Wednesday, July 22, 2009

Universal Health Care

The United States is the only industrialized country that does not have universal health care. There are an estimated 47 million U.S. citizens without health insurance. This places unimaginable stresses on the emergency departments of most hospitals because that is where people go when they have no other options. Overburdened emergency departments treat a very high percentage of indigent patients because it is against the law to withhold treatment to someone who needs it. This is only one of the factors that drive up health care costs in this country.

Expensive Health System
Current estimates put U.S. health care spending at more than 15% of GDP. This is a greater portion than any other United Nations member except for the Marshall Islands. Yet the U.S. lags far behind much of the rest of the world in both access to health care and quality of health care. Those Americans who do have access are receiving care that currently ranks only 37th in the world. Despite spending far more money than necessary to cover a limited number of citizens, Americans have a lower average life expectancy than those in other industrialized nations with universal health care, such as Australia, the United Kingdom, Canada, and Sweden. Infant mortality rates also remain higher in the U.S., despite declines in recent decades, and are higher than that of the European Union.

Most of the top 10 health care systems in the world are members of the European Union. Those citizens have not suffered from the woes of universal coverage as we've been warned by some commentators and politicians in the U.S. and the insurance industry in the E.U. is not suffering. Having discussed universal health care with a number of people being served by that system, I conclude that there is not now nor will there ever be a mass movement from national health to the U.S. health system. Despite the occasional foreign patient in our hospitals, the vast majority of people living under universal health care would not tolerate changing back to such an anti-democratic health system as the one in this country.

Garbage In; Garbage Out
At present, the United States is attempting to assemble a patchwork of changes designed to make no one happy but irritate as few people as possible. The end result may be slightly better than what we have now but will be far too expensive and inefficient to work. It will be garbage in and we can only expect garbage out after this endless series of compromises. The only winners will be the insurance companies. Such is the state of political polarization in the U.S. This also represents the level of political courage exhibited by our elected officials. Many of them know that the versions being considered in the House of Representatives and the U.S. Senate are far more expensive than necessary and are unworkable. Our legislators are supposed to put the country and its citizens above all else but this is not the situation in Washington, D.C. at the present time. A significant percentage of our elected officials are no more than cowardly politicians masquerading as statesmen. While pretending to protect the citizens of the United States from the dreaded “socialism”, they are, in fact, using that term (misunderstood by most Americans) to scare citizens into supporting a system that benefits only corporations, not real people.

Screwed By Insurance
Currently, several artificial layers of bureaucrats (insurance company employees) are positioned between you and your health care professional. Those layers are there to prevent you from getting the health care you desire when it doesn’t please your insurance company. They are extremely efficient at collecting your premiums but loath to authorize the treatments you need. Further, when treatment is authorized, you are often responsible for paying co-pays, deductibles and any difference between what the doctor charges and what little the insurance company considers “usual and customary rates” (UCR). At this time, most people who think they are covered by good health insurance are actually paying the insurance company and also paying the doctors and hospitals.

There can be no doubt that the health care system in the U.S. urgently needs changed. Insurance companies are an extremely expensive and inefficient method of rationing health care for this nation. Without the profit motive, covering every citizen of the U.S. would not be much more than the current costs for protecting (poorly) only a portion of the population. There are several innovative ways to pay for this health care as exhibited by systems already in place around the world. A peculiarly American system should not be hard to configure but for the trepidation of our legislators and their reluctance to show even a little political courage. Universal health care is the most logical choice for a nation that wants excellent and cost effective health care for its citizens. What we will need are politicians with the courage to become statesmen and place the people of the United States above the profits of insurance companies. They need, also, to rise above an irrational fear of a word, "socialism", they don’t understand. Stop pretending to work on this problem while you are actually looking for ways to explain to the citizens of the United States that they don't deserve the same quality of health care enjoyed by everyone in many other countries.

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