Solving the American Health Care Crisis

Solving the American Health Care Crisis Chapter I Introduction “Health care is a right and not a privilege.” Senator John Kerry speaking at a Democratic Party Unity Dinner on March 25, 2004. During one of the presidential debates between President Bush and Senator Kerry in October 2004, Bush said, “Ours is the best health care system in the world,” in response to a question from the moderator. Kerry did not challenge Bush’s statement. Politicians often play on the emotions and patriotism of the people. Had Kerry challenged Bush’s statement and reminded the audience that the statement did not make sense according to facts about the American health care system, he would have lost votes. No country’s population likes to hear that their system is not good enough, especially when their leading politicians state it. The United States of America is the richest country in the world, with one of the highest GDPs per person. It has some of the brightest and best minds in the world. It has some of the finest medical schools, institutions, and hospitals in the world. America is one of the least bureaucratic countries, yet it spends over 16% of its gross domestic product (GDP) on health related expenditures. This figure is expected to rise to nearly 20% of the GDP of the United States within a decade. In 2005, it was projected that the federal government would be responsible for more than 50% of all spending in health related fields within the following five to six years. At the same time, more than 47 million people in the United States have no health insurance and millions more are underinsured. On average, the Western European countries, as well as Japan and Australia, spend 8 to 11% of their GDP on health care. Despite these facts, people in other rich industrialized countries have an average lifespan that is two to three years longer than that of the people in the United States. Besides the fact that the life expectancy rate of Americans is lower than that of Western Europeans and the Japanese, the infant mortality rate in the United States is nearly twice that of other rich countries. According to the World Factbook 2008 compiled by the Central Intelligence Agency (CIA), Cuba was one of forty-one countries that had a lower infant mortality rate than the United States that year. Singapore had the lowest infant mortality rate in the world, with 2.3 babies dying before the age of one for every thousand live births. Norway, Sweden, Iceland, and Japan, all had infant mortality rates that were less than half that of America, which was nearly seven out of every thousand babies dying before the age of one. The 2005 World Health Organization (WHO) report on the world’s health care systems ranked the United States number 1 in obesity and 35 overall. America scored low in other categories too, such as in fairness in health care, where it tied with Fiji at 54. This state of affairs in the American health care system is a black mark for American decision makers and politicians. Former President Carter said, “America can learn something from Cuba’s health care system.” The press rarely reports such statements because most people would have to swallow their pride to accept that a poor, communist country like Cuba has a lower infant mortality rate than the United States, and that the average lifespan of a Cuban is the same as for an American. T. R. Reid, author of The United States of Europe, writes in his book: Sometimes Americans seem to be in a state of denial about what Europe has achieved. American presidents from both parties, for example, have repeatedly declared that the United States has “the greatest health-care system in the world.” That claim is hard to support. The unified Europe has higher life expectancy, lower infant mortality, lower rates of heart disease and cancer, and health insurance that covers every person—all for about half as much per capita as the United States spends… Since the United States pays much more and gets much less in return, it might behoove American policymakers to stop bragging about their own health-care system long enough to take a look at what the EU nations have done. Subsequent chapters of Solving the American Health Care Crisis present charts that show aspects of the health care systems in different countries. There is a brief presentation on how each of these systems work, especially those of the rich industrialized countries. The information presented brings up a couple of important questions: Why is the cost of health care per person so much lower in these countries than in America? What can U.S. policymakers learn from their foreign counterparts? There is also an explanation of how the American health care system works, as well as why it has the highest cost per person in the world, followed by a discussion of the problems and issues relating to the cost of health. The latter are defined as:  Aggressive drug ads on TV and radio, and in newspapers and magazines  Lobbying and campaign contributions by drug and insurance companies  The cost of malpractice insurance for doctor  Frivolous lawsuits in courts  Fragmented and complicated health care policies and entitlement programs  Profits of insurance and drug companies  Bureaucracy  Lack of electronic health care records for patients  The high cost of drugs A look at all of these, as well as certain other problems and issues, will reveal why the cost of health care is so high in the United States. Basic health care should not be based on any ideology or system—i.e. capitalist, socialist, or their branches—it is a basic need. All politicians and decision makers in the United States should be concerned with finding a cost effective and ideal solution to the health care problem. It requires urgent attention and resolution from decision makers, much more so than any other domestic issue in America. In closing, suggestions and cost effective solutions to the American health care crisis are presented, ones that would benefit everyone in America. The solutions take into consideration the best practices of the health care systems of other affluent nations and the implementation of information technology (IT), which has a key role to play in cutting costs and in making any health care system more efficient and cost effective. Health care—like clean air and water, food and shelter, and education—is a basic need in any society, especially in rich countries that can afford it, and it is necessary for development into a more free and mature democratic society.