Uniquely American? Or Uniquely Bad?

So there I was listening to one of the docs who attended the White House photo-op to show their support for the President’s health care reform efforts.  Full disclosure - I wasn’t invited.  I was half paying attention to the radio until I heard her proclaim proudly that the plan put forth was “uniquely American”.

I’ve heard that before.  In fact, I’ve heard it a lot recently.  What does that mean?

Sure, we have a system right now that’s unique.  It’s uniquely bad.  It’s uniquely expensive.  It’s uniquely exclusionary.  When did any of those things become admirable?  When did we decide to brag about them?  Why are we so eager to be different?

Look, I understand what the President is trying to do.  He’s afraid that someone will look at what he’s trying to accomplish and scream, “Socialism!”  Or even worse, “Foreigner!”  But this approach baffles me.  Are we so isolated and xenophobic at this point that we are unwilling to accept any ideas at all unless they originated within the confines of the United States? 

I ask because setting up a better health care system is something that nearly every other comparable country has figured out.  Not always in the same way, and not always with the same amount of government involvement, but they are all cheaper than ours, they are all universal, and they are all similar if not better in quality.

Think about that as you watch Congress and the President crow over the passing of the Senate Finance Committee bill next week.  I grant you that getting a health care reform bill like this bill out of committee is a first in American politics.  I just don’t think it’s necessarily something to brag about.

I know reading the CBO report on the bill isn’t everyone’s idea of a good time, but it’s sometimes the only way to get unvarnished information.  And here are the facts.  The bill is estimated to cost $829 billion over 10 years.  It is deficit reducing, but we only get that through new taxes and some Medicare Advantage cuts. 

Don’t get me wrong.  I believe those Medicare Advantage cuts are warranted.  I also don’t mind paying taxes for worthwhile things.  But we should be honest and admit that we are increasing our spending on health care, not decreasing it. 

What do we get for that money?  Not nearly as much as you think. About 14 million more people will be on Medicaid or CHIP in 10 years.  Another 23 million people will be in the insurance exchange.  A few million people will leave private health insurance.

Universal coverage?  No.  We will reduce the number of uninsured Americans by 29 million people.  This means that ten years after this massive bill goes into effect, after we’ve spent an additional $800 billion on health care, there will still be 25 million people under the age of 65 who have no health insurance in the United States of America.

This is the best we can do?  After all this fighting, after all the horse-trading and passion and screaming and crying, this is really what $800 billion buys?  Quality will barely move.  We’ve done nothing to contain costs.  And we will still have 6% of the nation without insurance.

You know what?  I don’t want a “uniquely American” solution.  Give me almost any of the solutions in Europe.  I’d even take some of the health care systems in Asia.  Happily.  Do you have any idea what those systems could achieve with this kind of increased funding?  We can’t even achieve universal coverage; we can’t even get close. 

I’m thrilled we are strengthening the safety nets.  I’m glad we are making sure people with pre-existing conditions will get care.  I’m not against subsidies, I’m not against insurance company regulation, and I’m definitely not against reducing the number of people who lack insurance.  This plan is certainly unique, and I guess American.  So, mission accomplished!

Don’t get me wrong.  I wouldn’t vote against this bill because it’s not perfect.  But please, don’t ask me to cheer for it.

 

Read more about health care policy and get your questions answered at Rational Arguments.

 

 

Follow Aaron E. Carroll on Twitter: www.twitter.com/DSYGAaron

Comments

[lwilso20]

Great job Dr. Carroll, and you were great on Fox Business too. Keep it up and don't forget "Think for yourself!" ;)

[reddflagg]

There is a scene in "Sicko" where a woman tells Bush that she is working several part time jobs to survive and Bush replies "That is uniquely American."

I have often wondered about lack of interest in what works in other countries in order to save ourselves some grief.

[mamalisa38]

For profit health insurance is immoral. The only way to maximize profits, and that's what Wall Street demands, is to raise premiums and deductibles and deny claims.

Single payer is the only answer to the health care crisis in this country.

[mamalisa38]

What's really sad is that in 2004, George W. Bush and the Republican's gave $950 million to Iraq to institute universal health care.

[jmpurser]

Thank you. Every time I hear that phrase in connection to our "health care system/reform" I want to throw up.

[singlepayercentral]

All I can say is "AMEN".

[ProudMilVet]

The main reason for this lack of knowledge is because America is always on this ego trip about being number one in everything. We constantly proclaim to the rest of the world that we are " The greatest nation ever created, The last best hope on earth, The shining city on a hill ! " As if no other other country has it as good as we do. Nonsense ! Our economy is in the toilet. Our Political system has become a do nothing joke. Our gun laws are insane. Violence is rampant . Our health care system is still broken . About the only thing we seem to be good at any more is introducing our insane fast food habits to the rest of the world so they can become as obese as we are .

[seawolf77]

Nailed it!

[David Horton - Huffpost Blogger]

And not just Europe. Does it never occur to Americans to check out what Australia and NZ do about health care? The lack of knowledge that Americans have about the world outside its borders is self-destructive.

[jmpurser]

Well if they were doing it right they'd be doing it in America right? That's all we need to know!