August 21, 2009
The health care debate-13: The US falling further behind
(For previous posts on the issue of health care, see here.)
I have pointed out repeatedly that the US lags badly behind other developed countries in the quality and cost of the health care it provides its people. And all indications are that the US is going to fall further and further behind as other countries adopt universal health coverage based on the single-payer model.
President Obama keeps saying that if we were starting from scratch, a single payer system would be the best option, but that given the existing situation of an employer-based private health insurance system, it would be too disruptive. This is just an excuse for protecting the interests of the drug and insurance industries. After all, Medicare was introduced in 1965 and within one year, by July 1, 1966 19 million seniors were enrolled in it, almost all of the nearly 20 million people over the age of 65 at that time (see table 2-1, page 9), and there were no major problems in that transition.
Furthermore, as this article in the journal Health Affairs points out, other countries such as Taiwan made the transition from a US-style system to a single payer one quite easily. (Thanks to Heidi Nemeth for the link.)
Taiwan established a compulsory national health insurance program that provided universal coverage and a comprehensive benefit package to all of its residents. Besides providing more equal access to health care and financial risk protection, the single-payer NHI also provides tools to manage health spending increases. Our data show that Taiwan was able to adopt the NHI without using measurably more resources than what it would have spent without the program. It seems that the additional resources that had to be spent to cover the uninsured were largely offset by the savings resulting from reduced overcharges, duplication and overuse of health services and tests, transaction costs, and other costs. The total increase in national health spending between 1995 and 2000 was not more than the amount that Taiwan would have spent, based on historical trends.
Additionally, Taiwan did not experience any reported increase in queues or waiting time under the NHI. Meanwhile, the government has taken regular public opinion polls every three months to gauge the public’s satisfaction with the NHI. It continuously enjoys a public satisfaction rate of around 70 percent, one of the highest for Taiwanese public programs. (emphasis added)
As Scott Hanley says:
In 1995, Taiwan began providing government-run health insurance for everyone; by the end of the year, almost everyone in the country had enrolled and abandoned their US-style system of mixed private and public hospitals and free market insurance. What happened to health care costs? In the first seven years they ... stayed about the same.
That's right. They went from 57% insured to 97% insured without increasing overall spending on health care. People liked it, used it, remained healthy, and it was just as affordable as the private system that had insured not much more than half the population.
A recent report says that China has decided to have universal health care by 2011, and will "take measures within three years to provide basic medical security to all Chinese in urban and rural areas, improve the quality of medical services and make medical services more accessible and affordable for ordinary people."
Obama and the Democrats seem to start their negotiating process with what they think that the most reactionary elements in congress will accept, instead of the one that the country needs, let alone a really good one like a single-payer system. Cartoonist Tom Tomorrow explains the futility of this strategy.
Veteran journalist Russell Mokhiber lists the top 10 enemies of the single payer system, in alphabetical order. One or two of the names on the list may surprise you and you need to read the article for Mokhiber's reasons.
American Association of Retired Persons (AARP)
America's Health Insurance Plans (AHIP)
American Medical Association
Health Care for America Now
Kaiser Family Foundation
The Lewin Group
Pharmaceutical Research and Manufacturers Association of America (PHRMA)
However far Obama goes to appease the reactionary elements, they will still oppose reform because they want to kill it altogether. They do not want to give the Democrats a signature victory on a major issue, and they are aided in their efforts by those Democrats in Congress who are in the pockets of the health industry.
POST SCRIPT: Nutters gone wild
We have seen many examples of nutter behavior recently and it is hard to determine who is the craziest. A strong contender must be this woman who shouts "Heil Hitler!" at a Jew who is originally from Israel who was speaking in favor of health reform and for the creation of a national health care system like they have in Israel. Not surprisingly, he goes ballistic. Also watch her behavior at the end when he tells her that he had to pay $8,000 for a two-hour visit to a US emergency room. Priceless.
David Waldman notes that, to add to the irony, she is wearing an IDF T-shirt, which she presumably thinks gives her the license to freely use Nazi allusions.