Health Care in the United States

     A subject that has been kicked around for some time and has a few attempts at doing something about, resulting in the mess that is known as Obama Care, which made the matter worse instead of better.  I think it's time to look at the issue again.
     To start with we should look at what's really happening in the American health care system, as opposed to what we might fool ourselves into believing. Our health care system is a mess. We have the most expensive health care system among the advanced nations of the world, with the lowest life expectancy, the highest infant mortality rate and some of the longest waiting times to see a physician. We spend almost twice as much on a per capita basis on health care the our next most expensive neighbor, Canada. We spend almost twice as much, as a percent of GDP, than France, Canada and Germany. Even though most other countries have a form of universal health care, the US spends more government revenue for health care than any of them, even though the government's share of the total costs is the least.
     The World Health Organization compared the medical care across various nations and produced some disturbing results.

      Other evaluations have been made by other organizations and the results are similar to the WHO. The United States is 37th in the rankings in health care for most of the world, the lowest of all the North American and European major nations.
      A partial listing of the health care rankings by the WHO show the results of that ranking

 

     One good measure of a health cares effectiveness is the rate of infant mortality. Where once the US was not the worst in that category, over time the other nations studied showed that we a lagging behind the advanced nations in that respect.

     The problem is even worse when one looks at the growth rate for medical costs over the last 40 years of so.

      While the rest of the world is seeing a rise in the cost of health care, the US is really out of control
       A recent study by the Commonwealth Fund didn't exactly coincide with the WHO's findings, but both studies indicated the poor plight of the US healthcare system.  

       

     It might be useful to break the above chart down for specific parameters.

      It seems that the UK is doing something right, but Canada, with it's single pay system, is ranked only slightly better than the US in both studies. So a single payer system alone doesn't guarantee success. Perhaps we should look at what the UK does that makes it such a success.
      To start with there is not a single health system in the UK. Each of the countries comprising the UK has it's own publicly funded healthcare system.
   

    

      But they have a lot of similarities. They are all have government funded universal healthcare. What the conservatives call Socialized Medicine, with just some twists. They all seem to have sprung from the major healthcare overhaul  that occurred in 1948 with the birth of the NHS, and modified since then with the last reorganization occurring in England in 2013. The other countries in the UK have also performed changes in their systems over roughly the same time period. It should also be noted the most of the medical systems in the rest of the advanced nations include prescription drug coverage, at least to some extent.

    The biggest opponents to the US adopting any form of healthcare as  practiced in the UK, the western European nations, or most of the advanced nations of the world,  is the insurance industry. They have a fully paid PR staff and a horde of lobbyists dedicated to demeaning the UK's NHS and any other government funded system. They generate tons of propaganda toward that end. Obama Care is an example of just how powerful the insurance industry is. It  resulted in a windfall for them.
    They pick and choose what data to emphasize to make the universal health care systems look inferior. But, they don't bother to compare the US system to the countries of Europe,the UK, Japan, Australia or other advance nations of the world. One of the selected data points they like to trot out is the wait times to see a doctor. But, as the data shows, the US is ranked fifth for that category by the Commonwealth Fund study. They love Canada with it's longer wait times and they publicized that fact as an example of what "Socialized Medicine" will bring, but that isn't representative of what you see in the UK or other European health systems. Of course anything that smacks of socialism is an anathema to a conservative, who believes that the free market is much better at curing ills. That is true where a free market exists, but when you think about it, the medical industry is not working in a free market. It is highly controlled industry by anyone's definition. They say that some unnamed bureaucracy in Washington will be making our medical decisions for us if we adopt a government run universal health system. But, the fact remains, unless you are very rich, an unnamed bureaucracy runs your medical decisions now through the allowable procedures dictated by the insurance companies. Of course if you're on Medicare or any of the other government programs, the decisions are already being made by a government bureaucracy. Only the very wealthy can take advantage of a pseudo free market for their health care because they are generally self insured. They can go anywhere and get any treatment they desire. Not so for the great unwashed masses.
     They like to portray the government bureaucracies as a bunch of know nothing government appointees to create a greater fear factor, but in fact they are the same type of experts in each of the medical fields that the insurance companies employ, only without the profit motive.  
     The price we pay for patented prescription drugs is mind boggling . A lot of this is the governments doing: it often takes over a Billion Dollars to bring a new drug to market.  The FDA is so afraid that a drug might turn out to have harmful side effects that they demand extraordinary measures be taken before it is approved for the American consumer. Another important factor is something the many European countries take advantage of that we don't. They have tremendous power to negotiate drug prices because they can act for their whole country, while our position is fragmented, thus losing that bargaining position. I know of no other product that is free to set their own prices without competition, that has the property of being needed by the consumer. The drug companies have a total monopoly on their own drugs as long as they are protected by a patent. It is very cheap to manufacture and distribute drugs, so the price they can sell the drug  can be low and still turn a profit. To some extent the US is subsidizing the prescription drug market for most of the world. The drug  companies can sell to Canada cheaper and make a profit and depend on charging enough to the American consumer to cover the R&D costs, as well as boost the profit margin.
    We have some things to look proud about. The US leads the world in medical innovations.  Since 1951, 76 Americans have either been awarded, either as individuals or shared, the Nobel Prize for Medicine. That is more awards than all other nations combined. Of course a lot of these awards were to scientists that weren't native born Americans. This reflects the wealth that America is able to expend on research facilities and grants as much as any thing else which brings research scientists to our shores. The next most was awarded to researchers in the United Kingdom with 19.
     We can boast of some of the greatest medical centers in the world, and if you have access to them and you have the necessary financial position, you can match or exceed the medical treatment you can receive any place else. Of course some of our top medical professionals pick and choose which insurance plans they will take, and, in fact some don't take any at all. It's cash only.
     Something to think about.