How About That Best Health Care In The World? genre: Little Red Ribbon-Hood & Six Degrees of Speculation

Ham & Cheese

During this election cycle we've often heard politicians argue that the United States has the best health care system in the world. Unfortunately, there are problems with how this assertion should be measured and a new report suggests that U.S. politicians have ignored one very important factor. Specifically, for the 47 million people who lack health insurance, the results can be deadly despite the following inane comment from George Bush at a recent speech in Cleveland:

I mean, people have access to health care in America. After all, you just go to an emergency room.

In the report released by "Researchers Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine", the evidence suggests that the United States ranks dead last in terms of preventable deaths...a statistic that fully refutes the wisdom of the president's observation. Basic logic should tells us that treating conditions in an emergency setting is inferior to routine care and monitoring...which rarely happens for those individuals who lack health insurance.

France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.

If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.

Nolte said the large number of Americans who lack any type of health insurance -- about 47 million people in a country of about 300 million, according to U.S. government estimates -- probably was a key factor in the poor showing of the United States compared to other industrialized nations in the study.

"I wouldn't say it (the last-place ranking) is a condemnation, because I think health care in the U.S. is pretty good if you have access. But if you don't, I think that's the main problem, isn't it?" Nolte said in a telephone interview.

All the countries made progress in reducing preventable deaths from these earlier rankings, the researchers said. These types of deaths dropped by an average of 16 percent for the nations in the study, but the U.S. decline was only 4 percent.

"It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance," Commonwealth Fund Senior Vice President Cathy Schoen said.

"The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals and efforts to improve health systems make a difference," Schoen added in a statement.

As one can see, this report clearly points out just how absurd it is for the President to make the above statement. Yes, everyone knows that the uninsured can go to the emergency room...if they're having an urgent medical event such as a heart attack, kidney failure, diabetic coma, and so on...but they're not going to be provided with long term care in the form of heart medication, blood pressure medication, or insulin The care that is needed to treat long term medical conditions and chronic diseases and to avert or reduce these emergency room events as well as the increased risk of death is not available to many of the uninsured.

The bottom line is that the prevailing problem being ignored by the President and the 2008 GOP presidential candidates is the cost of health insurance and the inability of many, if not most of the 47 million uninsured, to afford it.

The topic was discussed in the recent ABC New Hampshire Republican debate. The following are a few relevant excerpts that clearly demonstrate the insufficiency of the GOP's proposals to correct this urgent and expanding problem.

MR. ROMNEY: Charlie, it -- that doesn't mean it shouldn't be improved. And I think -- I think that the notion of people buying their own private health insurance is a very good one, so long as a lot of them do it. Only 17 million Americans right now buy their own health insurance. If 50 million Americans were buying their own health insurance -- because it would be just as tax-advantageous to do it that way -- and we had a health savings account, people -- economists believe there'd be a 30 (percent) to 50 percent reduction in the cost of health insurance, and quality would come up.

MR. GIBSON: You all have proposed free market, consumer- purchased insurance, and you all talk about giving tax deductions for buying insurance. Let me do a little math. The average family employer-provided insurance, when the companies buy it, its $13,000 a family.

Now, you've talked about a 15 (thousand) to 20,000-dollar deduction, right, for people buying their own insurance? If you take a median-income family of $62,000 in this country, you've just saved them $3,000 on their taxes. That doesn't come close to buying an insurance policy.

MR. GIULIANI: Charlie, a health savings account actually helps to accomplish what the governor is talking about. If somebody can put aside -- and the plans that we've been talking about include a health savings account -- you'd have a -- you'd have an exemption up to 15,000 (dollars). If you could find a policy for 11,000 (dollars), you could have a $4,000 health savings account. You would be able to buy some of your health care and your prevention yourself. It gives you an incentive over a lifetime to deal with wellness.

None of these comments address the fundamental problem. The fact is that the vast majority of the uninsured don't have the income to buy health insurance even if they wanted to do so.

Let's look at some of the GOP candidate’s specific statements. Mitt Romney seems to suggest that the problem will resolve if we can simply get more individuals to buy private health insurance. Excuse me, but there are millions of Americans who can't even afford to pay their portion of an employer sponsored insurance plan. Just how are those individuals going to be able to afford even more expensive individual policies?

Rudy Giuliani's plan isn't any better. Note Charlie Gibson's explanation whereby the government offers a tax incentive for individuals or families to purchase private insurance. However, to do so, a family needs to be able to afford at a minimum of $13,000.00 (the amount they currently pay for employer sponsored insurance) in order to receive a $,3000.00 tax break. If you haven't the ability to pay for the insurance, the tax break is meaningless. Therefore the Giuliani plan only works for those who can already afford health insurance. It sounds nice to talk about a 15 to 20 thousand dollar exemption, but it isn't going to help those with low incomes who already pay minimal taxes.

When Giuliani goes on to laud the benefits of an HSA, he is once again insulting our intelligence. If most of the people who lack health care had the ability to set aside $4,000.00 in an HSA...or under their mattress...wouldn't they already be doing so? Further, the assumption that people aren't mindful of their own wellness is laughable. If you can't put food on the table for your family, you sure as hell don't put $4,000.00 in an HSA account for wellness care.

Frankly, the bulk of the GOP rhetoric on health care is little more than smoke and mirrors intended to feign concern without ever having to fund care. I would relate it to one of my favorite expressions told to me by an old friend, "I'd have a ham and cheese sandwich...if I had any ham or cheese." By and large, the same logic holds for the plight of the uninsured.

In fairness, both John McCain and Mike Huckabee argued that the lack of wellness and preventative care are largely responsible for the skyrocketing costs of health care. Their statements are a sensible equivalent to the oft heard expression, "you can pay me now or pay me later"...except for one critical omission. The "pay me now" portion of the equation is the lion's share of unfunded health care costs...costs which are only currently covered by health insurance...the health insurance that millions can't afford...and that the GOP has little desire to fund.

Since the health care industry isn't absorbing these costs (and doesn't want to), they have absolutely no motivation to offer to subsidize this type of care. At the same time, it’s abundantly evident that the GOP opposes the government stepping in to cover these costs. The truth of the matter is that the health care industry and the GOP both accept that it's cheaper (and more profitable) to continue only requiring the health care industry to provide indigent emergency care. In the end, that essentially leaves few people advocating for the needs of the uninsured...and more people in the morgue.

It's been more than seven year since George Bush sold the American public on the notion of "compassionate conservatism". Let's hope that the election of a Democrat in 2008 will be the first step towards seeing it demonstrated.


1 On January 9, 2008 at 5:32 AM, peggy wrote —

The problem is much worse than the 47 million without any insurance. Millions have inadequate and even fraudulent policies. This is madness. From the outside looking in, it must appear that we have lost our minds along with our humanity.

2 On January 9, 2008 at 8:43 AM, Anna wrote —

The problem isn't only that so many are uninsured, although that surely is at the top of the list. The system is broken also in the amount of paperwork--often confusing--that must be dealt with by individuals, health care providers, and businesses that provide their employees with insurance; the poor quality of many policies; all the limitations and exclusions on which physicians and which facilities you can use according to your plan or an extremely high cost for coverage that allows you to choose any provider (remember all the scare tactics that claimed Hilary's health care plan would take away your "choice"?); and the constant fear that you can go bankrupt in the event of serious medical conditions even if you have insurance. Huge amounts of money that could go to actual health care are wasted on the voluminous costs associated with providing health insurance through a welter of different insurance companies. Plus, one should realize that a certain percentage of our health care dollar goes not to direct care or even to the administration of health care insurance but as profits to stockholders in insurance companies and to the bloated salaries of insurance industry executives. Although much of American health care is indeed excellent, there are rampant problems with the current system.

3 On January 10, 2008 at 10:39 AM, mr Earl wrote —

Insurance company executives are mass murderers and need to be arrested and charged as such. Any one who works for a health insurance company is a "little Eichman".

Who was denied, Who died ,today?

To The Bastile, to the barracades!

4 On May 28, 2013 at 3:00 PM, insurance broker wrote —

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thanks for providing such data.

Thought Theater at Blogged

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The number of uninsured in the U.S. continues to expand amid the hollow rhetoric. It’s been more than seven year since George Bush sold the American public on the notion of “compassionate conservatism"". Let’s hope that the election of a Democrat in 200... [Read More]

Tracked on January 8, 2008 12:39 PM

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