I only wish I had more time. This is going to be half-assed, and for that I apologize.
The problem with US healthcare is not solvable by a single payer system, because it would not be accepted by Americans, nor do most Americans want government providing all of these services.
Agreed. And that, IMHO, is part of the problem. Americans are shooting themselves in the foot with their close-mindedness in this respect.
The lowest infant mortality rate of a nation of any size is Sweden at 3.49; ours is at 6.8 and there are probably 20 nations in between...
Thirty-three, actually. Granted, that includes
all nations...but if we count only developed nations, we still rank 28th (In spite of recent improvements,
according to HRSA).
...It is difficult to take into account population variations, availability/acceptability of birth control, and migration, particularly "unofficial" migration.
That's true, but those factors would affect most
developed nations roughly equally. Besides, should not the measure of quality health care be its success in meeting the needs of the community, rather than the relative ease with which it does so?
Americans dying of preventable causes is a function of late detection and lack of awareness of risk more than it is an indictment of the health care system.
This is true, but the 10,000 Americans to which I refer are cases that can specifically be linked to inadequate insurance. These are individuals who, because they could not
afford treatment, did not seek medical care (resulting in delayed diagnoses) delayed or discontinued care they knew they needed, or were unable to access medications that would have saved their lives for financial reasons. Should this number seem high, let me point out that one million Americans die annually from preventable causes. One percent of all preventable deaths doesn't seem like much -- until it affects someone you know.
Should the government take care of a smoker with lung cancer? Pay for a desired but not medically indicated abortion? Repair a non-medically hazardous cosmetic condition? Who are you going to take care of and who are you not going to take care of?
Who do private insurers take care of? Not my friend's husband, who had cancer ten years ago. He's self-employed, and no insurance company will take him on -- no matter how much he pays. Private insurers also won't take care of my three year old nephew, who's autistic -- mental health patients are one of the most needy and most underserved groups in America. Private insurers won't pay for my mother's post-hysterectomy hormone supplements (which may prevent breast cancer and osteoperosis), and they won't pay for Vioxx for my brother, who is crippled by Crohn's-related arthritis at the age of 34. They won't pay for one of the two medications recently prescribed for me so that an otherwise healthy twenty five year old woman can have a baby. So before you tell me who we
shouldn't be covering, let me tell you who we
should.
The responsibility for this can not fall solely on government...
Why can't it? That's an argument that I'm sick of hearing. In this country, we have something historians and political scientists used to call Civic Responsibility. It's why we have highways and a federally-supported military. It's why the police aren't hired guns, and why many remote rural communities have affordable electrical service. It's why we have public schools. Public schools are perhaps the best example of why health care
should be everyone's responsibility. Sure, not everybody's happy with the public schools. But internationally,
we rank second (just behind Finland) in child literacy rates. That's a far cry from being twenty-eighth or thirty-fifth (depending how you count) in health care. And regardless of anyone's criticism of public schools nationwide, the important thing is that every person in America -- even the children of illegal immigrants -- has access to the school system and all the services it provides.
Look at the taxation rates in some of the nations you mention and then look at wha the average citizen is getting for health care there.
Okay. Let's look.
Aggregate healthcare spending (as a function of the GDP) averages about $4,887 per capita in the United States. Switzerland -- the second highest spender -- spends $3,248 per capita, Germany around $2,800, and the U.K., about $2,000 in 2001.
But we wouldn't want that "inferior" care that people in other nations are content to settle for, would we?
Let's look again. Switzerland is ranked #20 by the WHO; Germany is ranked #25. The UK, the closest system we have to "socialized" medicine, is ranked #18. The United States is ranked #37.
If the German government is in dire straits, it's not because of their healthcare expenditures, I can assure you of that.
Ref. 1 Ref. 2 Ref. 3 It's no wonder that when people from all over the world want top of the line health care, they come to the US.
That's not technically true. When
wealthy people from all over the world want top of the line health care,
and they are willing and able to pay for it, the come to the US. Meanwhile, thousands of people who live right here can't get access to the treatments they need because they are too expensive. For support, I refer you to the book
Health Care Meltdown by the late Dr. Robert Lebow. I can't quote it here, but he devotes several chapters to the problem of accessibility in the American system. In essence, we have the technology, but most people can't afford to use it.
The problem in the US health care system is unnecessary procedures, litigation, and lack of choice/portability of health care. Level the playing field and educate the consumers - the quality will have to improve and the costs will have to come down as these organizations compete.
In my opinion -- and the opinions of many who are far, far wiser than I -- establishing a single-payor system is the optimal way of "leveling the playing field." Competition works in so far as demand remains elastic, but in the case of health care, it's just not. People have to have health care, and those who are able to pay exorbitant prices will continue to do so for as long as they are able. But health care isn't like any other commodity. It is a civil service, like public education. It is, I would argue, a basic human right. It's a right that's being denied to tens of thousands of Americans each year -- and ten thousand of them are dying for lack of it. Many people have suggested ways to modify the current system, ways to regulate it, and ways to improve what we have, but, call me a revolutionary, I believe the best thing we can do is dismantle it. Take the whole thing apart and start over. Otherwise, we're going to end up with a system that's so complicated, it will take a four-year degree just to figure out how to get a prescription.
And
that's my opinion. Am I cute when I'm politically inflamed?
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