US Health Care Debate: Data, Dogma, Deception

While the US is struggling with many problems that the rest of the world shares, corrupt banking practices, ageing populations, and highly polarised political parties, there is one area where they are in a unique fight that was settled in most advanced countries some time ago, how a society should best provide health care to its citizens.

The decades long debate on health care has become more of a litmus test of ideologies than a fact based policy discussion with deep lines drawn on either side of the key issue of whether health care is a right gained at birth as a citizen or a privilege to be earned through a paycheck.

In the middle of the issue is big business for insurance companies, lawyers and pharmaceutical companies who like things they way they are and have purchased the attention of most members of of our Congress that can provide help.

While the facts mostly go unnoticed the rhetoric leans towards the hysterical with the left making unsubstantiated charges of uninsured people dying by the hundreds of thousands and the right describing government operated death panels.

These aren’t the terms being used in bars or coffee shops, this is the language that our Congressional Representatives throw across the aisle at each other like kids throwing rotten apples.

The facts show that mortality rates do not correlate with having health insurance and it is well known that insurance companies already ration health care through approvals and cost. But it is easy to show that people suffer more without treatment they can’t get because of the lack of insurance, and it is within the bounds of the agreement we sign to have insurance that there are requirements and limits.

When it was decided to establish Medicare in the 1960s that divide was clear from the beginning, with the opposed side implying that it was like “ giving people that smoked cigarettes and people that drank beer” (Barry Goldwater-1964), and other seeing it as a natural evolution of a more benevolent society.

As the facts show it was nearly impossible for people over 65 to find a company that could afford to sell them policies and provide the expected profits to their shareholders at the same time.

The need for profitable growth is the main reason that companies try to sell insurance to healthy people that won’t use it, as opposed to sick people that need it, this is the conflict that made it obvious to other countries that it wasn’t a business so much as service, like national highways, power grids and military efforts.

The best way to so those things is together as a large group as we all benefit.

There was no middle ground to be found in the debates in the 1960s and it has yet to be discovered 50 years later. The conflict, like most wars has not been without heavy costs, the US pays over 15 per cent of it’s GDP for health care as opposed to the 8 per cent average of most other industrialised nations.

That comes to over $4,000 for each of our 300 Million people per year, we can agree that is a lot of money to pay for a system that, according to a Fox News Poll, was thought to need total rebuilding by 33 per cent of Americans. State run, single payment healthcare systems funded by taxes like the UK and Canada only had 16 per cent of the population that unhappy.

The 1993 battle for reform that was lost by Clinton’s Democrats cemented the status quo in place for over a decade, although in 1997 Balanced Budget Amendment was passed that reduced Medicare payments as part of the budget balancing act.

In 2003 George Bush’s Republican administration expanded the Medicare to include new drug benefits millions with no price controls or ability to negotiate prices with manufacturers.

While it is a great help to many people the layers of bureaucracy and guaranteed pricing for the drug companies makes it one of the most expensive welfare programs ever created and Bush signed this into law knowing that it was entirely deficit funded and that it would add to the national debt for years after he left office.

President Obama’s platform up to the election included health care system reform, and it was part of his year one agenda. One of the reasons that was mentioned early in the debate was to make businesses more competitive as the global competitors operate in countries where state run systems paid for workers health care out of taxes.

One of the most compelling arguments for this opinion is the statement that GM pays more for health care per car, $1500 vs. $600 according to a report from the Council on Foreign Relations.

As all things around the health care debate there is a strong opinion in the other directions, one from American Enterprise Institute Fellow Thomas Miller who says that the high level of productivity and a favorable environment for investment in the US, are much larger factors for competitiveness than the cost of health care.

The higher spending per capita figures are deceptive in that in many areas of the country have 2X the average rate, and the oft stated figure of 45 million uninsured would suggest a large group spends much less per year than the $4,200 average.

This is likely the source of the discontent of the US healthcare system mentioned earlier, and the high level of care received by some people suggests that the hard task of giving up some care so others can have a little is not going to be a popular tact.

Despite the concerts for Haiti and the millions in aid to Africa American people aren’t feeling very generous to each other at the moment, having been polarized by the political system into believing that there are “real” Americans and a group of invaders, most of which have been here as long, or certainly long enough to become one of us.

The Health Care debate has now become a Waterloo of sorts, as one Republican Senator claimed that it would be for Obama, but it isn’t Obama’s but all of ours.

You either believe health care is part of an advanced societies’ obligations to it citizens or you don’t.

If you don’t you join an ever smaller circle of countries that the facts say spend more to get less, while leaving millions with nothing. Your choice America.

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