From my blog "One Little Victory"
Say "Ahhhhh"
Today's Topic: Health care in the United States of America
WARNING: THIS IS GOING TO BE A LONG POST
This is probably the most vexing issue in the U.S. today,
though special interests and conservative paranoids have made
this issue far more complicated than it really is. As you can
probably surmise, I went to see Michael Moore's
"Sicko" the other night and, love him or hate him,
the man made some good points. But as opposed to having this
post be a debate over Michael Moore's views, we're instead
going to look at why I have reached the conclusion that I
have.
Two assumptions I am utilizing for the purpose of this
article:
1) How we treat our least fortunate in the United States says
a great deal about our values as a society.
2) Neither capitalism nor socialism is good nor evil left unto
itself. Rather, it is how the concepts are applied. It is my
sincere view that we as a nation have taken capitalism to a
very unhealthy place, allowing the most successful capitalists
to become more successful at the cost of others. This, to me,
is where the line must be drawn, and where socialist concepts
must be applied.
Politics have supported the status quo and reduced the quality
of health care in the United States. Our infant mortality rate
has risen fairly dramatically since 32nd ranked infant
mortality in the developed world (second worst). Our life span
has fallen off compared to the rest of the industrialized
world, as has our average height.
We are the most "powerful" nation on earth, and we
are happy with one of the worst health care systems in the
industrialized world?
Let's take a look at some of Moore's claims from
"Sicko" and juxtapose them to the fact-checking done
by CNN. For the purpose of this article, I will take CNN's
word over that over the self-appointed MTV health expert Kurt
Loder. Loder is one of the science-denying idiots still trying
to run around "debunking" Al Gore's An Inconvenient
Truth. Let's just say that if you get your news from Loder,
you could be doing a tad bit better. Frankly, who gives a
rat's ass what that pinhead thinks?
So back to Moore's claims:
1) Out of 50 million uninsured people in the U.S., roughly
18,000 will die each year due to being uninsured.
CNN Response:
For the most part, that's true. The latest numbers from
the Centers for Disease Control and Prevention say 43.6
million, or about 15 percent of Americans, were uninsured in
2006. For the past five years, the overall count has
fluctuated between 41 million and 44 million people. According
to the Institute of Medicine, 18,000 people do die each year
mainly because they are less likely to receive screening and
preventive care for chronic diseases.
2) The United States spends more of its gross domestic product
on health care than any other nation.
CNN Response:
Again, that's true. The United States spends more than 15
percent of its GDP on health care -- no other nation even
comes close to that number. France spends about 11 percent,
and Canadians spend 10 percent.
Like Moore, we also found that more money does not equal
better care. Both the French and Canadian systems rank in the
Top 10 of the world's best health-care systems, according to
the World Health Organization. The United States comes in at
No. 37. The rankings are based on general health of the
population, access, patient satisfaction and how the care's
paid for.
So, if Americans are paying so much and they're not
getting as good or as much care, where is all the money going?
"Overhead for most private health insurance plans range
between 10 percent to 30 percent," says Deloitte
health-care analyst Paul Keckley. Overhead includes profit and
administrative costs.
"Compare that to Medicare, which only has an overhead
rate of 1 percent. Medicare is an extremely efficient
health-care delivery system," says Mark Meaney, a
health-care ethicist for the National Institute for Patient
Rights.
3) Moore shows patients in Canada, Great Britain, France and
Cuba all waiting patiently for health care that they easy and
free access to.
CNN Response:
Not as simple as it looks in the movie.
In most other countries, there are quotas and planned
waiting times. Everyone does have access to basic levels of
care. That care plan is formulated by teams of government
physicians and officials who determine what's to be included
in the universal basic coverage and how a specific condition
is treated. If you want treatment outside of that standard
plan, then you have to pay for it yourself.
"In most developed health systems in the world, 15
percent to 20 percent of the population buys medical services
outside of the system of care run by the government. They do
it through supplemental insurance, or they buy services out of
pocket," Keckley says.
The people who pay more tend to be in the upper income or
have special, more complicated conditions.
In the movie, Moore focused exclusively on people who did have
health insurance, shining light on the dirty tactics that
insurance companies. While Loder is quick to dismiss those as
dreadful exceptions, upon whose word are we to believe that
these are exceptions? Even people in the industry were more
than willing to talk to Moore about the unethical and immoral
behavior taking place.
So while most people agree that our system needs to change,
there is sharp disagreement over whether this should be done
privately or through the government.
In order to present the discussion in a more (relatively)
neutral spotlight, I found this article from About.com.
What is Universal Health Care?
From Bobbie Sage,
Your Guide to Personal Insurance.
Universal Health Care Gains Popularity
Universal health care gained popularity with former
President Bill Clinton. Although President Clinton's proposal
is looked at as a large failure, it did start the universal
health care ball rolling and got many in America thinking
about a united health care plan. Ever since President
Clinton's proposal, the debate on a united and universal
health care system for the U.S.A. has continued to be weaved
into election topics as a proposed cure to the United States
health care crisis, which estimates have said leaves 41-50
million people in America without health insurance.
What is it?
Universal health care or also commonly known as a
singe-payer system, united health care system, or national
health care, would be similar to the current U.S. Medicaid
health care program for low-income peoples but would apply to
all citizens of the U.S. regardless of ability to pay.
Who else does this?
Many countries have a united or national health care
system, and all industrialized countries except for the U.S.,
have some sort of single-payer universal health care system.
Most notably Canada and the UK have coverage under this type
of united health care.
Sounds great! How come we don't have a national health
care system in the U.S.?
There is no right formula for a united universal or
national health care system. All countries have different ways
of accomplishing the task of insuring every citizen in their
country. How to accomplish a national health care single-payer
system in America and if it would be better and more
cost-effective than our current system are the main debate
areas for universal or national health care in the U.S. There
are many advantages and disadvantages to a single-payer health
care system in the U.S.
Advantages:
Every citizen would be covered under a national united
health care system and administrative costs could be
drastically reduced. According to the article Make Healthcare
a Right. It's Cheaper! by By John R. Battista, M.D. and
Justine A. McCabe, Ph.D., studies have shown that with a
publicly administered system health care costs would have been
reduced in Connecticut by two billion dollars in 1999 by the
reduction of administrative costs along with other different
medical buying techniques such as buying medications in bulk.
Disadvantages:
Income taxes would increase and private insurance
companies may be put out of the health care administrative
business. Not to mention many Americans are worried it is just
another route to socialism so therefore taking away private
health care is un-American.
Most would not argue that basic health care should be an
available human right to all Americans and most would also
agree that our current system is not working and we should all
get united on health care in the U.S. The universal national
health care debate will be with our society for an inevitable
amount of time, or at least until healthcare is available to
more Americans, so expect this to be a topic for politicians
in many future elections.
So let's look at some of the points from this article.
1) Every citizen would be covered and administrative overhead
would be dramatically reduced.
Response: And I can hear the conservatives saying, "why
should I have to pay for someone else's health care"?
Answer: Because that's what society does for the worse off. We
take care of each other, knowing that we will be taken care of
if and when the time comes. Pure capitalism lacks compassion -
compassion must exist in society for that society not to
become evil. And for all we have grumbled over the years about
the Soviet Union and China, and more recently Iraq and Iran,
we are the ones looking pretty evil around the globe, and for
good reason.
2) Income taxes would increase.
Response: Yep, and I don't mind paying my taxes when I know
that they are being used responsibly. During the Clinton
administration, my taxes not only funded domestic, foreign and
military budgets, but also helped get rid of the deficit.
Under the Bush administration, I am pretty sure most of my
taxes are sitting in the Middle East - and they don't belong
there. And remember, while taxes would go up, out of pocket
expenses would be nearly eliminated.
3) Private insurance companies may be put out of the health
care administrative business.
Response: Boo hoo. The goal of private insurance companies is
to make money - that is at odds with providing quality health
care to all people that need it. It is a question of values -
are we worried about our people or about the insurance
companies? There is a reason that insurance companies have
expanded into the financial services industry - providing
insurance to society is an untenable means of doing business.
Twenty to thirty years from now I can see this entire industry
being either regulated or government controlled, particularly
after debacles such as Katrina. There is a role for private
insurance, but that role should be limited and tightly
regulated.
4) Universal health care is a path to socialism.
Response: Yep, just like in France, Great Britain, and all of
western Europe. I don't see "Commies" taking over
the world, as I am pretty sure the collapse of the Soviet
Union proved the fallacies of communism. But our society is
now failing as well - it's a question of whether you choose to
remain in denial about this and whether or not you are able to
keep an open mind about what is best for everyone. Try
thinking outside of yourself.
There are two other items from the movie worthy of some
attention. First, a highly interesting interview with a former
British government official, who succinctly distinguished
between American and European societies. European governments,
he pointed out, are afraid of their people and thus do what is
in the best interest of the people. In America however, the
people are afraid of the government, thus leaving the
government free to do what is in the best interest of the
government. On many levels, we have become the Redcoats that
we rebelled against.
The most disturbing and revealing scene of Moore's movie
served as support to this point. There is a tape of Nixon
speaking (on February 17, 1971) with aide John Ehrlichman. The
conversation was as follows:
John D. Ehrlichman: “On the … on the health business …”
President Nixon: “Yeah.”
Ehrlichman: “… we have now narrowed down the vice
president’s problems on this thing to one issue and that is
whether we should include these health maintenance
organizations like Edgar Kaiser’s Permanente thing. The vice
president just cannot see it. We tried 15 ways from Friday to
explain it to him and then help him to understand it. He
finally says, ‘Well, I don’t think they’ll work, but if the
President thinks it’s a good idea, I’ll support him a hundred
percent.’”
President Nixon: “Well, what’s … what’s the judgment?”
Ehrlichman: “Well, everybody else’s judgment very strongly
is that we go with it.”
President Nixon: “All right.”
Ehrlichman: “And, uh, uh, he’s the one holdout that we
have in the whole office.”
President Nixon: “Say that I … I … I’d tell him I have
doubts about it, but I think that it’s, uh, now let me ask
you, now you give me your judgment. You know I’m not to keen
on any of these damn medical programs.”
Ehrlichman: “This, uh, let me, let me tell you how I am …”
President Nixon: [Unclear.]
Ehrlichman: “This … this is a …”
President Nixon: “I don’t [unclear] …”
Ehrlichman: “… private enterprise one.”
President Nixon: “Well, that appeals to me.”
Ehrlichman: “Edgar Kaiser is running his Permanente deal
for profit. And the reason that he can … the reason he can do
it … I had Edgar Kaiser come in … talk to me about this and I
went into it in some depth. All the incentives are toward less
medical care, because …”
President Nixon: [Unclear.]
Ehrlichman: “… the less care they give them, the more
money they make.”
President Nixon: “Fine.” [Unclear.]
Ehrlichman: [Unclear] “… and the incentives run the right
way.”
President Nixon: “Not bad.”
Trust me when I say that the "not bad" by Nixon was
damn near gleeful.
The next day, Nixon publicly announced he would be pushing
legislation that would provide Americans "the finest
health care in the world."
Finally, I have had friends raise the issue of cost, and what
such a program would do to our nation. Let's put some context
on this.
Let's take Hillary Clinton's health care proposal, estimated
to cost between $90 and $120 billion dollars annually. Just
for giggles, let's assume that the cost will be on the high
side, let's say $150 billion per year.
Let's put $150 billion into context:
* The cost of war in Iraq is estimated at around $2
trillion so far, or about $500 billion per year.
* We give Israel between $6 and $10 billion in foreign aid
each year.
* We give annual subsidies exceeding $1.5 billion to big
oil companies, and fail to collect billions more in taxes each
year.
* The Bush tax cuts for the rich will total $477 billion
between 2001 and 2010.
Sounds like we have the money. We simply lack the political
will and the moral character to make it happen.
Michael Moore has a simple and effective plan for resolving
the health care crisis in America:
1. Every resident of the United States must have free,
universal health care for life.
2. All health insurance companies must be abolished.
3. Pharmaceutical companies must be strictly regulated
like a public utility.
Sounds too simple, but it works. I would amend #2 to provide
for supplemental insurance for those exceeding the benefits of
the system, but this would need to be tightly regulated.
By the way, this movie opens with one of my favorite
"Bushisms":
GEORGE BUSH: We got an issue in America. Too many good
docs are getting out of business. Too many ob-gyns aren't able
to practice their love with women all over this country.
Well Dubya, the docs in Britain are making the equivalent of
$200 K a year. Not enough for people like Dubya perhaps, but
enough to "get by".
See the movie.
------A couple of additional thoughts since I wrote this a few
hours ago:
Addendum #1:
The scare tactic of the Republicans is that universal health
care will mean that a bureaucrat will be responsible for
determining what care you will receive. Well, surprise! That
is already happening with private health insurance. As a
matter of fact, the movie demonstrated well the incentives
given to doctors and administrators for advocating less or
even no care. One such person testified that she knew she had
signed one man's death warrant, but knew that the cost savings
would be rewarded by her employer. Conversely, doctors in
Great Britain are given pay incentives for how healthy their
patients become, how much weight they lose, whether or not
they quit smoking, etc. THIS IS A SCARE TACTIC OF THE
CONSERVATIVES AND NOTHING MORE!
Addendum #2:
The good "Dr." Loder was incensed that one French
patient was allowed to vacation on taxpayer dollars in order
to recuperate. Now I initially thought this was (at least) a
bit unusual, but then I thought.... the French work less than
we do (35 hours a week) and get more vacation time, yet are
also more productive workers than Americans. They are also
healthier. This leads me to a simple conclusion; treat workers
like crap and they perform like crap and won't feel good about
themselves doing it. Treat people well and they will perform
well... they will also be able to keep work in perspective,
not let it dominate them and thus be more productive while
they are working. That's a pretty easy choice to me.
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