For the Health of the Nation: Ensure a Public Option

Just days ago, America celebrated her birthday with fireworks, spontaneous renditions of the Star Spangled Banner and chants of, "We're Number One!"

In a crucial area, health care, the chant is untrue. Many of us love the individual doctors who may have saved our lives or the lives of loved ones. But the health care system in this country is not top-ranked. It's not even close to number two. Its poor quality and excessive expense are sucking the life out of America. For the health of the nation, both physically and economically, we need a system with a public option -- that means a government-sponsored and managed alternative. And we need it now.

First, the issue of ranking. In the year 2000, the last time the World Health Organization stacked up countries' health systems, the United States came in 37th, behind the likes of Chile, Morocco, Cyprus, even drug war-torn Colombia, to which the U.S. donates hundreds of millions in foreign aid. The U.S. Centers for Disease Control and Prevention pointed out late last year that the U.S. ranked 29th in the world for infant mortality in 2004, a statistic that steadily worsened since 1960, when the U.S. ranked 12th. Twenty-two countries' rates were below 5 deaths per 1,000 live births. The U.S. rate was 6.78 deaths.

Similarly, the U.S. ranks 42nd for life expectancy, down from 11th two decades ago. Contributing to that decline is the parallel drop in Americans covered by health insurance, researchers said. While 46 million Americans lack insurance, Canadians and residents of European Union countries benefit from universal health care.

We are 37th -- Yea! We are 29th -- and falling! We are 42nd -- and dying! These are not the chants of proud Americans. These are not the chants of vibrant Americans. In fact, these are not the chants of Americans who could continue financially supporting this sick system even if they wanted to. And they don't.

The cost of the American system, with its private health insurance industry in the business of profiting off of illness by limiting care, cutting corners and denying access to those with "pre-existing conditions," is suffocating the U.S. economy. In this one unenviable area -- spending -- the U.S. is number one. Health care expenditures are a shocking 16 percent of U.S. gross domestic product (the value of all goods and services produced in a nation in a year), far ahead of the closest competitor. That would be France, where it's only 11 percent. That's followed by Switzerland, Germany, Belgium, Canada and Austria, where it ranges from 10.8 down to 10.1 percent. These are all countries that provide national health care.

Looking at it another way, the average expenditure per individual, America remains in the undesirable position of most profligate spender. The average for an American was $7,290 in 2007, the latest year for which comparable statistics were available. But the average for the 30 countries in the Organization of Economic Cooperation and Development was a mere $2,964, with the closest to the U.S. being Norway at $4,763.

Those costs marginalize U.S. manufacturers as they attempt to do right by their American workers while scrambling to compete in international markets. Here's how Dr. Atul Gawande put it in his June article, "The Cost Conundrum," in The New Yorker:

"Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance... By a wide margin, the biggest threat to our nation's balance sheet is the skyrocketing cost of health care. It's not even close."

President Obama warned the American Medical Association, which opposes national health care, about exactly the same thing in June when he said this: "If we do not fix our health care system, America may go the way of G.M." Would those wealthy physicians bail out the government then?

Clearly these costs don't contribute to quality since U.S. rates of infant mortality and life expectancy are so relatively poor. And they factor large in personal bankruptcies and delay of care as individuals are unable to keep up with medical care's morbidly obese costs.

A Kaiser Family Foundation poll in February found that 53 percent of Americans cut health care because of cost in the previous year. A quarter reported putting off health care they needed such as doctor's visits and surgery, and twenty percent said they have not filled a prescription. Another part of the poll explains this: "13 percent say they have used up all or most of their savings trying to pay off high medical bills in the past 12 months, and just as many say their medical debt means they have difficulty paying other bills. A similar proportion (12%) say they have been contacted by a collection agency, while a smaller share (7%) report being unable to pay for basic necessities like food, heat or housing."

We are Number One? This is cruel. This is wrong. This must stop.

I know that many Americans view my native land, Canada, not as a country, but as an unofficial 51st state. But the difference between Canada and the 50 states is that Canada has national health care, thanks to Tommy Douglas, the former premier of Saskatchewan, and a party leader. One huge difference between the American system and Canada's national health care is the extreme cost of administering private insurance in the U.S. A study published in 2003 in the New England Journal of Medicine showed that administrative costs were $1,059 per person in the U.S. but only $307 per person in Canada. That excessive $752 in administration costs paid in the U.S. for each insured person has only grown larger in the ensuing years. The study concluded: "A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system."

In 2004, the Canadian Broadcasting Company conducted a poll to determine the country's greatest citizen. People everywhere could vote, for anyone they wanted, so an actor, like Tommy Douglas' grandson, Kiefer Sutherland, could have won, or a famous singer like Celine Dion or Shania Twain. But Canadians chose a politician -- Tommy Douglas, the father of national health care. That's how we feel about the national health care system in Canada.

Don't let the Republican Party-of-No stop this. Don't let big vested interests like the pharmaceutical, insurance, and for-profit hospital corporations keep America down. In poll after poll, Americans have made it clear they want a public option. They want care as good as Canadians get. They're paying more than twice the price for it. To ensure that America is Number One, Congress better deliver it before the end of August.

Comments

[Upset2]

Let us experament with national health care with only Congress in the test and use the same standards of care and delivery used in foreign countrys. Lets see how many congress folk die because they are to old for treatment. See if that passes. Then also try for term limits and get red of the crud that govrerns us so they can no longer line there own pockets..

[sbrobert]

Nothing short of Single Payer will actually work for guaranteeing health coverage for everyone. It is disappointing to see at this critical moment in history that people are willing to settle for so little.

Worse, Consumers Union/Consumer Reports seems to have been bought off. After being a champion for Single Payer for decades before anyone ever heard of it, they suddenly are attacking it as some sort of fringe left idea and with other lies.

In fact, most Americans surveyed want exactly what Single Payer offers: Freedom to choose your doctor or other provider and have the government pay the bill. All for lower cost than our for-profit private insurance system now.

Equally important as coverage and cost: Single Payer breaks the insane connection between work and health coverage. No civilized country makes such a connection. Why would you want to have your health coverage disrupted at the very moment you are having your work disrupted?

Even more important now with the issue of jobs: Why should an employer have the disincentive of having to pay for health care when hiring a new employee?

By the way, you can go to http://www.coveramericatour.org/share_your_story.html to tell your story to Consumers Union and let them know what you think of them selling out to the for-profit insurance industry.

[60srad]

I agree. As long as the insurance racket plays any role in the "plan," the only result I can picture is a new, more lucrative scam, whereby they put their cherry-picking into overdrive, knowing that our tax dollars will pick up the slack and effectively subsidize their ever more obscene profits.

[formermtnmama]

A dozen of us just attended a rally for health care at Sens. Corker and Alexander's offices in Nashville, mostly staff from the USW HQ in Nashville. There was a couple hundred of us out there. Labor was there along side of health care advocates, unemployed workers, peace activists and just plain folks who want to make sure everyone has access for affordable health care. It was 90 degrees and felt like 100, one person dropped due to the heat. We hope she had insurance.The time to get in the street in now, the time to get on the phone is now, and make sure our elected officials do the right thing and show the political courage to pass meaningful health care reform. President Gerard - your staff in Nashville join in this fight, we must get this done.

[Wirewoman]

Leo, this blog rocks. I will send it out to all the doubters and fence-sitters I know because the right has sold the lie that Canadians are flocking over the border to use the wonderful US health care facilities because the are forced to wait in long lines at public clinics and cannot choose their own doctors. Your personal testimony on this is really important.

[FpalJr]

Leo, I agree, that every American should be able to get HealthCare coverage, that is affordable. HealthCare should not be a decision that has to be made between food or Care. That is just not right and should not be the way it is in the greatest country in the world.

[acholger]

The House has proposed a plan that is barely acceptable... and the Senate is known for being more completely bought and paid for by the insurance/medical lobby... I expect to see a broadside attack that
rolls back the best of the House bill... everything Leo says in this blog is accurate... but, I expect, and am prepared to continue the struggle for expanded and improved medicare for all. Tommy Douglas is rightfully a heroic person to Canadians... as well as to admirers like myself. But, Douglas fought and organized a movement to take on the Health Insurance industry, and a well organized medical establishment who went on strike to resist the birth of Canadian national healthcare... I personally think Leo has the capability to do in the US what Douglas did in Saskatchewan and then all of Canada... and I'm ready to help

[stack]

You are right, Leo. We can't let the Republicans do to us on this what they did to the elderly on Medicare Part D! What a sham!