The Best Health Care System in the World?

Roger Madison
Does the USA provide the best health care in the world for its citizens?

This question and the debate on Health Care Reform has really been bothering me. I have tried to get my mind around the issues, and lend my support to the best outcome for me and others. This article shares a perspective that I believe has been lost in all of the political posturing. It is almost impossible to know if the bill that will eventually pass will make as much of a difference as it needs to. So , I looked for some measurement that would at least idenitfy a goal that makes sense amid all the special interests.

The moment of truth for health care is at hand, and the distortion that perhaps gets the most traction is this:

We have the greatest health care system in the world. Sure, it has flaws, but it saves lives in ways that other countries can only dream of. Abroad, people sit on waiting lists for months, so why should we squander billions of dollars to mess with a system that is the envy of the world? As Senator Richard Shelby of Alabama puts it, President Obama's plans amount to "the first step in destroying the best health care system the world has ever known."

According to Nicholas D. Kristoff, in a NY Times article, Unhealthy America, "That delusion may be the single greatest myth in the health care debate. "

The United States ranks 31st in life expectancy (tied with Kuwait and Chile), according to the latest World Health Organization figures. We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the United States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland.

The figures are even worse for members of minority groups. An African-American in New Orleans has a shorter life expectancy than the average person in Vietnam or Honduras.

There is one American health statistic that is strikingly above average: life expectancy for Americans who have already reached the age of 65. At that point, they can expect to live longer than the average in industrialized countries. That's because Americans above age 65 actually have universal health care coverage: Medicare. Suddenly, a diverse population with pockets of poverty is no longer such a drawback.

The top agenda item for the Obama administration -- and the country -- is the issue of Health Care Reform. This single issue has implications for the economic recovery, care for veterans of our ongoing wars in Iraq and Afghanistan, jobs and employment security, women's abortion rights, and the health care of 36 million to 47 million uninsured Americans (depending on who is counting).

The myths and distortions, promises and hyperbole, fear mongering, and deliberate misinformation have formed battle lines not seen since the Civil Rights Legislation of the 60's. I have been trying to sort out the key messages in all of the ongoing debates, and there are many. Keeping up with the compromises and changes requires a mainframe computer, to track the actual progress that resulted in a 2,000 page bill that was passed by the House of Representatives on Saturday.

So what does this really mean for us on the sidelines, and what should we do? There are three fundamental starting points that frame everything:
  1. The position of the political left is that universal health care for all Americans should be available - - cradle to grave -- with adjustments for ability to pay, and without exclusions due to pre-existing conditions. A means should be provided to afford health care for all.
  2. Caught in the middle are those who currently have health care coverage who "like the coverage they have" and "like the doctor they have." These may complain about costs, but aren't facing bankruptcy. They just want to keep the choices they have made, with no "takeaways", and reduce the cost increases they face annually.
  3. The position of the political right is "Just say No." They believe that the free market system has provided the best health care system in the world (which is a myth), and the insurance companies, doctors, hospitals, and pharmaceutical companies should be left unfettered to provide "choice" to the marketplace. Removing obstacles (most importantly, any federal government interferance) will foster competition and bring down costs.
So there are three contending issues: universal availability, freedom of choice (for the health care companies and individuals), and cost.

All the evidence up to this point indicates that the cost is rapidly putting quality healthcare beyond the reach of individuals, families, and small businesses -- especially the poor.

The two opposing approaches promise to increase coverage, and "bend the cost curve."

The goal of "universal coverage" seems to be off the table. After all is said and done, there will still be some number of Americans uncovered.

Those are the issues being debated. The goal of providing Americans with the "best health care system in the world" has been lost. Many of the countries that rank above the USA in any given measure have universal healthcare coverage, and they don't drive thousands of their citizens into bankruptcy each year.

So, what are the implications for the outcomes available? Here are the options:

  1. The compromises that have been introduced have destroyed any hope of universal coverage. However, any step toward reform that slows the unbridled ripoff of the health insurance companies and big pharma is movement in the direction toward later enhancements.
  2. Defeat of this measure will have widespread negative ripple effects if you supported the election of President Obama and the majorities that were won in the House and Senate. A shift in the balance of power is riding on this single measure -- regardless of what else is going on.
Faced with these options, the only conclusion for me is to actively voice my opinion in support of the Democratic led measure -- even though it falls short of the goal of universal coverage. I believe we must support our President and his party to do whatever it takes to overcome the "Just say No" position of the Republican right. Failure is NOT an option.

Earlier, I compared this to the Civil Rights Legslation of the 60's. That legislation also was fraught with compromise -- one of which introduced the notion of "minority rights" -- in place of the goal of Black equality. Without that compromise, we would not have a Black president today. The compromise that will ultimately come out of health care reform will open the door to a future of better health care -- especially for the least among us.

I spent the last few weeks calling and writing my congressional representative -- even though he is a Republican who voted "No." When we win this battle, I will work eaqually hard to replace him with a Democrat in 2010.

I encourage everyone to call and write your Senators to express your support of Health Care Reform. And finally, when the elections of 2010 place all Representatives on the ballot, make sure you join the fight to replace those who just said No.

Roger Madison