Health Care Reform

It is long past time for the United States to join the civilized world. Spain, Germany, France, Canada, England, Italy, Brazil, Israel, Singapore, Taiwan, Finland, The Netherlands, Scotland, Australia, Japan, New Zealand, Mexico and many more nations have national health care services which provide universal health care. Each one is different. Some are some form of government provided health care, others are single-payer systems where all the providers of basic health care services are private but the bills for service are paid by a single public entity out of mandatory contributions or taxes. In the latter cases all decisions of service are made by the patient and doctor.

The most talked about, because of its proximity and success, is Canada. Here is a comparison

Category
Current System	US	Single-Payer/Canada
Uninsured	45 million	0
Total Cost (2002 projection)	$1.6 trillion USD	$1.1 trillion USD
Cost Per Person 2002 (aka Per Capita)	$5,440 USD	$3,507 USD
Administrative Costs (2003)	$399 billion USD	$114 billion USD
Cost Difference of 28 Top-Selling Drugs (2002)	$1.00 USD	$.72 USD
Infant Mortality, Deaths per 1000 Live Births, 2000	7	5
Life Expectancy (average male and female), 2002	77.3	79.8
Health Insurance Employees, per 10,000 enrollees	Cigna: 31.2, Wellpoint:13.7	Ontario (Canada) Health Insurance Plan: 1.2
Employers' Medical Benefits Costs	8% of salaries and wages	0.6% of salaries and wages
Applicants per Medical School Place	2.4	5.5

Health care must be seen as a right. If life is a right of all humans then health care is as much a supporting right as food and shelter. Of course having a 4,000 square foot home is not a right, nor is caviar, but basic nutritious food and shelter from the elements are. So a private hospital room with cuisine, perhaps not, but both preventive and curative medicine is necessary for life.

This should be obvious. There should not be a debate. But it is politically difficult because of the vested interests of the insurance industry. They have no intention of losing their profits and perks. They have created a system where they make exorbitant profits by denying proper care. Thirty to forty percent of every dollar goes to "administrative" costs, most of which are outrageous senior executive pay scales and profits to the largest shareholders. Much of the rest pays for bureaucrats whose job is to find ways to deny coverage to people who have already paid for insurance.

Here are some more facts:

• In 2008, health care spending in the United States reached $2.4 trillion, and was projected to reach $3.1 trillion in 2012.1 Health care spending is projected to reach $4.3 trillion by 2016.¹
• Health care spending is 4.3 times the amount spent on national defense.³
• In 2008, the United States will spend 17 percent of its gross domestic product (GDP) on health care. It is projected that the percentage will reach 20 percent by 2017.¹
• 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.³
• Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, according to the Organization for Economic Cooperation and Development.⁴
• Un-insured. Nearly seven million Californian lack health insurance during all or part of the year. About 70% of these people are employed but do not receive employer-based insurance.
• Under-insured. Most insured Californians are “under-insured.” Under insurance means that you have health insurance but procedures or benefits are not covered or are only partially covered.
• For example, your insurer has excluded a preexisting condition from your policy. Or it may be that your deductibles and co-payments will become a financial burden that could lead to personal bankruptcy if you become seriously ill. Or your lifetime policy benefit is too low and your share of costs will be enormously high if you have a catastrophic illness.
• Last year two million Americans – 75% of whom had health insurance – were forced to declare personal bankruptcy because of their medical bills.
• Lack of personal security. You should have the personal security knowing that whatever your employment status, age, income, or medical history or condition, you have health insurance. The United States is the only industrialized country that doesn’t have a national health insurance plan that covers everyone.
• Runaway premiums. Annual health care premium cost increases far exceed cost-of-living increases. Both employees and employers are paying more and more. Very soon the average annual cost for a family health insurance policy will be $20,000 – not including the co-payments and deductibles for which you are responsible to pay.
• Rising deductibles and co-payments. Even as premiums rise dramatically, we are paying more and more out of pocket for the heath care services we need.
• Employer squeeze. Employers are placed in the uncomfortable position between employees and insurers. Employers face the difficult task of choosing among insurers and among the myriad of policy plans. They must then communicate the unwelcome news to employees about higher premiums, co-payments, and deductibles.
• Emergency rooms closures. Today, for every Californian whether insured or not, emergency rooms are less and less available for emergencies. Why? Emergency rooms have become the health care provider of last resort for the uninsured. They are providing so much uncompensated care that some have been forced to close their doors.
• Lack of choice of providers. Your choice of health care providers is severely limited by insurance companies. Often, you are not able to find a provider near where you live.
• Poor benefits. Many insurance plans have limited benefits. For example, mental, dental, and vision health care are often non-existent or inadequate.
• Inefficiency and confusion. We have thousands of insurance companies and tens of thousand of insurance plans. It is confusing for patients and providers and very inefficient. Much too much of the health care dollar – nearly 30% – goes towards administrative costs, marketing, and profit instead of towards direct health care services.
• Poorer medical outcomes. The United States has the worst population-based health care outcomes in the industrialized world. For example, our life expectancy is the lowest in the industrialized world. To a large extent, this is because there are no system-wide standards of care or standards for reporting and investigating errors. It is estimated that over 700.000 Americans die each year in from preventable medical errors in hospitals. Clinical waste in our system is a big a problem as administrative waste.

It is time. Time to tell the Blue Dog Democrats to shape up. Time to tell Harry Reid to grow a spine. Time to tell Diane Feinstein that 72% of Americans favor a public option according to a CBS/New York Times poll.
http://www.cbsnews.com/stories/2009/06/19/opinion/polls/main5098517.shtml

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Americans generally see government involvement in health care in a positive light, and most support it. Fifty percent think the government would be better than insurance companies at providing medical coverage (up from 30 percent in 2007), and 59 percent think the government would be at better holding down costs (up from 47 percent in 2007).

More generally, 64 percent of Americans say the government should guarantee health insurance for all Americans. Just 30 percent think this is not its responsibility. Those percentages have been stable for many years.

When presented with the option of a government-administered health insurance plan similar to Medicare to compete with private health insurance companies, 72 percent are in favor and just 20 percent oppose. Even 50 percent of Republicans favor that option.