Why capitalistic health care fails
Monday, February 16, 2009
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There are times when the differing of opinions does nothing but raise tension. But there are also times when it’s helpful in expanding all sides’ understanding of what they do or do not agree with.
Such a moment occurred in The Commuter’s office not long ago, where a philosophical debate took place between those who believed in a less restricted capitalist system, and those who believed more market guidance was needed.
One side argued it was unfair to penalize wealth. The other, that guidelines were necessary in protecting the common citizen. And one topic that provided many moments of contention was health care, and whether or not our American health care system ‘works,’ which in this case will mean providing the largest amount of people with the most amount of protection, both from illness and from cost.
— The health care debate: Deciding who gets what —
One argument that was oft-repeated was the rhetorical question, “Who are you to tell me what to do with my money?”
To which it should be said that any democratic state needs institutions in order to function. One example would be a traffic light: It restricts freedom, but also allows cars to pass in an orderly fashion without running into one another, thus opening up freedom from fear of being killed and from clogged roads.
Another reply is that, every so often, we in America get to vote on a number of things, including who represents our causes in local, state and federal legislature. For those of us living in states which have public ballot initiative systems – Oregon being one – citizens have the opportunity to both create and decide whether to implement legislation themselves. In these ways, each generation chooses what it is they find valuable, and exercise their choices through voting to change laws or lawmakers. This is important, for one generation which believed in separating whites and blacks soon gave way to one which valued equality, and in this same way we get to choose what we support.
Granted, citizens don’t absolute control over this process, but there is quite a bit of room for us to change the institutions which govern our daily lives. More and more, universal health care is becoming something which our generation agrees upon as being important. A poll taken in 2007 by CBS and the New York Times showed that providing health insurance for all was more important than keeping its cost down by more than a 2-1 margin, and an even greater number of people believed America should have universal health care.
So while one may say they don’t want others telling them what to do with their money, it’s the collective conscious of the American citizen which ultimately takes priority over the collected arguments of the individual.
— My money, my choice? —
Another claim cited in the health care debate was that one shouldn’t be penalized for being wealthy. This is to imply that initiating a universal health care system would be too costly.
In 1960, the United States spent 5.3% of its GDP, or gross domestic product, on health care. According to the 2000 census, that number was 13%; in 2007 it rose by 17%, and it’s projected to reach 20% by 2017, according to the National Coalition on Health Care (nchc.org). This is compared 2007 figures which put health care as a percentage of GDP at 8.3% for the United Kingdom, 8% for Japan, 11% for Switzerland, and 10% for Germany, and these nations all have some sort of universal health care coverage; in fact, a Japanese family of four need only pay $280 US a month in premiums, with employers paying more than half of that. In the UK you don’t have to pay any premiums at all.
Another argument follows: Even though health care is a smaller percentage of those nation’s GDP, it ends up costing their citizens more than in the US. But according to the Organization for Economic Co-operation and Development (OECD.org), we in the states end up paying more than 37% of our health care costs to private insurers, the highest percentage in the developed world. Second-place Netherlands pays 17% to private insurers, and Germany, Switzerland and Japan pay 9%, 8.8%, and 0.6% respectively. Since the public’s share of total health care costs in the US is already 44% (OECD.org), it’s not much of a stretch to bring that figure closer to the 80% figure found in such countries as Luxembourg, the UK and Sweden, all of which enjoy excellent health care systems.
By sharing the burden of health care between all citizens, and by organizing it nationally rather than through private for-profit companies, we are ensuring that the money spent goes towards health and not profit.
— US is best… except when it’s not —
The argument heard most often in the national health care system debate is that the US is healthier and enjoys higher quality care than other countries with nationalized systems.
The facts say otherwise. Despite higher spending than any of the following countries, the U.S. has higher infant mortality rates and lower life expectancies than the UK, Germany, Japan and Switzerland, all of whom have some form of socialized health care. Even in innovation the US lags behind, with 2/3 the number of MRI machines and 1/3 the number of CT scanners per million people than does Japan. Combine this with that fact that 28% of Americans polled by Gallup said they have put off medical procedures due to cost, and a simple truism emerges: Health care only works when you can afford it, and it does no good to the 28% of America who can’t.
The United States is the only rich democracy in the world whose individuals pay more for health insurance than the percentage covered by the public. It’s more restrictive and more expensive, forcing some people with preexisting conditions to go without coverage (a practice illegal in nations such as Germany). Our health providers make comfortable profits in a time when less people have access to basic health screenings which detect conditions which would get worse over time and end up costing our system much more money.
Familiarizing one’s self with the systems of other countries doesn’t make you weaker or less American, and an idea implemented by someone else first doesn’t make it any less of a good idea. All it means is that you’re willing to seek out what works in a system and what doesn’t, and be smart enough to figure out what needs to be done to fix what’s wrong. And by looking at America’s health care system, it’s clear that as long as for-profit companies are running the show – whose policies over which we have no control – we will never have an adaptive, flexible and fair health care system that works for citizens, or one whose rules will change based on the needs of patients rather than the needs of those making the most money.
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