THE 100,000 FOOT VIEW ON HEALTH CARE (Part I)

"The needs of the many far outweigh the wants of the few."
- "Star Trek"'s Mr. Spock -


In the past week, I have read some excellent posts concerning the state of our health care system. One was on June 19th, at Burr Deming's superb nttp://www.fairandunbalanced.com/ "Fair and unbalanced" blog. It gave a succinct summary of our current scenario, with Republicans and conservatives providing warnings as to why we must not adopt a public, government-run option ("...if government competes with private insurers, it will be unfair to private insurers..."). The other, a June 17 post on Marc McDonald's always thought-provoking site "Beggars Can Be Choosers.com", http://www.beggarscanbechoosers.com, points out how hypocritical "GOP politicians think it's fine to enjoy tazpayer-funded health care benefits. They just don't want these benefits for anyone else in America." Marc also urges those who believe we need a strong public health insurance option enacted this year to write letters to the editors of our daily newspapers. These posts both got me to thinking.


Months ago, I had originally intended to do an exhaustive study of the Canadian, British, French, and Dutch health care systems. each of which would be termed "socialistic" or "socialized medicine" by modern conservative Republicans. My intent was to refute, myth by ridiculous myth, all the fearful, untrue, and ignorant allegations being made against those government-run programs by Republicans. For prior to any government plan whatsoever being proposed to or released by Congress, we have already seen crazy and disparaging remarks made about a public plan from the likes of Michele Bachmann and Mitch McConnell. We are also starting to see lobbying efforts and misleading ad campaigns developing to defeat the adoption of a public plan altogether. These campaigns, begun and/or supported by wealthy, corporate profiteers and their conservative Republican pals in Congress, are all built on fear and distortion.The "Swift Boat [Lying] Veterans" ad producers from 2004 are active participants in this attempt to scare the population away from a public option. We will be seeing and hearing the latest examples of these master-deceivers on TV and radio soon, to be sure. It is shadowy forces like these who made me all the more determined to do a comprehensive study. Yet, as I began doing research and interviewing Canadians and Europeans for my framework, I discovered many differences between, and intricacies involved with, each system. So many, in fact, that I decided to abandon that approach. For such a post would require a mega-multi part installment series to do it justice, and I have neither the time nor the energy to devote to such an undertaking at the moment. So rather than get bogged down in the details of one plan versus another, I decided I would start out with a broad 100,000 foot overview of our system and take into account possible alternatives, BEFORE the full-blown Congressional debate begins. This will then be a two-part, 100,000 foot view.

This broad, 100,000 foot view reveals many cracks in what appears to be a broken system. Costs are constantly rising, well above the inflation rate. They are rapidly becoming far too high for a huge and ever-growing number of the population. Indeed, health care in the United States is nearly the costliest per capita in the entire world. According to the World Health Organization's latest study (2005), rankings of expenditures by country on health care as a percentage of Gross National Product (GNP) place the U.S. in second place overall, at a whoping 15.2% of GNP! By comparison, the so-called "socialistic" system in France ranks 10th (at 11.2%), "socialistic" Canada's ranks 18th (at 9.8%), and the most supposedly "socialistic" system of all, in the United Kingdom, comes in at number 41 (at a mere 8.2%, just over half the cost of our own)! But, with the huge percentage of our GNP going into our privately-run system, are we getting our money's worth? In relation to what citizens of those other "socialized" countries are receiving, we may not be.

A WHO study ranked U.S. citizens 24th overall in terms of life expectancy (at 70 years). This was behind "socialistic" France (3rd, at 73.1 years), "socialistic" Canada (12th, at 72 years), and the "socialistic" United Kingdom (14th, at 71.1 years). Another WHO study ranked France's health care system the best in the world overall, the United Kingdom's 18th, Canada's 30th, and ours 37th. A CIA World Factbook update just released on April 2, 2009 listing infant mortality rates per every 100,000 live births places France (3.3), the United Kingdom (4.85), and Canada (5.04), all ahead of the United States (6.26). So are we, as conservatives love to claim, with our private health care system, in posession of the best system worldwide? Are we getting the most bang for our health care buck as opposed to those living in the "socialized medicine" countries? The evidence strongly suggests we are not, and so it would seem prudent we must begin searching for a better and cheaper alternative. After all, when one person tells you that you have a tail, that's his or her opinion. When two tell you, it may very well be a clique. But when three or more tell you that you have a tail, you had at least better turn around and have a look, right?

Congressional Republicans, insurance companies, and pharmaceutical manufacturers do not want a public health care option to compete against the current private system. They know that most of us would opt for the more reasonably-priced public system. The GOP prefers things just as they are, with 1 in every 6.5 of us uninsured, unable to afford high private insurance premiums, and with the insurance firms and pharma houses reaping billions in profits each year. They like the system whereby these greedy entities can raise prices at will. The oft-made Republican claim that the "free market" regulates and corrects itself is absolute nonsense here, just as it has proven to be in the fields of mortgage banking and energy. As in those sectors of the market, competition has NOT kept prices down at an affordable level. Instead, we have seen exclusion, price-fixing, wild and irresponsible speculation, and wholly unecessary excesses like exorbitant executive board salaries. Rather than self-regulating, this "free market" of private health care has only enabled the wealthy and big members of our medical/industrial complex to maximize excessive profit for themselves while excluding millions of Americans from coverage and effectively dictating treatment methods, medicine dosage, and hospital-stay lengths to those they do cover. So long as corporate insurance and pharma execs can pay themselves multi-million dollar annual salaries, that's perfectly ok with Republicans. Meanwhile, though, nearly 50 million Americans remain uninsured and are subject to bankruptcy in cases of catastrophic illness, and millions of elderly are forced to choose between medication and food at certain times of the month. There is no rational excuse or defense for this blind and cold-hearted Republican wish to keep things exactly as they are today!

I see the major problems with our existing setup as being unequal coverage and blatantly excessive profiteering by some from the illness and suffering of others. Congressional Republicans and their wealthy corporate allies see instead a major problem in replacing or modifying this system, as doing so would cut back on profit for already massively profitable businesses. Clearly, theirs is a case of severely mistaken priority. In this prosperous country, health care must be a human RIGHT for ALL, not just a privilege for the portion who can afford it. We have no problem with ensuring and mandating that education be made available for all citizens. So too should it be with health care.

We are now starting to hear horror stories of long office waits, delays in receiving treatment, high costs, inability to choose one's own doctor, and a litany of other allegations against government-run health care coming from defenders of the status quo. These are distorted claims, exaggerations, and outright lies being made to scare everyone away from a public option. If your doctor appointment is for mid or late afternoon under our current system, though, you invariably experience a long wait, as physicians often overbook. With a public plan, the universal accessibility may indeed increase waiting time. but the institution of high co-pays for office visits should discourage unnecessarily frequent doctor visits for trivialities. Regarding treatment delays, my Canadian, English, and Dutch acquaintances all assure me that, in their experience, the only delayed treatments involve those for optional, cosmetic, or non-life-threatening conditions. In other words, it may take some time to get a non-cancerous mole removed, or to have liposuction, or a face-lift. But your emergency appendectomy, heart attack, stroke, or car crash injury receive immediate treatment, just as they do here now. After all, Canadians aren't dropping dead on the streets of Toronto or Winnipeg or Vancouver due to delayed medical care, nor are Brits on the streets of London or Manchester, nor the French on the streets of Paris or Marseilles. As for costs, we have already seen how much less of their GNP the citizens of "socialized medicine" countries pay for health care than we do with our greedy private system, even taking into account the higher income taxes paid in these "socialist" countries. (Perhaps if our own millionaires and billionaires paid a fairer share of taxes, as they do in Canada and Europe, our own costs may drop a bit)? So many of the anti-public option elements who profit handsomely off of the sickness of others present a standpoint without much merit and are simply offering mere expressions of self-interest. This current system cannot be allowed to remain as it is any longer.

The 100,000 foot view of our health care system reveals many flaws and injustices. We should be ashamed of a system which places excessive individual profit well ahead of the common good, and we should replace such a system with one that allows for, at the very least, some real competition from the public sector. 72% of voters favor a public option and 57% have even expressed willingness to pay higher taxes for it.

Marc McDonald's advice is sound: we should all write letters to the editors of our newspapers and favorite magazines. We should also write, email, and/or call our Congresspersons to let them know this costly and unjust system MUST be reformed - NOW!

UP NEXT: Part II in this series, in which I will make a radical new proposal for change. I promise: it will be a briefer post.