Paying more for health care, and getting less
Our state government is looking at health-care reform, and its also likely to be a major issue in next years presidential election. And again we will hear dire warnings about the horrors of socialized medicine.As it is, about 45 percent of all American health-care spending comes from government at some level: local, state and federal. So the system we have is nearly halfway down the road to socialism.American health care is also grossly inefficient. We spend about 16 percent of the nations gross domestic product on health care, more than any other country. And if you get what you pay for, then Americans health should lead the world.The common measures of public health are infant mortality rate, expressed in deaths per 1,000 live births, and life expectancy. At6.3 deaths per 1,000 live births, the United States ranks 33rd in the world, behind Iceland (2.9 infant mortality rate, and 83.4 percent of health-care spending comes from public coffers), Japan (3.2 and 81.5 percent) and Portugal (5.0 and 73.2 percent), among others.As for life expectancy, we rank 38th, at 78.2 years, behind Japan (82.6), Iceland, Switzerland, Spain and Costa Rica (78.8). Thus many nations with socialized medicine spend less and get better results. Theyre more efficient, even though they lack the discipline of the market.As it is, 45 percent of our health-care spending comes from various public treasuries, and 16 percent of our GDP goes to health care. That means 7.2 percent of our GDP goes to socialized medicine.Ireland spends 7.1 percent of its GDP on health care, and it has socialized medicine. It also has a longer life expectancy and a lower infant mortality rate.If we were as efficient as the Republic of Ireland with its socialized medicine, we could cover every American without raising taxes, meanwhile eliminating most private spending on health insurance, physicians, drugs, hospitals and the like. Wed have about $1 trillion a year to apply to other things.Without having to support our inefficient health-care system, our industries would be more competitive in world markets (ask any American automaker). Money would be freed for more productive pursuits, thereby improving our economy and our standard of living. Millions of Americans who labor in jobs they hate, just to have health insurance, would be free to move to work they enjoy, where presumably they would be more productive. And there should be a lot less litigation, since one major reason people sue is to recover medical costs.So if there are health-care systems that are cheaper and provide better results while covering everyone, why arent we moving that way?Perhaps because the current system is huge. It includes insurance companies, HMOs, hospitals, clinics, billing departments, collection departments, specialized computer software developers, lawyers, claim examiners, drug companies, advertising agencies, all with an interest in preserving the current system, no matter how deep its flaws.Its sort of like chattel slavery was before 1860 an immense investment that was so much a part of the American system that despite its cruelties and economic inefficiency, only a few radicals could imagine eliminating it, even though most other civilized nations had charted a different course.It took the bloodiest war in American history to change that. We ought to be able to do better in the 21st century.Ed Quillen is a writer in Salida, Colo., where he produces regular op-ed columns for The Denver Post and publishes Colorado Central, a small regional monthly magazine.
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