We are in Australia, and my wife just paid for a general practitioner's visit to examine possibly dangerous sun damage to her skin. The doctor's examination cost her $37 Australian, and the topical medication just $10Au. So what is wrong with a health care system that functions so well, yet is mostly paid for by Australia's taxpayers?
Perhaps it's time to bust the myth that universal, or government-run, or 'socialized' medicine is somehow less desirable than the present U.S. system of private health insurance. We know the U.S. has the highest per capita health care costs in the developed world. So how does that make private health care that is owned and run by privately-owned health care providers (except for Medicare) more desirable?
It just isn't true that total health expenditures -- government plus private spending -- is unsustainable. Australia spends about 9.5 percent of GDP on health services, for instance; the United States spends 17.7 percent. And though U.S. spending, whether or not a good value for money, hasn't undermined its economy or sapped the vitality of the country, it has held back higher worker productivity.
Australia has a government-run and insured health care system that covers every citizen cost-free, with additional private insurance for those that can afford it. And there was absolutely no waiting period in Australia's fifth largest city, Adelaide, with the appointment scheduled just one day in advance.
The physician my wife consulted said that the only drawback to the Australian system, in her opinion, was the difficulty of keeping the same general practitioner, as there were some 44,000 GPs in Australia, and a patient had to see whoever was available at the time needed. Then what about our own Obamacare?
The Commonwealth Fund, a noted health care foundation, provides some of the best research on comparing national health plans and policies. And it maintains the U.S. Affordable Care Act will enable the U.S. to only begin to catch up with the rest of the developed world in not only health care benefits but global competitiveness, even though it still relies on private physicians and doesn't regulate drug costs.
First, working-age Americans are sicker and die younger than citizens in many other developed countries," say two researchers of the Commonwealth Fund. "This health disadvantage translates into a competitive disadvantage, as there is a well-documented relationship between workers' health status and their productivity. The annual economic losses from diabetes and depression alone are estimated to exceed $100 billion."
The ACA could significantly improve the U.S. workforce's overall health. Insurance expansions have been shown to improve beneficiaries' health and raise their future earnings. Since the main coverage provisions of the law took effect, 12 million to 17 million working-age adults have gained health insurance. In addition, the ACA has stimulated a wave of innovations in health care, many focused on the things that keep us well, like prevention, telehealth, and promoting healthy lifestyles and living environments. To the extent that these succeed, the benefits will be felt in workforce productivity and business competitiveness.
Second, taming our nation's astronomical health care bill would further improve our ability to compete in foreign markets. We spend more on health care than any other wealthy country, as I said -- health spending represents nearly one-fifth of the U.S. economy, compared with one-tenth in the average industrialized nation. This leaves fewer resources available for research, infrastructure, education, and other investments that are foundational to economic competitiveness. Warren Buffett went so far as to call our health system "the tapeworm, essentially, of the American economy."
Another study by the Commonwealth Fund reported:
•The United States stands out for having the highest rates of chronic health conditions, such as diabetes and heart disease: 87 percent of older adults in the U.S. reported at least one chronic illness, and 68 percent reported two or more.
•Despite having Medicare coverage, U.S. adults age 65 or older were the most likely to report that cost posed a barrier to care. One-fifth (19 percent) said cost was the reason they did not visit a doctor, skipped a medical test or treatment recommended by a doctor, did not fill a prescription, or skipped doses.
•U.S. survey respondents were also the most likely to report trouble paying their medical bills (11 percent). Only 1 percent in Norway and Sweden reported the same.
So the U.S. Affordable Care Act is just a beginning in offering equivalent health care benefits of other developed countries. Yet many of our poorest red and southern states are refusing to expand their own health care coverage, though much of it will be paid for by the federal government. Hence they will remain our poorest states, with the greatest income inequality whose citizens will be most in need of better health care. Need we say more?
Harlan Green © 2015