Published: August 31, 2007 09:58 pm      

Government health care could be modeled on Medicare

A recent letter to the editor suggested that national health insurance run by the government is the last thing this country needs because of government inefficiency and bloated bureaucracy. In general, the government doesn’t do much efficiently or economically. There is, however, one exception. Medicare. The facts of our health system make a change to a single-payer, government-run program on the Medicare model almost a no-brainer.

First, how does our health care compare to other countries? The World Health Organization ranks the U.S. health care system 37th in the world. We rank 44th in infant mortality and 21st in life expectancy. We have 47 million uninsured and 30 million underinsured citizens. One-third of the uninsured have incomes of $40,000 or more. Since 2000, 6.8 million have been added to the ranks of the uninsured, including many from the middle class. Each day, 50 people die because they had no insurance — 18,000 a year. Of the 1.5 million personal bankruptcies each year, 55 percent are related to health issues. Between 1981 and 2001, medical related bankruptcies increased 2,200 percent, 80 percent of those in the middle class. These figures alone would support what many professionals in the health field believe — the system is broken beyond repair.

What does this broken system cost us? The U.S. spends 16 percent of its GDP on health care costs, a figure that is rising 14 percent per year. (No other country spends more than 11 percent GDP.) We spend more than twice per capita what any other country spends, and that includes the 47 million uninsured. All this for a system that isn’t taking care of our health needs — unless you are wealthy or are lucky enough to have workplace insurance, which is in rapid decline.

So how do we spend so much for so little? In a real sense the answer has to do with corporate greed that wants to squeeze all possible profit out of the system, and if that means people have lousy health care, so be it. Private insurers spend 10 percent to 20 percent on administrative costs. (Did you know that since 1970, the number of medical doctors in the U.S. have increased by 40 percent while medical administrators have increased by 3,000 percent?) Private firms also have to pay dividends and CEO salaries that can only be termed “obscene.” One of the great ironies here is that because these private firms are in the business to make profit, they actively seek to deny health claims. Employees are rewarded for denying claims while giving care is punished. Some system.

Another component to our broken system relates to drugs. We pay 30 percent to 80 percent more for drugs than the rest of the world. Why? Because other governments bargain for drug prices to keep them reasonable. The argument that drug companies need the profit for research doesn’t hold water. Marketing, administration, and CEO salaries eat up 51 percent.

What’s the answer? The rest of the developed world came up with that decades ago — universal health for all using a system modeled on Medicare. Medicare administrative costs run about 2 percent, compared to the 10 to 20 percent we now pay private insurers. Medicare pays 15 percent less than private insurers for services (bargaining power). Eliminating excess administrative costs or paying world drug prices would cover insuring all those without insurance, including children.

The health system we have now is immoral. That citizens in the wealthiest nation in history are forced to choose between needed drugs and food or heat in the winter is unconscionable. Poll after poll shows that a majority of Americans want a change.

Why are we still mired in an inefficient system that delivers second-rate care to most of us? My senators, Byrd and Rockefeller, like all senators, have no reason to care. They get the best health care in the world for free. Senators also receive massive contributions from big-pharma and other health care entities that have many lobbyists working to insure, not our health, but continued profits and enormous salaries to a few CEO’s.

Thousands will continue to die needlessly. Millions of children will have their futures stunted from lack of health care. Health problems will bankrupt millions more. The elderly will make impossible choices. But a few will make lots of money. And that’s the American way.

Craig Etchison

Center for Nonviolent Alternatives

Fort Ashby, W.Va.