Friday, July 3, 2009

American Health Care: A Private or a Social Concern?

The 2009 CIA World Factbook estimates that the USA ranks 180 (out of 224 nations) in infant mortality rates. The number 1 country for infant deaths is Angola. Like most of the nations with higher rates, Angola is an impoverished “developing” country. The USA, however, has a greater number of deaths in infancy than Cuba, the European Union, Taiwan, Canada, New Zealand, Australia, South Korea, Israel, Hong Kong, Japan, or Singapore (which has the lowest infant mortality rate).

The World Factbook further estimates that, in 2008, the USA had 8.27 deaths per 1,000 people. Its death rate in general, then, is lower than the rates in Japan or the European Union, but still higher than those in Canada, Cuba, China, New Zealand, Hong Kong, Taiwan, Australia, Brazil, India, South Korea, Chile, Iran, Israel, Iraq, Mexico, Singapore, or the United Arab Emirates (which has the lowest overall mortality rate). Last year, the USA had 3.03 more deaths per 1,000 than Iraq (5.14)!

US citizens have an average life expectancy of 77.85 years, lower than the United Kingdom (78.54), Germany (78.8), France (79.73), Italy (79.81), and Canada (80.22),

According to the New York Times, in 2006 Canadians spent $3,678 per capita on health care. US residents spent $6,714 per capita. (About 38% of that difference can be explained by the difference in the two countries’ economies. But even with numbers adjusted to accommodate that difference, US Americans paid $1,141 more per person for health care than Canadians.)

The National Coalition on Health Care states: “Although nearly 46 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens.” In 2007, health care spending represented 17% of the gross domestic product of the USA. In 2008, the increase (5%) in employer health insurance premiums was double the rate of inflation. Health care spending in the USA is over four times the amount spent on national defense.

The AFL-CIO reports, “Profits at 10 of the country’s largest publicly traded health insurance companies rose 428 percent from 2000 to 2007, while consumers paid more for less coverage.”

Ron Williams, CEO of Aetna, earned $24,300,112 in 2008, making him the highest paid health insurance company executive. (In 1910 all the corporations in America paid less in taxes [$24,043,500] than Williams earned 98 years later.)

President Obama has introduced and supported the idea of a public option in health insurance coverage, a compromise between the current model of private insurers (as supported by the American Medical Association and fiscal conservatives) and the social-services model of public health (as practiced in Canada, the UK, France, Cuba, and China).

A public health insurance option means that the government would provide health insurance in competition with private health insurers, with the intention of driving down health care costs in America and insuring the millions of Americans now without health coverage of any kind. Only one health insurance provider or a closely tied group of providers covers 94% of metropolitan areas in the USA, with the effect of limiting competition in those communities and driving up healthcare costs. A public option could benefit from having lower administrative costs (Medicare, for instance, provides coverage with a lower overhead than the average private insurer can). If the public option proves popular and competitive, private insurers would likely lower rates to compete.

Centrist Democrats appear to be in a bind because, on one level, there is great popular support for the public option—65-85% of Americans support it, according to a variety of polls—while, on another level, health industry PACs contribute generously to Democratic and Republican campaigns—and (this is awfully cynical, I know) actually doing something about health care in America would rob them of the campaign issue that "somebody ought to do something about health care in America."

According to Nate Silver, Senator Mark Warner of Virginia has received $69,000 in contributions from health industry political action committees, even though he has served less than six months in the Senate. Like the 20 other senators currently “uncommitted” to a public health insurance option, Warner is a Democrat. (Except for Olympia Snowe, all the Republican senators oppose the public option.)

Opponents assert that a public option would be both inferior to private-sector insurance and destructive to private insurers. Their reasoning is that, although public health care would be (in their opinion) inferior, more people would gravitate to it because of its relatively low cost.

Some people object to a public option on principle, believing that the government should not interfere with lawful free enterprise (especially given the precarious position of the US economy now), and on practical concerns, believing that the government would be a less efficient provider of healthcare benefits than the current private insurers.

Many of these opponents attribute the USA’s lagging health statistics to factors other than the free market and/or monopolies, while others continue to tout the USA’s relatively good health statistics in comparison to nations in sub-Saharan Africa.

I unapologetically support so-called “socialized medicine”—on par with “socialized” highways, postal service, military defense, and public education. I don’t claim that such an approach to health care is perfect and without problems, but it does appear to me that, after decades of comparison, we can see greater benefits in, say, the British National Health Service than we Americans currently enjoy, and greater risks—large numbers of uninsured Americans and increasing bankruptcy due to high healthcare costs—in our current system.

Obama has chosen a compromise that I would not consider desirable—except for political expediency. However, the idea of a “public option” seems better than the status quo, at least—especially given my firsthand experience with increasing insurance premiums and deductibles and the rather shockingly streamlined “drive-thru” (though hardly “fast”) approach of the private medicine I have recently experienced.

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