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 Day 19

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Single Paye: Too Expensive for Whom?

Paying for Health Care and Not Getting It

by JOE DeRAYMOND

In 2003, the United States spent $1.679 trillion dollars on health care. In 2006, the estimated spending was $1.937 trillion (Center for Medicaid and Medicare Services, Office of the Actuary, from California Health Care Foundation 2005). This includes government spending, private insurance payments, and, in 2003, $779 billion in out of pocket payments by individuals.

On a per capita basis, in 2006, each United States citizen will spend over $6000 on medical care. 15 per cent of our Gross Domestic Product (GDP) goes to health care.

This is more than twice any other nation’s per capita health care spending, or GDP spending. Unfortunately, this spending does not deliver health care to many of our citizens. As a nation, the US fares worse in comparison to other nations spending far less in health care categories such as life expectancy, infant mortality, and doctor and nurse/patient ratio.

We are all aware of our health system’s flaws. We read of the uncovered procedures, of the uninsured population of 45 million, of the inability of many elderly people to both pay for needed drugs and essential heating oil, of those who stay in hated jobs in order to maintain health insurance, of rising health care premiums that are literally bankrupting the flagship corporations of capitalism, Ford and General Motors. We note that half of all bankruptcies are caused by debt incurred by medical expenses. The individual case histories of people unable to obtain needed services are heartbreaking. (See "Uninsured in America, Life and Death in the Land of Opportunity" by Susan Starr Sered and Rushika Fernandapulle, 2005, University of California Press.) It is a system badly in need of an overhaul.

Yet, it is a system that has resisted overhaul time after time. Reforms, such as the Bush drug program for Medicare recipients, only lead to more expenditure, more profits for hospital corporations and drug companies. The health care consumer or recipient, each one of us, remains paying for a new Cadillac while receiving a beat up junker that won’t pass inspection.

Those of us who support a single payer, universal healthcare program for all US citizens, are often told that it would be too expensive. However, when we analyze the current national expenditures for healthcare, we see that we are already paying for healthcare for everyone and just not getting it. The taxpayer, through the US government payment of 60% of the total healthcare budget, is already footing the bill. By going to a single payer system, we would immediately eliminate $300 billion in duplicated administrative costs in our current multi-layered private insurance system. By adding these numbers and factoring in the cost savings for drugs and services that would accompany such a huge single buyer, we could fund healthcare for all. The estimated added taxpayer cost would be equivalent to one year of the Bush tax cut program. (See "Paying for National Health Insurance – and Not Getting It", by Steffie Woolhandler and David U. Himmelstein, 2002, Project HOPE, The People-to-People Health Foundation.) The change to a new, more efficient, single payer system could be accomplished by a gradual extension of the one healthcare insurance provider with a proven track record, Medicare.
The societal benefit to this approach is obvious. Healthcare is not a choice for anyone. We all need it, as surely as we need nutrition, education and housing. It is a crucial element in the lives of the citizens of a free nation.

It is an element of government neglect in the lives of the citizens of the United States. I read, recently, some analysis by Robert Fist, the chronicler of Middle East events and history, in which he noted that if the United States had provided Iraqis with a decent health care system after the invasion, it would have created much good will, and avoided the rise of resistance against the occupation. This was, and is, impossible. As noted above, the United States is woefully short of doctors and nurses, in the United States. It is not capable of providing medical care to populations, even in the United States, let alone Iraq. The Empire neglects its own citizens, and is only capable of abusing conquered populations, as events on the ground in Iraq have shown.

The health care system of the United States is hostage to the enormous profits distributed to insurance companies, hospital corporations, and drug purveyors. They swarm over the Congress, plying the legislative system with money, "expertise", and favors. Congressmen leave their seats to take jobs with pharmaceutical companies, as did Jim Greenwood of Bucks County, Pennsylvania, and Billy Tauzin of the 3rd District of Louisiana.

The healthcare corporate lobbies will not give up their piece of this $2 trillion dollar goldmine, for reasons of social equity. It is a lobby as venal and predatory as the arms procurement lobby, trading human lives straight up for money.

The US healthcare system now forces each citizen to scrabble for a little piece of security, as we pay exorbitant amounts for health insurance, and then more out of pocket. We cannot freely change jobs, for fear of "losing benefits". For those without insurance, it means fear of illness, neglect of your health, and a shortened life span.(See "The Moral Hazard Myth – The bad idea behind our failed health-care system", by Malcolm Gladwell, New Yorker, 8/29/2005.)

The January 24 Sharon Smith article in these pages, "Healthcare Reform for the Insurance Industry" notes a key problem with all the new State and Bush administration solutions to the "healthcare crisis". Each "solution" involves more money from the citizenry that is already shelling out with their lives and income to support the current predatory system.

It makes one remember that phrase from the Declaration of Independence: "Governments are instituted among men, deriving their just power from the consent of the governed; That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness".

JOE DeRAYMOND can be reached at: jderaymond@rcn.com