[Vision2020] Why Does the U.S. Make Health Care so Difficult?

[Nicholas Gier]

Dear Visionaries:

I'm back to regular column writing (I know--some will groan) and here is
this week's offering.  The long version is attached.

My daughter in Edmonton did not want to be identified, so the reason for
the "couple I know."

Just got the first review of my book MS "The Origins of Religious Violence:
An Asian Perspective," it is the best appraisal of any of my scholarly work
in 44 years.  Makes all that work worth while.

May the ranks of the Obama-insured grow and grow and grow,

Nick

*WHY DOES THE U.S. MAKE HEALTH CARE SO DIFFICULT? *


            In 1978-1979 I took my first sabbatical in Denmark. My former
wife was a Dane, but my daughter and I were able to join her as full
participants in the Danish welfare state. For a small initial fee we had
immediate access to free health care. There were no questions about our
income or pre-existing conditions.

            I know an American couple who work at the University of
Alberta.  They received unconditional health benefits as soon as they
arrived as landed immigrants.  While on vacation in the U.S., the wife
forgot to bring enough medicine for a very serious medical condition.  The
local Rite Aide wanted $2,000 for the drugs, so a friend in Edmonton sent
the drugs by overnight express. The Canadian pharmacy price of $50, which
she of course did not have to pay, was marked on the package.

Americans pay far more for their drugs than people in any other country,
even though many of them are manufactured in the U. S. An article in *Health
*Affairs (April, 2013) discovered that "prices for brand-name drugs were 5
percent to 117 percent higher in the U.S. than in other countries."
Citizens of the United Kingdom pay half of what Americans are billed for
their prescriptions.

In 2011 Denmark paid out $4,448 for each citizen for health care, and
$4,522 was spent for each Canadian. In both countries better health care
was obtained.  In stark contrast the U.S. spent $8,508 on each American
with much poorer results.

Health care expenses in the United Kingdom are $3,405 per capita, but
people there fare better than Americans in seven major illness categories.
The U.S. ranks last among 16 industrialized countries for preventable
deaths, which, according to the Centers for Disease Control, are estimated
at 200,000 per year.

I joined many others in opposing the Affordable Care Act, and our
opposition was included in the polls that Republicans used to criticize a
"government take-over" of health care.  The public option was of course not
part of the final bill, even though decades of experience with the world's
government-run health care systems prove that it the most efficient and
least expensive.  For years I have supported the late Senator Ted Kennedy's
proposal to extend "tried and true" Medicare for all Americans.

            As many other countries did after World War II, the U. S.
should have instituted universal health care fifty years ago.  The
inefficient private health insurance industry, which has much higher
administrative costs than Medicare, is now so strong that the Democrats had
no choice but to piece together the complex plan that is Obamacare.  It was
destined to fail in implementation and as well as in the goals of
efficiency and cost cutting.

            Republican obstruction in extending Medicaid in 20 states and
refusing to set up state health exchanges has made matters much worse.
Obama naively expected that states would set up their own exchanges, but
only 15 have done so on their own.  This was a tremendous extra burden on
the roll-out of the Affordable Care Act. Republicans will be responsible
for the negative effects on the uninsured in the Red States they control,
where an inordinate number of preventable deaths occur.

Former Massachusetts Governor Mitt Romney, over Democrats' objections,
insisted on the individual mandate in a plan very similar to Obamacare,
except the latter has more emphasis on controlling costs. Over 98 percent
of Bay State residents now have coverage. Critics claimed that Romneycare
would bankrupt the state, but health care costs have risen more slowly than
the rest of the nation. Two-thirds of those polled believe that Romneycare
has been a success.

I'm convinced that as the enrollments increase, more and more Americans
will agree with the people of Massachusetts that achieving universal health
care was worth the effort.

Nick Gier taught philosophy at the University of Idaho for 31 years.
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