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Health Care in America
Why we’re paying more and getting lessthan any other industrialized nation on Earth(and what can be done about it)
By Richard J. McCann November 2009
America is the richest country on Earth and spends a far greater percent of its wealthon health care than any other nation, yet we are ranked below the DominicanRepublic in terms of access to health care and behind Bosnia Herzegovina in terms of life expectancy. We’re paying top dollar and getting Third World service.It’s easy to make a case that health care reform is needed, and at this point is seemslikely we’ll get some. But what kind? The debate rages on from the House to theSenate to the White House, in blogs and town hall meetings, on Main Street and WallStreet and your street. Wherever three people are gathered you’ll hear at least fiveopinions, and just about the only thing you can count on is that these discussions willgenerate far more heat than light.This paper is designed to present the facts about the US health care system, dispelrumors and give a realistic outline of what is really being proposed on Capitol Hill.The House bill is a staggering 1100 pages, the Senate is still coming up with various proposals, and no one knows exactly what is going to pass across the President’s desk when the time comes for a signature. One thing we can be sure of: Health care reformis going to have a profound effect on the future of every American, at home andabroad.
What Is the Current State of Health Care in the US?
In 2009 health care spending in the United States is projected to surpass $2.5 trillion,eating up a whopping 17.6% of our gross domestic product (GDP). By 2018 it isexpected to rise to $4.4 trillion, double that of 2007. The congressional budget officeestimates that the cost of health care insurance for an average family of four will be$25,000 a year within the next decade.
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As a result of this high cost, 45 million Americans are living without health insuranceat any given time of the year. This number does not include the 16 million Americanswho are underinsured. A Harvard Medical School study recently reported that in 20082266 American military veterans died due to lack of health insurance. In the general population, an estimated 20,000 US residents die every year due to a lack of healthinsurance.
2
A recent study found that 62% of all bankruptcies filed in 2007 were linked tomedical expenses. These people didn’t lose their homes because they were uninsured;
1
National Coalition on Health Care Health care costs Web site November 12 2009
2
The Healing of America, by T.R. Reed, 2009
 
nearly 80% of them did have health insurance.
3
The costs simply went far beyondwhat they and their insurance coverage could handle. According to another publishedarticle, about 1.5 million families lose their homes to foreclosure every year due tounaffordable medical costs.
4
The United States now has the most expensive health care system in the world at17.2% of our GDP. Switzerland is a distant second at about 11.6% GDP, followedclosely by France at 11.1% GDP
5
.Our medical care is the most expensive on earth, but the quality is far below that of most other industrialized nations. Take life expectancy. Where do we rank? At 77.85years, we fall between Cyprus and Bosnia Herzegovina, ranked number 47 in theworld lineup.
6
The numbers are slightly more encouraging if you look at the amountof life you’re likely to enjoy without disabilities; in that category, the World HealthOrganizations lists us as 24
th
in the world.We know we’re paying more than any other country for our world-class doctors andmedical facilities, so how are we doing in terms of outcomes for surgery and medicaltreatment? According to a 2008 Commonwealth Fund report about the world’sindustrialized nations, the US ranks 19th in curing people of diseases that could becured.
7
 These are not the numbers you’d expect from the richest, most powerful nation on the planet. When it comes to quality of life measurements, Americans aren’t used tocoming in 47
th
, 24
th
or even 19
th
. There is one category in which we have managed toachieve number one ranking: deaths due to major surgical and medical mishaps.According to
The Healing of America
, by T.R. Reed, “Americans diagnosed withasthma die sooner than seven of the nine richest nations. Americans with diabetes dieyounger than any of these countries. After kidney transplants Americans have theworst survival rate. And if you are thinking of having major surgery in the UnitedStates here’s a statistic to ponder: Among those nine rich nations, the per capita rateof ‘Deaths Due to Major Surgical and Medical Mishaps’ was the highest in the US byfar.”
8
 Our kids are even in worse statistical shape. “Out of twenty-three wealthy countries,the American health care systems ranks dead last when it comes to keeping newbornsalive. Our rate of infant mortality is more than twice as high as the rate in the top-ranked countries, Sweden and Japan,” writes Reed.
9
 So who does have the best health care system in the world? The Commonwealth
3
 Himmelstein, D, E., et al, “Medical Bankruptcy in the United States, 2007: Resultsof a National Study, American Journal of Medicine, May 2009
4
Robertson, C.T., et al. “Get Sick, Get Out: The Medical Causes of Home MortgageForeclosures,”
 Health Matrix
, 2008
5
OECD health at a glance, 2007; Government of Taiwan
6
The Healing of America by T.R. Reed, 2009. P. 32
7
Ellen Nolte al. “Measuring the Health of Nations: Updating an Earlier Analysis,”Health Affairs, January/February 2008. p..71
8
The Healing of America, by T.R. Reed, 2009. P32
9
Ibid.
 
Fund, a private research organization based in New York City, regularly evaluates thequality and the access to health care of various countries throughout the world.According to their analysis, the highest overall rating goes to France, with the UnitedStates ranked 15
th
.
10
 
Socialized Medicine
Some politicians and pundits sneer at America’s health care reform legislation asanother form of European socialized medicine, in which the government runs theentire system, including hospitals and doctors. In fact, if you study the variousEuropean systems, you will find that while there are some countries that do have thistype of socialized medicine (England and Spain), there are others operating on a private model of health care (Germany, Switzerland and France). If you compare theUS to these last three countries, you will find that our health system is moresocialized than theirs, due to our Veteran’s Administration and the Indian HealthServices. The difference between these three private-model European countries andthe US is that in Germany, Switzerland and France 1) All citizens are required to havehealth insurance, 2) Insurance companies that offer universal health services must benon-profit, and 3) The government negotiates rates with all providers, and everyonemust charge the same rates.Another statement that critics like to make is that the government is unable toadminister health services effectively, suggesting any government-run operation willinevitably be bloated and inefficient. Many like to cite the US Postal Service as anexample of this kind of “bad deal” for the American public. A closer look shows that,as an independent government agency that takes no taxpayer dollars, the USPSmanages to deliver billions of pieces of mail annually, door to door, for a mere 43cents apiece. In comparison, FedEx can’t fly your letter from a pick-up center to itsdestination in the next town for less than $14.42, and its cheapest four-dayFedExGround service is $4.75.And then there’s patient satisfaction. What organization consistently receives thehighest rating of any health insurance provider in the US, public or private? The USgovernment. It receives top ranking for its Medicare, Department of Veterans Affairsand Indian Health Services programs. And they provide all this satisfying health careat administrative costs of 3%, compared to private heath insurance companies that runaround 20%.
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 It’s the medical equivalent of the 43 cent stamp compared to the private company charging $4.74 to $14.42 for the same service.
The Real Question
If the American people have learned anything in recent decades, it’s how to be goodconsumers, and it’s past time we applied these skills to our health insurance. We’re paying for Rolls Royce care and getting a used Hyundai with no air bags andquestionable brakes.
10
Cathy Schoen et al. Health Affairs Web Exclusive, November/ December 2006, p.W457
11
http://www.nationaljournal.com/njonline/mp_20090629_2600.php
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