Universal Health Care for Americans
The health care system in the US is so broken and there are so many examples of successful systems in other countries that it's one of the easiest problems for which to find solutions.
At the outset I'll suggest a single-payer plan, in which the federal government would provide the insurance function instead of private insurance companies. What I am suggesting is not socialized medicine, in which the federal government would hire the doctors and run the hospitals and so on. Our health care is of the highest quality; it is the insurance function that is broken. Insurance costs in the US are reported to run at 25 to 30 percent of total costs.
Are there alternatives? A single-payer plan need not be the only possible approach. A look at systems in other countries could indicate attractive features from which the US could choose in formulating a system.
First, let's do a quick overview of the problem: The US spends more than twice as much per capita on health care as does the average developed country, and its outcomes in the usual categories such as longevity and infant mortality are not as good as in other developed countries. The main reason for this is that more than 46 million Americans have no health insurance and millions more are underinsured. Significant categories are not covered in US plans, while Canada, for example, covers long-term care, mental health care, and dental care. Firms in the US find it difficult to compete with firms in other countries because of the cost of health care for employees: General Motors has reported that this adds an expense of $1,500 per automobile. Additionally, the prescription drug program just adopted in the US, with its donut hole and high prices, is a fiasco. All in all, dissatisfaction with the US system is higher than in other developed countries.
Let's recognize, at the same time, that opponents can offer some relevant arguments. Pharmaceutical firms in the US finance most of the R&D for drugs, and as a result other countries can sell those drugs at reduced prices. The US Department of Commerce reports that 8 out 0f 10 of the top-selling drugs are produced by companies headquartered in the US. Also, there can be long waits in other countries for surgery and other treatment; health care is rationed by design, rather than by affordability as in the US. Those who can pay may find medical treatment in the US a preferred option. Medical technology in the US may be the best in the world, and care should be taken not to jeopardize that. And finally, lifestyle decisions that Americans make, along with longer working hours and shorter vacations, may add to medical expenses.
Well then, how would one go about planning a system for the US? It need not be hopelessly difficult. Medicare could be extended to all rather than just the elderly. Its administration costs are less than 2 percent. The Veterans Administration, with similar costs of administration, also could serve as a model upon which to build. As for drug costs, Medicare should be empowered to negotiate with pharmaceuticals.
The usual argument that the US cannot afford universal health care is the easiest of all to refute. We can do it, no, we can do it better, for half the price.
At the outset I'll suggest a single-payer plan, in which the federal government would provide the insurance function instead of private insurance companies. What I am suggesting is not socialized medicine, in which the federal government would hire the doctors and run the hospitals and so on. Our health care is of the highest quality; it is the insurance function that is broken. Insurance costs in the US are reported to run at 25 to 30 percent of total costs.
Are there alternatives? A single-payer plan need not be the only possible approach. A look at systems in other countries could indicate attractive features from which the US could choose in formulating a system.
First, let's do a quick overview of the problem: The US spends more than twice as much per capita on health care as does the average developed country, and its outcomes in the usual categories such as longevity and infant mortality are not as good as in other developed countries. The main reason for this is that more than 46 million Americans have no health insurance and millions more are underinsured. Significant categories are not covered in US plans, while Canada, for example, covers long-term care, mental health care, and dental care. Firms in the US find it difficult to compete with firms in other countries because of the cost of health care for employees: General Motors has reported that this adds an expense of $1,500 per automobile. Additionally, the prescription drug program just adopted in the US, with its donut hole and high prices, is a fiasco. All in all, dissatisfaction with the US system is higher than in other developed countries.
Let's recognize, at the same time, that opponents can offer some relevant arguments. Pharmaceutical firms in the US finance most of the R&D for drugs, and as a result other countries can sell those drugs at reduced prices. The US Department of Commerce reports that 8 out 0f 10 of the top-selling drugs are produced by companies headquartered in the US. Also, there can be long waits in other countries for surgery and other treatment; health care is rationed by design, rather than by affordability as in the US. Those who can pay may find medical treatment in the US a preferred option. Medical technology in the US may be the best in the world, and care should be taken not to jeopardize that. And finally, lifestyle decisions that Americans make, along with longer working hours and shorter vacations, may add to medical expenses.
Well then, how would one go about planning a system for the US? It need not be hopelessly difficult. Medicare could be extended to all rather than just the elderly. Its administration costs are less than 2 percent. The Veterans Administration, with similar costs of administration, also could serve as a model upon which to build. As for drug costs, Medicare should be empowered to negotiate with pharmaceuticals.
The usual argument that the US cannot afford universal health care is the easiest of all to refute. We can do it, no, we can do it better, for half the price.
posted by Gladys at 1:51 PM
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