Health Care Crisis
I meant to do a post on this earlier this week, and got sidetracked. Part Two of Krugman's health care crisis series made the excellent point that America's system of health care (like its education and infrastructure--TJ) is not "number one":

The countries that have something to teach us are the nations that don't pinch pennies to the same extent - like France, Germany or Canada - but still spend far less than we do. (Yes, Canada also has waiting lists, but they're much shorter than Britain's - and Canadians overwhelmingly prefer their system to ours. France and Germany don't have a waiting list problem.)

Let me rattle off some numbers.

In 2002, the latest year for which comparable data are available, the United States spent $5,267 on health care for each man, woman and child in the population. Of this, $2,364, or 45 percent, was government spending, mainly on Medicare and Medicaid. Canada spent $2,931 per person, of which $2,048 came from the government. France spent $2,736 per person, of which $2,080 was government spending.

Krugman's first column discussed the fact that "health care costs have become a major burden on those businesses that continue to provide insurance coverage," a topic also addressed by Fareed Zakaria last week. Fewer businesses are able to offer health care to their employees**, and the new Health Savings Account plans being implemented as part of President Assclown's "ownership society" (translation: his base gets to own the rest of us) merely shift the cost and risk to the employee.

Brokers pushing the HSAs routinely use terminology like "this will teach people to be better consumers of their health care." Blame is laid at the feet of diabetics and other "minorities" who use up an "unfair" percentage of health services--at company meetings, insurance-industry phrases like "Most health care problems are self inflicted" and "If people would make lifestyle changes, they could cut their health care costs by 50%" are standard. That's America for you--individualism to the max. No recognition that health should be a societal concern, not an individual concern. And in fact, as Eschaton commenter phila noted, the GOP stands in the way of solving health problems like obesity and lung cancer. Witness their hysterical opposition to getting junk food out of schools, or restricting smoking.

A new line I heard this week was "Health insurance used to only cover catastrophic risk--that's what this country needs to go back to." As sallyh says, the Republican idea of optimum health care is: Don't use services and die young. Never mind that we pollute the environment, insist upon unhealthy workplaces, and have stolen away your chance to get out from under crushing debts; this is all your fault. Brokers are actually encouraging HSA participants to save up their health savings money for the post-65 years, rather than using it for medical services now. In other words, the HSAs encourage people to avoid health care, out of fear of using up their HSAs, which are earning interest, just like an IRA.

**This is, of course, not entirely true. The practice of paying CEOs obscene salaries and bonuses costs far more than health care, as this excerpt from a letter posted at the Poynter Institute regarding WSJ contract negotiations makes clear:

Recently, Dow Jones management hasn't seen eye-to-eye with us and other IAPE members. In our last contract negotiation, Chairman and CEO Peter Kann and COO Richard Zannino asked Journal reporters and other employees to accept a wage freeze and major cuts in health benefits.

The proposed cuts were not just wrong-headed but also fundamentally
unfair. As Peter and Rich called for belt-tightening on our part, they have awarded themselves unprecedented salary increases and bonuses. IAPE fought for and won a better contract last year. [snip]

Because we stood together, we got a better contract. We saved some of
our health benefits and won wage increases that included a 3.25%
increase for this year.

How sad is it that losing only some of your health benefits is considered a major victory? Getting back to Krugman's most recent column, his point is that we spend far more than our European counterparts, but get less in return. He blames this on doctors' salaries, the pharmaceutical industry and bureacracy, for the most part. These are all things that can be corrected, if politicians are willing to follow the example of countries like--gasp!--France, and end the ridiculous chest-thumping assertion that America's medical system is the best in the world.
- posted by TJ @ 3:30 PM