Free Market Health

Recent study reveals catastrophic failure of US health system

© Bryan Zepp Jamieson
5/3/06
http://zeppscommentaries.com/S&E/health.htm

For decades, Republicans, libertarians and other right wingers have been warning us against the perils of what they call “socialized medicine.” “It will be a vast, expensive, ineffective bureaucracy,” they intone, “heartless, soulless, crushing children and old people, forcing triage, and denying millions even the basics in an effort not to bankrupt the nation.”

Americans, on cue, went wide-eyed with fright, and swore that health care would, now and forever, be a free market enterprise.

The decades went by, and nations that had single-payer or national health not only failed to go bankrupt, but in most such countries, most of the citizenry seemed to be quite satisfied with the level and quality of health care they got. And if their taxes were higher, they never had to shop for doctors, or worry about whether the insurance company would cover a visit to the ER, or how to afford medications.

More recently, Americans noticed that they were spending an awful lot on health care. (As of 2005, the average per capita spent on health care is $5,200 a year). In return, they were getting a rather poor return. Fifteen percent of Americans had no health coverage at all, and nearly half the remainder had poor to barely adequate coverage. More and more, people were being killed by the rapidly escalating price of medications (next time you’re in the pharmacy, remember the money you are spending goes, in large part, to those fancy ads on TV that you so enjoy). And of course, everyone had to deal with endless paper work, and a maze of conflicting and often contradictory plans, providers, HMOs, hospital bureaucracies, and another maze of tax rebates and employer involvement. People were horrified to discover that insurance companies were dictating to employers who they could hire, based on health-risk estimates.

But so what if it cost more, delivered less, and suffocated everyone in a smoggy miasma of rules and regulations? It was a free people, enjoying the freedom and efficiency of the free market, and if a Canadian could have a fracture, and get it fixed without questions and an expense of five dollars out of pocket, no muss and no fuss, well, that just showed that the Canadian was a slave.

And of course, there was the horrible example of England. Free marketeers exchanged horrified whispers about the death-camp conditions of National Health. Children were starved and the elderly beaten and thrown in the gutter to die. Well, maybe not quite that bad, but it was pretty horrible. If it wasn’t for National Health, John Lennon could have gotten a decent pair of eyeglasses. Just goes to show.

During the Newt Gingrich era, Michael Moore had a show called “TV Nation” which could be best described as “60 Minutes on Acid.” Investigative journalism, with the inimitable Moore style. A combination of the goofy, and journalism of a quality America hasn’t seen in years. In one show, he compared health coverage between Canada, Cuba, and the US, using a leg fracture as the test case. According to Moore, the network pressured Moore on that story, having him declare Canada to have the best health care response. In fact, Moore later claimed, Cuba won, both in terms of cost (none) and quality and speed of health care. Canada was second, the US last. Even the toned-down “result” was unsettling to people who were used to accepting the cost and inconvenience of the American system as being a good trade off for superior health care.

A few years ago, WHO came out with a report that rated the United States 27th in quality of health care world wide. Given that Americans were already spending more per capita on health care at that point, it came as a shock.

Since then, of course, health costs have continued to climb, the Republicans initiated their disastrous Medicare plan, and the numbers of people with inadequate or non-existent health coverage have continued to climb.

But right wingers wove horror stories about desperate Canadians sneaking across the border to get an inflamed hangnail treated so as to avoid a ten-year wait (if anything, more Americans were trying to sneak into Canada, either for lowcost drugs or basic medical care), and most Americans nodded and agreed that yes, the sacrifices everyone else was making were worth it if they could get lucky and have the best medical care in the world.

But yesterday, a study was released that blew the tattered remnants of smug American certainty of the superiority of the US medical system right out of the water. The study examined non-Latino white males in the US and the UK, weighted for socio-economic status and limited to the ages 55 to 64. The average US male paid out more than double in insurance and out-of-pocket expenses what his British counterpart spent in taxes, and so it would be reasonable to expect that he would be healthier.

He wasn’t. He wasn’t even close. The differences in the incidence of various health problems between the two countries was stunning. The rate of diabetes was over twice as high among the US subjects (12.5% to 6.1%). The US also had extraordinarily higher rates of hypertension (42.4% to 33.8%), all heart disease (15.1% to 9.6%), cancer (9.5% to 5.5%), lung disease (8.1% to 6.3%), heart attacks (5.4% to 4%), and stroke (3.9% to 2.3%). In no category did the American subjects have a better record than their British counterparts.

The results were shocking. Newspaper articles reported inaccurately that smoking rates were about the same in both countries. In fact, England had and still has a much higher rate of smoking. Drinking is significantly higher in the UK, and one factor not mentioned is that one in two Britons lived in major metropolitan regions, most notably London, and the air quality, especially up through about 1970, was worse than anywhere in the US.

Brits had National Health, lived in a nasty climate, smoked like chimneys and drank like fish, and supposedly had a lower quality of living. By all rational guestimates, they should have been less healthy than the Americans. At best, they should have been roughly equal. Nobody expected such a wide disparity.

Socio-economic status was the best predictor of healthiness, but even there, the results were shocking. Wealthy Americans were, on average, about as healthy as poor Britons. The authors of the study suggested that perhaps the far greater economic insecurity that Americans feel could be a contributing factor. Although that didn’t explain the poorer health of Americans who were lucky enough to have a personal safety net.

The study doesn’t explain why the American system works so poorly, but it shows, beyond any doubt, that it is the most expensive failure in history.

If this doesn’t move America toward a universal health care system, then maybe the problem is just that Americans are just too stupid to avoid extinction.