[Vision2020] America's Health Care is a National Disgrace

[nickgier at adelphia.net]

Greetings:

This my radio commentary on KRFP 92.5 FM for tomorrow morning at 8 and 9:30.  All of last year's columns can be heard or read at www.NickGier.com.

Next week's topic for MLK's BD: "How Did We Lose Our Racial Color Blindness?"

AMERICA'S HEALTH CARE IS A NATIONAL DISGRACE

Nick Gier, Professor Emeritus, University of Idaho 

President Bush frequently praises the American health care system as the best in the world, and many Americans pronounce the two words "socialized medicine" as if they were poison.  But countries with single payer systems spend far less than we do, are much more satisfied with their care, and experience far better health than Americans do. Ranked according to 16 health categories, the U. S. is next to last among 13 industrialized nations.

In 2004 Americans paid $6,100 per person compared to an average $2,550 per capita in all other industrialized nations. A large portion of that cost was for drugs with Americans paying twice as much than citizens of these countries. Single payer systems are simply more efficient. Annual health administration costs in Canada, for example, are $300 per person versus $1,000 in the U.S. Administrative costs for Medicare are 2 percent as opposed to 13 percent taken by private insurance. 

Another aspect of the large U. S. costs is the fact that American doctors make  twice as much as other doctors do (an average $200,000 versus $100,000 per year).  These doctors also start their careers with little or no debt, compared to American physicians, who start their careers with an average of $100,000 in outstanding loans.

With regard to health statistics, the most dramatic differences are found in teen STD rates. Five times more Americans 15-24 have HIV than German youth of that age.  The U.S. teen syphilis rate is six times than of the Netherlands, and our teen gonorrhea rate is a whopping 74 times higher than the Dutch. 

Governmental programs that provide uncensored sex education and promote condom use are the key to this success in youth sexual health.  Contrary to what one might expect, European youth have fewer sex partners than Americans do and begin sex slightly later than Americans.

The U.S. infant mortality rate is 5 babies per 1,000 as opposed to 2 per 1,000 in the Czech Republic, Finland, Iceland, and Norway.  America would do much better in this category if it could provide prenatal care to all of its citizens. Studies have shown that for every $1 spent on prenatal care, $3 is saved by preventing complications that result from unsupervised pregnancies. The rate among African Americans of 9 infants per 1,000 approaches third world countries.  In 2005, more babies per 1,000 survived in Cuba than in America.

Although other countries are catching up, Americans are still by far the most overweight, impacting health costs significantly.  For every three Americans who are obese, only one Dane is, even with a diet heavy in dairy products.

A recent study of illness in the U.S. and Great Britain found that in every major category, Americans were sicker than their British counterparts.  There were twice as many American diabetics, and the American cancer rate was 4 percent higher.  The study was adjusted for ethnic diversity, so two reasons where given for the disparity.  First, there is much more obesity in America; and second, there is much more stress due to economic and health insecurity, especially among the 46 million without health insurance.  
	
Those who demonize socialized medicine have the misconception that the people who have it do not like it.  Surveys in the late 1990s, however, indicated that only the Italians at 20 percent were more dissatisfied than Americans at 40 percent.  Danes were 91 percent satisfied; Finns, 81 percent; French, 65 percent; Swedes and British, 57 percent.
	
A common response to European success is that they are homogenous societies with few ethnic divisions.  Germans, however, have been living with a large Turkish minority for decades, and other European countries have taken large numbers of refugees in the last 20 years.  Denmark has received more per capita than any other country in the world.

As the new Democratic Congress convenes, they should consider legislation that will move the U.S. to a single payer system as soon as it is feasible.  The savings in administrative costs alone would, using 2001 figures, easily cover all the uninsured.  I support Princeton economist Paul Krugman's proposal to extend Medicare to every American.