or in many European countries where universal care is their birthright.
Huge health spending in the US fails to provide us with top level health outcomes, largely because so many Americans have no health coverage at all. Japan spends half of what we do to produce the best health outcomes and longest living people in the world. The United States was ranked 37th by the World Health Organization on “Health System Overall Performance”. Our health outcomes are about the same as Costa Rica. Our infant mortality rates are far higher than in any other wealthy country, about twice the rate of Sweden, Finland or Japan. Do we really value mothers and babies only half as much as they do?
It is clearly not a lack of cash that brings us poor health outcomes in the USA. With four percent of the population we consume nearly 40% of the world’s medical expenditures. The problem is a lack of political will. All of the corporations milking vast wealth from our broken system have carefully bought political power – they are major campaign contributors. They buy power to insure that we will continue to have a “system” where nobody is in charge, and huge profit margins are maintained by the chaos, greed, and mismanagement that we choose to put up with. Medical care corporations exploit our fear of big government or “socialized medicine” to rob us blind. We need to have confidence that voters control our government and we can make it serve our needs.
Many of us in the USA have excellent health care as individuals but we have no “system” to make sure health care is efficient, effective, and available to all Americans. We need one. We have the most privatized system in any advanced country, and companies involved in Health Care expect big profits. At the same time we have 46 million Americans with no health coverage; and many others have woefully inadequate benefits. The number of uninsured Americans has increased during each year of Bush’s “compassionate conservatism”.
Those of us who have always had complete health insurance can’t feel what it is like to watch a beloved family member suffer more each day and know that you cannot get medical care for them unless you are ready to lose your home, cut down on food, or have your heat shut off. People without coverage usually go without the preventative or prenatal care they need. They finally end up in the emergency room, where costs are huge. For example, consider the cost of pre-natal care compared to the cost of caring for a premature baby, or the cost of podiatrist visits compared to foot amputations. We make it hard to get preventative care, and then pay the huge expenses for emergencies. A Rand corporation study shows that people who have health insurance but face major “co-pays” will also cut back on necessary health care.
I believe in capitalist private enterprise, since the market mechanism accomplishes many goals very well. Health care, however, is NOT one of them. National health care policy needs an overall guiding hand, since there is no incentive for private enterprise to either control costs or to extend care to everyone. Our system is catastrophically inefficient. According to data from the New England Journal of Medicine, health care administration costs per person are $1059 in the USA and just $307 in Canada. We can’t keep pretending that our health care system is anywhere near the best in the world, and we must immediately begin planning to accomplish that goal.
Much “health care” spending in the USA goes for large profit margins, huge executive salaries, and marketing. In contrast, other countries do not let drug manufacturers advertise directly to consumers. Many medical problems respond equally well to older or generic drugs, but Americans think they must have the pill they saw on T.V. to have first class care. Where health care is efficient and effective, governments have provided a basic structure to control cost and extend coverage.
It may be true that the maximum production of profit does not result in maximum health. Long-term chronic illness presents more profit potential than something that can be prevented or cured. Sickness and expenses might go down if the government seriously pushed dietary changes to reduce fat and sugar (or promoted exercise) – but heart care and diabetes management are major engines of profit. We need to focus on public health and prevention if we want better cost control or overall medical outcomes. Only the faintest lip service is given to prevention or public health in the USA; health care consumers have no wealthy backers to hire lobbyists or make campaign contributions.
The new Medicare prescription drug benefit is a glaring example of how poorly health care can be provided by private enterprise. It is a huge government giveaway to Bush’s campaign contributors in the insurance, pharmaceutical, and HMO industry, since any savings to seniors could have been accomplished through a system of bulk purchase of prescription drugs. It will help older Americans very little since there are no price controls, and we allow drug prices to rise at two or three times the rate of inflation.
Congressman John Dingell called it “a rotten situation” and said “the insurance companies will receive a very significant subsidy from the taxpayer – about 5.6 billion”.
The Bush plan actually prevents our government from negotiating with drug companies for bulk purchases of medications at lower prices, as is done by Medicaid, the Veterans
Administration, and nearly all advanced nations.
Scores of private companies presented competing and confusing Medicare drug coverage plans. Many senior citizens were frustrated by the great complexity of the program and the small reductions in price. Pharmacists described a “nightmare” and a “fiasco” scenario when the plan came into effect; many state governments needed to step in to protect patients who could not get needed medications.
The “Wall Street Journal” admits that our health system “has accumulated a massive bureaucracy that simply doesn’t exist in other countries”. They found that one fourth of “health care” workers did nothing but paperwork. It seems like all the money we spend on insurance companies, billing and bill collecting, excess corporate profits, advertising, etc. is actually an unacceptable government-protected form of graft and corruption, since we know that systems that omit these costly items produce better health outcomes for less money.
We have many good examples in Canada and Europe to choose from when we develop our new American health care system, but our people don’t want to be faced with anything that seems too different from what they are used to. A health care plan for our nation that is rapidly gaining political momentum is to simply expand the Medicare system to cover everyone. Americans are generally happy with Medicare; a highly efficient system that spends less than two percent of its revenue on operating costs. We could have basically the kind of health care system we have now, just better, cheaper, and guaranteed.
Universal Health coverage could be paid for with a 7% payroll tax, a 2% income tax, and current federal payments for Medicare, Medicaid and other federal and state insurance programs. We don’t want to mandate a “ceiling” on health care; people should still be able to buy supplemental insurance to get them an extra measure of comfort or care. What we immediately need is a floor of basic good quality health care coverage that all American citizens and businesses can stand upon with confidence.
When you or a loved one is sick you want to completely focus on getting them well. The very last thing you want to think about in that time of crisis is money. We know enough about the mind/body connection to understand that depression makes people get sicker. Sick people who are rapidly bankrupting their families may become so depressed that they have less ability to recover.
The main reason we need universal health care is to demonstrate caring and compassion, to relieve human suffering; but that “do gooder” sort of reasoning has not brought us universal health care. Corporate health care providers, through their lobbyists and political contributions, have preserved their right to drain your wealth away at your most vulnerable moment. Health care reform is now about more than helping our people. The health crisis is finally being taken seriously because it threatens to bankrupt our major manufacturing companies, as well as city and state governments. The USA has already lost about three million manufacturing jobs since Bush II ascended in 2000.
Most Americans, except for our leadership in Washington DC, realize that universal health care is an urgent need in the USA right now, for our people and our businesses. Employer based health care is falling apart as costs skyrocket. Many long established businesses in Michigan have retirees to support – they won’t be able to pay for pensions, or remain competitive in the marketplace, if they continue to have to pay for our current bloated and corrupt health care system. Our employees and companies must be able to depend on universal health care.
General Motors Chairman Rick Waggoner has said “Health care costs in this country are out of control”. “We would really like to see much more focus and leadership from elected officials, especially in Washington”. His company spends nearly as much for health care as it foes for steel. Health care costs are a major factor making it difficult for our industries to compete in the world market. Older auto companies in Michigan may spend over $1500 per vehicle on health care; Toyota spends only about $200 per vehicle in North America and less than $100 in Japan. When we fix health care we will take a big step toward helping our businesses compete. International companies may choose to locate in countries that offer the best value in health care. Ontario, Canada is right next door to Michigan, offering excellent universal health care to entice employers to locate there.
It is sad that human compassion and family values were not enough to make us develop universal health care. Now that many businesses and governments face insolvency because of health care costs most of us realize it is time to act.
Our people and businesses need affordable universal health care now! It cannot be held hostage to the inertia and ideology of the Republican Party. The fundamental health care reform that we need right now can’t happen in a Congress gripped by the current “culture of corruption”. It is a Congress bought and paid for by the very industries that are reaping windfall profits from our explosion in health care cost.
Time is of the essence! Progress toward universal health care is a most critical reason why we must elect a Democratic House of Representatives in 2006!
“If the nation adopted… [a] single payer system that paid providers at
Medicare’s rates, the population that is currently uninsured could be covered
without dramatically increasing national spending on health. In fact, all US
residents might be covered by health insurance for roughly the current level of
spending or even somewhat less, because of savings in administrative costs
and lower payment rates for services used by the privately insured. The prospects
for controlling health care expenditures in future years would also be improved.”
(Universal Health Insurance Coverage Using Medicare’s Payment Rates”,
Congressional Budget Office, Dec. 1991)
