Thursday, April 14, 2005

Health Care in America - more notes

A couple of days ago I linked to a NY Times article that said "[t]he United States has the most privatized, competitive health system in the advanced world; it also has by far the highest costs, and close to the worst results." The writer, Paul Krugman, promises to follow up with a series supporting tht statement.

From the looks of things he might write a series of books. There seems to be no shortage of data supporting the thesis.
This morning I came across yet another post about health care in America. I'm stealing it hook, line and sinker, so you, my beloved reader, do not have to trouble yourself with a hypertext link. I want to make it as easy as possible for this information to be read and understood.

Kash at Angry Bear posts a chart showing health care costs and some health care outcomes in various countries.

The United States, for instance, spends $5,267 per person on health care and has a life expectancy at birth of 77.1 years and an infant mortality rate of 6.8.

France spends about $2500 per person per year less than we do for health care and the French live two years longer and have a lower infant mortality rate.

Sweden spends less than half the money per capita on health care than the US, and the Swedes live longer and have an infant mortality rate a little over half the US.

The Japanese have longer life expectancies and lower infant mortality rates while spending only spending about 40% of our costs.

Kieran Healy at Crooked Timber posted a chart showing the percentage of health care costs borne by the governments of various countries. Thus, we learn that in the US, the government pays about 40% of total health care costs while the government of France pays 75% of its total health care costs, Japan 80% and Sweden 85%.

Let's combine the information from the two charts. In the United States, the government spends $2106 per person on health care while individual Americans pay $3160, for a total of $5267 per person. In France, the government pays $2052 while the individual Frenchman pays $684 per year. In Sweden, the goverment pays $2139 per person while the individual Swede pays $377.

Thus, our government pays about the same or more for health care than the governments of Sweden or France while buying only about half of the care. It is hard to see what we get for the additional $2500 or so per person per year. That seems to be money spent for nothing.

The choice for a normal American family of four is stark. You could have our current health care system, or your family could have the longer life of the French along with a little under $10,000 per year to spend however you choose.

You could have our health care system in its current form, or you could have the lower infant mortality of the Swedes along with more than $11,000 per year to spend however you wish.

I know that it is hard to have to wait a while to get hip replacement surgery, but at $10,000 per year from now until I need the procedure, I can afford the wait.

Dwight Meredeth is one of my favorite bloggers.
If I had as much knowledge as he I would not be nearly as patient or even-handed.
I guess I relate because I know the story of Cassandra.
Some look into next week. Some into the next "news cycle." Some into the next election.
A few, it seems, look far to the future with hope that the US can attain some of the benefits of modern civilization that many of our neighbors in the world community have had for years.

There is so much information about health care that I could spend the rest of the day compiling it.
Another powerful piece by Phillip Longman tells of the Veterans Health Administration's (VHA) success in totally retooling a delivery system into one of the most efficient systems in the world.

The writer advances the idea that the VHA could become the link to better care for boomers...

No one knows how we're ever going to provide health care for all these aging baby boomers. Meanwhile, in the absence of any near-term major wars, the population of veterans in the United States will fall dramatically in the next decade. Instead of shuttering under-utilized VHA facilities, maybe we should build more. What if we expanded the veterans health-care system and allowed anyone who is either already a vet or who agrees to perform two years of community service a chance to buy in? Indeed, what if we said to young and middle-aged people, if you serve your community and your country, you can make your parents or other loved ones eligible for care in an expanded VHA system?

Concluding that line of thought with a bleak scenario...

Does this plan seem too radical? Well, perhaps it does for now. We'll have to let the ranks of the uninsured further swell, let health-care costs consume larger and larger portions of payrolls and household budgets, let more and more Americans die from medical errors and mismanaged care, before any true reform of the health-care system becomes possible. But it is time that our debates over health care took the example of the veterans health-care system into account and tried to learn some lessons from it.

He notes that the Admistration is pushing for some kind of change, getting health care more into the marketplace and less in the area of employment.

Since our economic system is predecated on the idea that any unemployment in the single digit range is considered "good," I am in favor of any moves that might better insure that "good" number of families that are having a hard time meeting immediate needs, like housing, food and transportation - families for whom health insurance is so far out of reach that they simply don't have any.
I am not optimistic, however, that anyone on the prisident's team is interested in safety nets for unemployed people. Especially in the form of health care. Takes away the motivation of people to work, don't you know.

The article concludes with strong words about our much-bragged about private health care system.

As the health-care crisis worsens, and as more become aware of how dangerous and unscientific most of the U.S. health-care system is, maybe we will find a way to get our minds around these strange truths. Many Americans still believe that the U.S. health-care system is the best in the world, and that its only major problems are that it costs too much and leaves too many people uninsured. But the fact remains that Americans live shorter lives, with more disabilities, than people in countries that spend barely half as much per person on health care.

Best in the world.
Someone else's words, not mine.

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