Click amount to donate direct to CounterPunch
  • $25
  • $50
  • $100
  • $500
  • $other
  • use PayPal
Support Our Annual Fund Drive! CounterPunch is entirely supported by our readers. Your donations pay for our small staff, tiny office, writers, designers, techies, bandwidth and servers. We don’t owe anything to advertisers, foundations, one-percenters or political parties. You are our only safety net. Please make a tax-deductible donation today.
FacebookTwitterGoogle+RedditEmail

The Economics of Health Care in America

by YVES ENGLER

There were demonstrations of 600,000 people in Paris and 90,000 in Germany this past Sunday. Strikes have paralyzed both France and Austria recently. In Peru on Tuesday President Alejandro Toledo declared a 30-day state of emergency and sent troops into the streets to end strikes by teachers and many others.

What is happening? On the surface, the issues are pretty straightforward. In France the main issues are change to retirement benefits. Currently, public workers are able to retire after a 37.5-year contribution period, which the government wants to increase to 40 years. Germans unions are mad at Social Democrat Chancellor Gerhard Schroeder’s plan to cap unemployment benefits at 12 months for those under 55 and 18 months for those over 55. The proposal is also to make it easier for small firms to hire and fire new workers. The issues are similar in Austria. In Peru, teachers are demanding a wage increase of $60 to $260 (US) per month, which they claim is barely a living wage. Farmers want lower taxes on equipment.

Underlying the strikes and demonstrations, however, is a more fundamental question. What is the point of an economy?

While the answer may seem obvious enough–to provide people with decent lives–capitalism often confuses the matter by claiming its interests and the role of the economy are the same.

Take the U.S. medical system as an example. The U.S. spends by far the most money on health care of any country in the world, about 14% of gross domestic product. The next closest country spends just over 10 percent. Not only do Americans allocate a larger percentage of GDP to health care, they spend more in absolute dollars. Americans pay $4,637 on average for health coverage while Canadians, the fourth biggest spenders, shell out $2,200 (US) .

This is good for segments of the economy. Pharmaceutical companies are making big bucks, U.S. doctors are some of the highest paid, fancy new technologies are being sold that purportedly do miraculous things, the hospitals are getting their cut and the insurance companies keep raising their costs, so surely all is swell.

Not really. According to the N.Y Times there are “60 million uninsured during a year (May 13)”

Don’t despair, however, since according to the Financial Times at least “the system is world-class (May 24)” for those with employer paid insurance. But is it?

American life expectancy is only the 17th highest in the world. More importantly a World Health Organization study that counted years of good health showed that the U.S. ranked even lower by that measure. “The United States rated 24th under the system, or an average of 70.0 years of healthy life for babies born in 1999.” Christopher Murray, a director from WHO summarized the findings; “Basically, you die earlier and spend more time disabled if you’re an American rather than a member of most other advanced countries.”

This doesn’t sound “world class” and it isn’t. Unless we define “world class” as the degree to which the system is controlled by private interests. No other industrialized country has a medical system with a greater for-profit orientation. And capital is happy, so why let early death dampen the mood.

To be fair to the U.S. medical establishment, lower American life expectancy is not solely the result of its absurd profit orientation. Nor is the medical sector the only one where the economy has lost its way in serving ordinary people.

For instance, one of the reasons for the shorter American life expectancy is the degree to which Americans work. Even though new time saving devices have been invented and production capabilities are expanding, Americans are still working longer. As a result of the weakening of the organized U.S. working class, Americans are now working 200 hours more than they did in the early 1970s (NY Times April 12). This is taking place while in Europe people are working less. The average Norwegian now works 29 percent less than the average American–a total of 14 weeks per year less. In the past two decades the percentage of Americans over 65 who are still working has increased by close to 50% (La Presse) Because of a 1983 Congressional decision, by 2027 the American retirement age will officially increase to 67. This is not just happening in the U.S. The extremely pro-business Tory government in Ontario, Canada’s largest province, decided to increase the province’s workweek so workers could work 60 hours in a given week and not receive a dime in overtime pay.

According to the N.Y. Times, “the harmful effects of working more hours are being felt in many areas of society. Stress is a leading cause of heart disease and weakened immune system.” (April 12) It’s unhealthy to work so much but also why would we bother? Technological advances should lead to more leisure, not less. But somehow the mainstream press seems to miss that point.

The overwhelming dominance of “capitalist logic” is such that all too often the ills of our world are explained through the lens of what is good for a tiny minority of our population. For instance, according to a recent National Post article “productivity losses due to depression, anxiety, substance abuse and burnout run at about $33-billion a year in Canada (May 14)” Or how about those World Bank officials who complain about the devastating impact AIDS is having on African economies.

Productivity losses? Impact on economies? Isn’t depression damaging people’s lives and aren’t African children growing up without parents?

But capitalism has its own logic and according to it everything that can be, should be explained in economic terms. And if it can’t be explained in economic terms than surely it isn’t really important. What regular people care about is all too often irrelevant.

Nevertheless, people do care.

That is why a few days ago 7,000 East German steel workers voted to strike for a 35-hour workweek. Currently they work 38 hours, which gives them three hours less leisure than their West German counterparts and unemployment is high in their region so they hope a reduced workweek will help create jobs. In France, hundreds of thousand of people care enough to hit the streets to say 37.5 years of work is enough. In Peru, millions care enough to demand a living wage.

These people are acting in the self-interest of their communities, which is not the same as the self-interest of capital.

They are acting sensibly, and should be supported if one considers the economy as an instrument for the community of all people.

YVES ENGLER is vice president communications for the Concordia Student Union Montreal. He can be reached at: yvesengler@hotmail.com

 

Yves Engler’s latest book is ‪Canada in Africa: 300 years of Aid and Exploitation.

More articles by:

2016 Fund Drive
Smart. Fierce. Uncompromised. Support CounterPunch Now!

  • cp-store
  • donate paypal

CounterPunch Magazine

minimag-edit

September 29, 2016
Robert Fisk
The Butcher of Qana: Shimon Peres Was No Peacemaker
James Rose
Politics in the Echo Chamber: How Trump Becomes President
Russell Mokhiber
The Corporate Vice Grip on the Presidential Debates
Daniel Kato
Rethinking the Race over Race: What Clinton Should do Now About ‘Super-Predators’
Peter Certo
Clinton’s Awkward Stumbles on Trade
Fran Shor
Demonizing the Green Party Vote
Rev. William Alberts
Trump’s Road Rage to the White House
Luke O'Brien
Because We Couldn’t Have Sanders, You’ll Get Trump
Michael J. Sainato
How the Payday Loan Industry is Obstructing Reform
Robert Fantina
You Can’t Have War Without Racism
Gregory Barrett
Bad Theater at the United Nations (Starring Kerry, Power, and Obama
James A Haught
The Long, Long Journey to Female Equality
Thomas Knapp
US Military Aid: Thai-ed to Torture
Jack Smith
Must They be Enemies? Russia, Putin and the US
Gilbert Mercier
Clinton vs Trump: Lesser of Two Evils or the Devil You Know
Tom H. Hastings
Manifesting the Worst Old Norms
George Ella Lyon
This Just in From Rancho Politico
September 28, 2016
Eric Draitser
Stop Trump! Stop Clinton!! Stop the Madness (and Let Me Get Off)!
Ted Rall
The Thrilla at Hofstra: How Trump Won the Debate
Robert Fisk
Cliché and Banality at the Debates: Trump and Clinton on the Middle East
Patrick Cockburn
Cracks in the Kingdom: Saudi Arabia Rocked by Financial Strains
Lowell Flanders
Donald Trump, Islamophobia and Immigrants
Shane Burley
Defining the Alt Right and the New American Fascism
Jan Oberg
Ukraine as the Border of NATO Expansion
Ramzy Baroud
Ban Ki-Moon’s Legacy in Palestine: Failure in Words and Deeds
Gareth Porter
How We Could End the Permanent War State
Sam Husseini
Debate Night’s Biggest Lie Was Told by Lester Holt
Laura Carlsen
Ayotzinapa’s Message to the World: Organize!
Binoy Kampmark
The Triumph of Momentum: Re-Electing Jeremy Corbyn
David Macaray
When the Saints Go Marching In
Seth Oelbaum
All Black Lives Will Never Matter for Clinton and Trump
Adam Parsons
Standing in Solidarity for a Humanity Without Borders
Cesar Chelala
The Trump Bubble
September 27, 2016
Louisa Willcox
The Tribal Fight for Nature: From the Grizzly to the Black Snake of the Dakota Pipeline
Paul Street
The Roots are in the System: Charlotte and Beyond
Jeffrey St. Clair
Idiot Winds at Hofstra: Notes on the Not-So-Great Debate
Mark Harris
Clinton, Trump, and the Death of Idealism
Mike Whitney
Putin Ups the Ante: Ceasefire Sabotage Triggers Major Offensive in Aleppo
Anthony DiMaggio
The Debates as Democratic Façade: Voter “Rationality” in American Elections
Binoy Kampmark
Punishing the Punished: the Torments of Chelsea Manning
Paul Buhle
Why “Snowden” is Important (or How Kafka Foresaw the Juggernaut State)
Jack Rasmus
Hillary’s Ghosts
Brian Cloughley
Billions Down the Afghan Drain
Lawrence Davidson
True Believers and the U.S. Election
Matt Peppe
Taking a Knee: Resisting Enforced Patriotism
FacebookTwitterGoogle+RedditEmail
[i]
[i]
[i]
[i]