Time to Revamp Antiquated Health Care System
The American health care system is broke. But instead of addressing the core problems we are constantly being bamboozled by razzle-dazzle and smoke and mirror routine to make us believe we have the best health care in the world. The simple and plain truth is we do not.
The first pinprick to deflate our self-delusion came eight years ago when the World Health Organization ranked health care systems of 191 countries. While Italy and France got the top spots, the United States was ranked 37th. We were 33rd in death rates for children under five and we ranked lower than some countries in sub-Saharan Africa for immunization.
More recently the prestigious Commonwealth Fund has been publishing comparative health statistics from industrialized countries and we don’t look good on that scale either.
The Commonwealth Fund compares indices like access to health care, health coverage, status of national health, quality of life and fairness of the system to the citizens. We trail the industrialized countries in all indices. While we were better in providing an emergency and acute care we lagged behind in taking care of the chronically ill.
And then there is this big elephant in the room that no one seems to notice or care. There are an estimated 50 million people in this country who have no health coverage. A majority of them just cannot afford to buy the coverage. President Bush in one of his ‘decider’ modes said that these people could always get treatment in an emergency room. In his simplistic solution one could hear the echoes of Mary Antoinette’s who is believed to have said that if the peasants cannot get bread they should eat cake. Some of our uninsured do go to the emergency rooms when they are acutely ill but otherwise they have no safety net.
However in one area, expenditure on health care, we are far ahead of industrialized nations. We spend $ 6102 per person (15.3 % of US economy) on health care whereas other industrialized countries spend little more than half that amount. And they live longer, have better health than us, and they are generally more satisfied with their care than we are.
So where is the sinkhole that sucks up all that money for which we have precious little to show? Actually there is more than one.
One sinkhole gets all the attention but in reality it is a tiny one. Malpractice insurance premiums and jury awards constitute but only 0.46% of total health spending. Practicing defensive medicine by ordering unnecessary and redundant tests adds about 9% to the cost but according to the Department of Health and Human Services it is not in itself that significant. The big sinkholes however are the health care insurance industry and pharmaceutical industry.
Since 2002 the health insurance companies have raked profits that defy any business model and could be labeled as obscene. Between 2002 and 2005 they had the profit margin of 152.7%, 60%, 32.9% and 21.4% respectively.
The pharmaceutical companies are no different. According to Dr. Marcia Angell, a professor at Harvard Medical School and a former editor of the prestigious New England Journal of Medicine, top pharmaceutical companies made more profit than the rest of Fortune 500 companies combined. Just in six months after the cumbersome, complicated and industry-friendly Medicare Drug Plan became law in January 2006, the ten largest pharmaceutical companies raked in $8 billion in profits.
This broken and inherently unfair system has been with us for decades and all effort to reform it has been defeated in the Congress. A majority of lawmakers, on both sides of the political divide, are beholden to health care insurance companies and pharmaceutical companies.
During her husband’s first term, Hillary Clinton tried her hand at reforming the system but was soundly defeated. Now in the wake of the forthcoming presidential election both she and Barak Obama are repeating the same gospel of change. One wonders if they would have the political courage to take on the powerful giants. As we all know it takes more than wishful thinking to plug the giant sinkholes that have been sucking the life, literally, out of American people.
A universal health care is the crying need of our country. It is not a perfect system - no system is - but it is more equitable and fair than the one we have been living under for so long.
- aghaji@bex.net
