Why health care reform? Why now?

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Our local newspaper editor was kind enough to consider a submission from me. The following article appeared in the November 25, 2009 edition of the Dunn County News.

Health-care reform is the hot topic in the United States these days. I’ve been encouraged by the number of people discussing the issue while I’m out and about, at the store, the pizza joint, the post office.

Sadly, too much of our focus has been on the small number of screaming matches that have erupted in various forums. I believe people resort to shouting and name-calling because there’s a serious lack of knowledge surrounding health-care in the United States and around the world.

Why reform, why now? The U.S. spends approximately $7,300 per person per year on health care. In comparison, Norway, the #2 highest spender on health care, spends approximately $4,800.

We spend 53% more per year on health care than any other nation in the world. The industrialized nations of the world spend, on average, $2,964 per person per year. Of the 30 member nations of the Organization for Economic Co-operation and Development (OECD), only 5 spend more than half of what we spend on health care.

Viewed another way, we spend 16% of our total gross domestic product on health care. From 1990 to 2004 our health care spending increased by 123%, while personal income increased by only 32% and our gross domestic product increased only 104%. Spending on health care has been increasing at an average rate of 9.9% per year, 2.5 percentage points faster than our GDP, which means we’re constantly increasing the portion of our spending on health care, which requires us to spend less on other necessities.

What do we get for our spending? We hear a constant refrain that the United States has the best health-care system in the world. A quick look at some basic stats shows that’s not the case.

The United States has a life expectancy of 78.1 years, placing us #23 within the 30 nations of the OECD. In Japan and Norway, the leaders within the OECD, citizens live roughly four years longer. Of course, a number of factors influence life expectancy at birth, not just health care.

For that reason, a common comparison of health-care systems is infant mortality, because proper pre-natal care is one of the largest determinants of infant health. The United States has an infant mortality rate of 6.7 deaths per 1,000 live births. Eight nations of the OECD have infant mortality rates less than half ours. If we could cut our infant mortality rate in half we would save the lives of 14,000 infants every year.

Another common comparison is mortality rates from treatable diseases such as cancer. Opponents of health care reform will often, rightly, point out that cancer patients in the United States have a higher chance of surviving cancer than patients in countries such as Canada or the United Kingdom. Those opponents however cherry-pick their countries, attempting to ignore the fact that the United States ranks 7th in the OECD in cancer mortality rates - again, while spending far more than any other nation in the world. For breast cancer we rank 11th, and for lung cancer a dismal 20th.

So do I mean to disparage our hospitals and doctors and nurses with these statistics? Not at all. We do indeed have some of the best medicine in the world, if you can access it.

What’s broken is the way that we provide access to and pay for health care. If you have money or a good insurance plan, the doors of American hospitals are open to you. But in this time of recession, where 7.4 million people have lost their jobs, more and more people are faced with either losing their insurance or having to find the thousands of dollars needed to cover their own insurance.

Around 46 million people in this country don’t currently have insurance, many of them prohibited from purchasing it due to pre-existing conditions. A recent study found that 45,000 people per year die due to lack of access to medical care because they don’t have insurance. The uninsured lack access to basic preventive health care and treatment for chronic conditions.

We often hear that government is inefficient while the marketplace makes private industry more efficient. However, the government Medicare system includes costs of about 3% for administrative overhead, i.e. paperwork. Private insurance companies, on the other hand, spend 20-30% of our health care dollars on administrative overhead.

Part of the insurance company’s overhead is a system of assessing claims and choosing which to deny. A recent study of California insurance companies found 20-30% of all claims are denied. This is the rationing we hear so much fear-mongering about in a government plan.

We need to understand that this rationing is going on now, in the private system. However, in a for-profit system like ours, rationing is done not to ensure that everyone is cared for, but to inflate the profits of private insurance companies.

It’s clear to me that there are financial and logistical reasons for our government to be more involved in the provision of health care. However, I think the far greater argument is the moral argument.

We read nearly every week in the pages of this newspaper letters touting that “We are a Christian nation.” I believe we are far greater than that. We are a Muslim nation, a Buddhist nation, a nation of all faiths. And all major faiths have as their most basic tenet that we should care for our fellow man.

We have too often, especially these past few years, fallen short of these expressed ideals. But the greatness of this nation is in our never-ending striving for the better. The American dream supposes that we can all improve our station in life, our quality of life.

I believe our government should reflect our values. We currently provide basic education, fire and police protection, national defense, all through our government. Every industrialized nation in the world provides basic health care for every citizen, and all of them do it at far less cost than us, many of them with much greater effectiveness.

We don’t have to reinvent the wheel. We can look to nations like Germany and Switzerland who use private, non-profit insurance companies and private hospitals to ensure basic care for everyone. Now is the time. Please, take the time to become informed, then contact your elected representatives and make your views known.

For good information on the issue, check out the web sites of the Kaiser Family Foundation and Consumer Reports.

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