Wednesday, October 21, 2009

The Health of Americans' Healthcare

The Bigger Picture
Published on October 1st in Metro Éireann By Charles Laffiteau
Today I want to discuss the health of healthcare in America. As evidenced by his nationally televised speech to the US Congress last month, President Obama has made healthcare reform his top domestic policy initiative now that the American economy appears to finally be on the mend. But while the health of the American economy remains the top concern of most Americans, President Obama also believes that healthcare reform must be an essential element of any plan to revive the US economy. Is he right? Let’s see.
On the one hand America does indeed offer its citizens the best healthcare available anywhere in the world that “money can buy.” On the other hand that same statement also encapsulates the single most significant shortcoming of America’s healthcare system. It is the best in the world, but only if you can afford to pay for it. Unfortunately 15% of the American public, over 45 million people, have no health insurance because they can not afford to pay for the best healthcare “money can buy.”
America was actually the first country in the world to provide health insurance and was also the first country to provide different types of injury, disability and sickness coverage. In 1850, Franklin Health Assurance began offering the first private-sponsored insurance for injuries from railroad & steamboat accidents and in 1890 the first private-sponsored insurance for disability & sickness was offered. Then in 1911 the first employer-sponsored group disability & sickness policy was issued and in 1965 the first public-sponsored (government) Medicare group disability & sickness plan was begun.
Today, America is still the world’s leader in medical innovation and spends three times more than Europe does per capita on biomedical research. American companies’ account for 75% of the world’s R&D spending in biotechnology and the top 5 American hospitals carry out more clinical trials than all the hospitals in any other country. When it comes to groundbreaking research, the Nobel Prize in medicine or physiology has gone to more U.S. residents than recipients from all other countries in the world combined.
But America also spends an astounding 15% of its GDP on healthcare, more than twice what Ireland spends and also much more than any other country in the world. But if 45 million Americans can’t afford health insurance, how does America finance such an expensive healthcare system for the other 255 million Americans who do have insurance?
Well, of the 85% of Americans who do have health insurance, about 60%, roughly 155 million US citizens, have employer provided group healthcare insurance, 10%, or 25 million people, buy private-sponsored insurance directly from heath insurance companies and the remaining 75 million (mainly 65 years or older Americans) are covered by America’s public-sponsored Medicare health insurance programme.
One would think that if America is spending so much more on healthcare than any other nation on earth, that this additional spending would be reflected in comparisons of the health of Americans with the heath of citizens from other countries. Au contraire! In fact the World Health Organization’s (WHO) ranking of countries based on measures such as infant mortality and life expectancy put the US at the bottom of the WHO’s list of wealthy more developed countries and behind countries like Cuba that aren’t on that list. When the WHO compares American healthcare with healthcare provided by all of its other 190 members, America ranks 1st in spending but 37th in terms of overall healthcare performance, 38th in life expectancy and a dismal 72nd in overall level of health.
Liars figure, but figures don’t lie. So given the preponderance of factual data that tells Americans they are paying more for healthcare but getting less than their counterparts in the EU, Canada and Cuba, why is President Obama’s push to reform America’s system of healthcare arousing so much anger among some American citizens?
Part of the answer is that some of those who are opposed to President Obama’s healthcare reform proposals don’t understand what a poor return they are getting on the money they are spending on healthcare. The 155 million Americans covered by employer paid health insurance plans never see that money in their paychecks so many of them don’t realize that as their employers cost for this coverage grow, the employers pay for this with lower wage increases and by reducing the total number of people they employ.
The 75 million older Americans covered by Medicare don’t realize what this coverage costs because they don’t pay for their medical treatment and drug prescriptions. The US government does. This past August US Representative Gene Green, a Texas Democrat, held a town hall meeting on healthcare. Like many other town hall meetings this summer it was heavily attended by older conservative voters and anti-Obama Republican activists who had been urged to turnout in angry protest by conservative radio and TV talk show host demagogues like Rush Limbaugh, Sean Hannity and Glenn Beck.
At one point during Representative Green’s town hall meeting, a conservative activist speaking against President Obama’s healthcare reforms turned and asked the other attendees if they “oppose any form of socialized or government-run health care.” Almost all of those in attendance said they agreed. Mr. Green then asked how many of those present were on Medicare (A government-run health plan) and almost half of them raised their hands. So people who don’t understand that Medicare is government-run health care aren’t really reacting to the healthcare reforms Obama is proposing.
For some of them, their anger is simply a reflection of their fear of change. Better the devil you know, than the one you don’t. Others may really believe the disinformation about “death panels” that Republican politicians like Sarah Palin are spreading. But I also believe that many of them aren’t actually reacting because of what President Obama is proposing, but rather because of their racial anxiety about who President Obama is. It’s this latent racial fear that cynical Republican politicians are now exploiting to benefit themselves rather than America’s citizens. “Shame!”

Charles Laffiteau is a US Republican from Dallas, Texas who is pursuing a PhD in International Relations and lectures on Contemporary US Business & Society at DCU.

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