Halfway Hell of Health Care Reform (aka, why the presidential campaigns are killing me)

(PHOTO: Sanja Gjenero)

Health care systems fascinate me. Endlessly. I could read about the policy and practice of socialized or privatized medicine until my eyeballs burst. And with the US presidential campaigns underway, I have ample opportunity. That is, for my eyeballs to burst.

I MEAN SERIOUSLY. I understand the basic tenets of Republicanism: lower taxes, keep the government out of things and when it doubt, let market forces dictate. But it just doesn’t work for health care. It doesn’t. So when I started scrolling down this page from the New York Times, which sums up each of the major players stances on health care reform to this point, my eyes certainly began to get a little twitchy around the edges. Democrats, shocker, are generally pushing for universal health care coverage, with slight variations on the theme - some stress insuring the not insured, or insuring children; some stress bringing costs down for everyone; not everyone thinks it should be mandatory.

But all the freakin’ Republicans are like..market forces, competition, choice BLAH BLAH BLAH. I know they believe what they are saying, that they are not mentally handicapped sociopaths (a special place in hell is reserved for Mitt Romney, however, who signed onto universal health while the governor of Massachusetts and now doesn’t like it so much...). But one look at the World Health Report from 2000 (available in it’s full glory here, press release here) will tell you that that US system is broken and merely tinkering with the tax incentives and opening up insurance choices cross-borders will not do it.

Let me summarize the numbers (remember these are based on late 90’s data) for the rankings and expenditures of 191 countries:

France ranked 1st in its health care system and 4th in population health. Health care consumed 9.8% of the GDP. It spent, on average $2369 per person per year on health, of which about 77% was publicly funded.
The US ranked 37th in its health care system and 72nd in population health. Health care consumed 13.7% of the GDP. It spent, on average $4187 per person per year on health, of which about 44% was publicly funded.

I find this contrast particularly amusing as most conservative Americans would rather die than be French (freedom fries anyone?); most French people would rather die than have to speak with an American, so fair’s fair).  But these statistics show that Americans spent a lot more money and ended up a lot less healthy. While the World Health Report has about a million suggestions, one of the clearest is that healthy countries have universal health care, that everyone should try to insure as many people as possible and that private medicine does come at the cost of public.

But you already knew all that. For more research and news check out this site: Physicians for a National Health Program, particularly the research page. They advocate a single payer system (which basically means federally operated insurance, but not necessarily public hospitals, doctors). I think I might actually quit being a journalist and try to work for them. Handing out fliers or something.

Like I said, these are not new figures or new ideas. What is new is that we have a whole bunch of powerful people campaigning to run the United States of America with the promise of changing the way it does health care. It is an opportunity to do something radical. Something amazing: to do away with HMOs, pre-approved treatments, co-pays, deductibles, the uninsured and the underinsured.

The tragic thing is, even IF a Democrat gets in, judging by their position statements, it’s unlikely that a universal, single-payer system will evolve (the only one really up for it is Dennis Kucinich and who’s he, eh?). Many people who advocate for single-payer universal coverage (which yes! is expensive!) see the only way to finance the system is through healthcare savings from basically stripping the overhead/profit margins of private companies (this study from the New England Journal of Medicine found that around 30% of health care costs are administrative, compared to about 17% in Canada’s single payer system; likewise Medicaid and Medicare operate with much lower overhead costs compared to private insurance companies).

My personal opinion, disregarding the political difficulty of completely killing off for-profit US health care companies, is that the whole enchilada is the only way to go. And as much as I want to give Republicans a swift kick in the hiney (Mr. Romney would get something even better), I have to admit that at my darkest moments, I think that they halfway measures of weeny-assed Democrats might actually be as bad if not worse in the long term.