Republican government makes you sick (and broke)
Britain's National Health Service comes in for its fair share of derision; anecdotes of crooked teeth and long waits for sex-change operations abound. This concern about long waits for gender-adjustment surgery is presumably why American reactionaries yelp about socialism whenever the question of universal healthcare is raised. The other party is the only reason this country does not have universal halth care; despite the fact that President Clinton was elected with a mandate to implement it.
Now comes a new study that should properly humiliate all of us: the UK's NHS produces better outcomes, across the board, at all income and social levels, than does our gloriously capitalist and stunningly inefficient system. This for two reasons: Britons suffer less stress and have universal healthcare. One cause of the lowered stress in the UK versus the U.S. is that in the UK, incomes are rising, also across the board - while in America, of course, everyone but the top 1% has seen a drop in real income since 2001, when the oh-so-efficient MBA administration took power. For example, incomes rose 2.1% last year - while inflation was 3.4%, which translates to a 1.3% pay cut. Sorry, y'all.
It's worth it to take a closer look at the numbers. In 2004, U.S. healthcare spending was $1.9 trillion, about 16% of GDP. Per capita, that amounts to $6,280. By contrast, the UK spends about $2,600 per capita, for a total share of GDP of about 7.7%. If present trends continue, we will spend $4 trillion on healthcare in 2020, or about 20% of GDP. By that time, by the way, the number of uninsured - who are mainly lower middle-class workers who don't have coverage from their employers - should reach about 60 million.
So where does the money go?
Of course, the other side has its own answers to the healthcare crisis - it's just that, as usual, their answers are politically motivated and thus useless. For example, they complain about the cost of malpractice lawsuits, which cost an estimated $4 billion a year all told, including insurance premiums. That's $4 billion out of total healthcare spending of $1.9 trillion. You do the math. Then of course, there are 'health savings accounts' or HSAs; the idea being to set aside money for health care in an interest-bearing account. Not a bad idea, unless you act all irresponsible and get sick, that is.
Now take a look at the best-run U.S. health system: Medicare. It theoretically covers 100% of the eligible population, though you can opt out if you so choose. It has the highest consumer satisfaction rates in the industry, with the lowest administrative costs. If consumers had a choice, odds are they would flock to Medicare by the dozens of millions. Just ask our right-wing overlords: the health plan of Congress is basically Medicare, except with a drug benefit that works.
In a very real way, the healthcare crisis is the biggest danger to our long-term prosperity and security. No company that operates as does our healthcare system - grossly overcharging for inferior results - could survive in the marketplace. Just assuming that we could switch overnight to the Canadian model - to be a bit less frugal than the Brits - and have their costs and outcomes, our average life expectancy would rise by four years, and costs would go down from 16% of GDP to 10%. That's an annual savings of over $700 billion. Not a bad number when we have a combined annual budget/trade deficit that's twice as high.
Now, why isn't this sensible course - save money, get better results, what's not to like? - not going to be taken anytime soon? The answer is simple: because republicans would rather waste over $700 billion a year and let you die a few years early than create a workable solution that contradicts their ideology. After all, any kind of collective, societal or government effort is bad - and decades of propaganda and hundreds of millions of dollars have spent on that message. Of course, endless campaign contributions from their special-interest pals in Big Pharma also have a marvelous way of clarifying the reactionary message: that, for the sake of the abstract notions of 'individualism' and 'capitalism', we can't have a system that allows you more choices - just compare Medicaid's options with your own crappy HMO, if you're lucky enough to have coverage in the first place - and is more cost-efficient while being universal.
In a rational universe, we wouldn't even be arguing about the policy choices that need to be made. However, the universe of our republican overlords isn't rational - it's ideological (and corrupt, but that's a different story). That's the commonality between our grotesque health system, the gargantuan budget deficit, the Iraq war, the trade deficit, the weakening dollar, exploding gas prices (ANWR ain't the answer, boys), stagnant incomes, and a host of other problems besides. When confronted with real-life problems, reactionaries don't look at what the best solution would be - they look at what their ideology tells them and what their corporate masters/donors would like. And they don't have the courage or moral fiber to cut themselves loose from their ingrained myopia and do what is best for all of us, for our common good.
And until they are voted out of every office they hold, it's not going to get any better.
Now comes a new study that should properly humiliate all of us: the UK's NHS produces better outcomes, across the board, at all income and social levels, than does our gloriously capitalist and stunningly inefficient system. This for two reasons: Britons suffer less stress and have universal healthcare. One cause of the lowered stress in the UK versus the U.S. is that in the UK, incomes are rising, also across the board - while in America, of course, everyone but the top 1% has seen a drop in real income since 2001, when the oh-so-efficient MBA administration took power. For example, incomes rose 2.1% last year - while inflation was 3.4%, which translates to a 1.3% pay cut. Sorry, y'all.
It's worth it to take a closer look at the numbers. In 2004, U.S. healthcare spending was $1.9 trillion, about 16% of GDP. Per capita, that amounts to $6,280. By contrast, the UK spends about $2,600 per capita, for a total share of GDP of about 7.7%. If present trends continue, we will spend $4 trillion on healthcare in 2020, or about 20% of GDP. By that time, by the way, the number of uninsured - who are mainly lower middle-class workers who don't have coverage from their employers - should reach about 60 million.
So where does the money go?
- Advertising. American pharmaceutical companies spend as much money on advertising - all those TV spots for god knows how many ED drugs don't come cheap - as they do on research and development, about $20 billion a year.
- Overstaffing. The pharmaceutical companies employ one salesperson for every doctor.
- Profits. Profit margins - which benefit CEOs and investment banks, not patients - are up by Exxon-eque levels.
Of course, the other side has its own answers to the healthcare crisis - it's just that, as usual, their answers are politically motivated and thus useless. For example, they complain about the cost of malpractice lawsuits, which cost an estimated $4 billion a year all told, including insurance premiums. That's $4 billion out of total healthcare spending of $1.9 trillion. You do the math. Then of course, there are 'health savings accounts' or HSAs; the idea being to set aside money for health care in an interest-bearing account. Not a bad idea, unless you act all irresponsible and get sick, that is.
Now take a look at the best-run U.S. health system: Medicare. It theoretically covers 100% of the eligible population, though you can opt out if you so choose. It has the highest consumer satisfaction rates in the industry, with the lowest administrative costs. If consumers had a choice, odds are they would flock to Medicare by the dozens of millions. Just ask our right-wing overlords: the health plan of Congress is basically Medicare, except with a drug benefit that works.
In a very real way, the healthcare crisis is the biggest danger to our long-term prosperity and security. No company that operates as does our healthcare system - grossly overcharging for inferior results - could survive in the marketplace. Just assuming that we could switch overnight to the Canadian model - to be a bit less frugal than the Brits - and have their costs and outcomes, our average life expectancy would rise by four years, and costs would go down from 16% of GDP to 10%. That's an annual savings of over $700 billion. Not a bad number when we have a combined annual budget/trade deficit that's twice as high.
Now, why isn't this sensible course - save money, get better results, what's not to like? - not going to be taken anytime soon? The answer is simple: because republicans would rather waste over $700 billion a year and let you die a few years early than create a workable solution that contradicts their ideology. After all, any kind of collective, societal or government effort is bad - and decades of propaganda and hundreds of millions of dollars have spent on that message. Of course, endless campaign contributions from their special-interest pals in Big Pharma also have a marvelous way of clarifying the reactionary message: that, for the sake of the abstract notions of 'individualism' and 'capitalism', we can't have a system that allows you more choices - just compare Medicaid's options with your own crappy HMO, if you're lucky enough to have coverage in the first place - and is more cost-efficient while being universal.
In a rational universe, we wouldn't even be arguing about the policy choices that need to be made. However, the universe of our republican overlords isn't rational - it's ideological (and corrupt, but that's a different story). That's the commonality between our grotesque health system, the gargantuan budget deficit, the Iraq war, the trade deficit, the weakening dollar, exploding gas prices (ANWR ain't the answer, boys), stagnant incomes, and a host of other problems besides. When confronted with real-life problems, reactionaries don't look at what the best solution would be - they look at what their ideology tells them and what their corporate masters/donors would like. And they don't have the courage or moral fiber to cut themselves loose from their ingrained myopia and do what is best for all of us, for our common good.
And until they are voted out of every office they hold, it's not going to get any better.
posted by Michael at 10:50 AM
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