U.S. Wastes Billions Of Healthcare Dollars Every Year

 Americans like to think that the money they spend each year for health insurance goes to actually pay for health care. It doesn't. The truth is that the U.S. spends hundreds of billions of dollars each year that doesn't contribute to the health of any American.

The money goes to pay the overhead for private insurance companies -- profits, executive and employee compensation, stockholder compensation, et cetera. The people receiving this money provide no health care. They simply suck dollars out of the health care system.

No matter what kind of health care system a country has, some money will be spent on overhead (managing the system), but Americans spend far more on overhead than other countries do -- and that is largely why health care costs so much more in the U.S. than in most other countries. For instance, Canada spends only about $1 on this compared to $4 in U.S. for each person.

Consider this excellent article by Melissa Healy of the Los Angeles Times:

In the United States, a legion of administrative health care workers and health insurance employees who play no direct role in providing patient care costs every American man, woman and child an average of $2,497 per year.

Across the border in Canada, where a single-payer system has been in place since 1962, the cost of administering health care is just $551 per person — less than a quarter as much.

That spending mismatch, tallied in a study published this week in the Annals of Internal Medicine, could challenge some assumptions about the relative efficiency of public and private health care programs. It could also become a hot political talking point on the American campaign trail as presidential candidates debate the pros and cons of government-funded universal health insurance.

Progressive contenders for the Democratic nomination, including Sen. Bernie Sanders of Vermont and Sen. Elizabeth Warren of Massachusetts, are calling for a “Medicare for All” system. More centrist candidates, including former Vice President Joe Biden and former South Bend, Ind., Mayor Pete Buttigieg, have questioned the wisdom of turning the government into the nation’s sole health insurer.

It’s been decades since Canada transitioned from a U.S.-style system of private health care insurance to a government-run single-payer system. Canadians today do not gnash their teeth about co-payments or deductibles. They do not struggle to make sense of hospital bills. And they do not fear losing their health care coverage.

To be sure, wait times for specialist care and some diagnostic imaging are often criticized as too long. But a 2007 study by Canada’s health authority and the U.S. Centers for Disease Control and Prevention found the overall health of Americans and Canadians to be roughly similar.

Some Canadians purchase private supplemental insurance, whose cost is regulated. Outpatient medications are not included in the government plan, but aside from that, coverage of “medically necessary services” is assured from cradle to grave.

The cost of administering this system amounts to 17% of Canada’s national expenditures on health.

In the United States, twice as much — 34% — goes to the salaries, marketing budgets and computers of health care administrators in hospitals, nursing homes and private practices. It goes to executive pay packages which, for five major health care insurers, reach close to $20 million or more a year. And it goes to the rising profits demanded by shareholders.

Administering the U.S. network of public and private health care programs costs $812 billion each year. And in 2018, 27.9 million Americans remained uninsured, mostly because they could not afford to enroll in the programs available to them.

“The U.S.-Canada disparity in administration is clearly large and growing,” the study authors wrote. “Discussions of health reform in the United States should consider whether $812 billion devoted annually to health administration is money well spent.”

The new figures are based on an analysis of public documents filed by U.S. insurance companies, hospitals, nursing homes, home-care and hospice agencies, and physicians’ offices. Researchers from Hunter College, Harvard Medical School and the University of Ottawa compared those to administrative costs across the Canadian health care sector, as detailed by the Canadian Institute for Health Information and a trade association that represents Canada’s private insurers.

Compared to 1999, when the researchers last compared U.S. and Canadian health care spending, the costs of administering health care insurance have grown in both countries. But the increase has been much steeper in the United States, where a growing number of public insurance programs have increased their reliance on commercial insurers to manage government programs such as Medicare and Medicaid.

As a result, overhead charges by private insurers surged more than any other category of expenditure, the researchers found.

In U.S. states that have retained full control over their Medicaid programs, the growth of administrative costs was negligible, they reported. (The same was true for Canada’s health insurance program.) But in states that shifted most of their Medicaid recipients into private managed care, administrative costs were twice as high.

America’s Health Insurance Plans, a group representing private health insurance companies, said administrative practices shouldn’t be blamed for escalating the cost of care in the United States.

“Study after study continues to demonstrate the value of innovative solutions brought by the free market,” AHIP said in a statement. “In head-to-head comparisons, the free market continues to be more efficient than government-run systems.”

AHIP cited a recent report by the Medicare Payment Advisory Commission, an independent body that advises Congress. The report showed that Medicare Advantage plans — which are privately administered — deliver benefits at 88% of the cost of traditional Medicare.

Even so, the study authors concluded that if the U.S. health care system could trim its administrative bloat to bring it in line with Canada’s, Americans could save $628 billion a year while getting the same health care.

“The United States is currently wasting at least $600 billion on health care paperwork — money that could be saved by going to a simple ‘Medicare for All’ system,” said senior author Dr. Stephanie Woolhandler, a health policy researcher at Hunter College and longtime advocate of single-payer systems.

That sum would be more than enough to extend coverage to the nation’s uninsured, she said.

Public Wants Universal Health Care For This Country

Yesterday, I brought you a Monmouth University Poll that showed Americans don't like socialism (likely because they don't understand it). The charts above are from that same poll (done between April 11th and 15th of a national sample of 801 adults, with a 3.5 point margin of error).

Democrats have been pushing universal health care. Some want a single-payer system (like Medicare-For-All), while others want to improve Obamacare and add a public option -- but all want to cover all citizens with health insurance and lower the cost of medical care and drugs.

Trump and the Republicans have been labeling all the Democratic plans as "socialism". Considering what the people in this poll thought of socialism, one might think that would be the death knell for universal health care -- but it isn't. A significant majority of the public wants universal health care, and they are buying the GOP claims of socialism.

Note the charts above, about 58% say they would favor a universal health care plan, while only 37% would oppose it. And about 57% say it is not socialism, while that same 37% claim it is. The fact is that Americans want our health care system fixed. They want all Americans to get decent health care at a price they can afford -- and calling it socialism doesn't deter them from that view.

I think that's great. I don't care what those people call universal health care, as long as a viable version of it is instituted -- and evidently, most Americans agree.

Green Party - Best Cure For Ebola Is Health Care Justice

As the United States has recorded its first Ebola death and people in this country are starting to worry about the disease coming here, the Green Party reminds Americans that the best defense is a health care system that covers everyone. Here is the statement the party released on October 8th:

The United States’ broken health system adds to the risk of potentially catastrophic epidemic.

Doctors Margaret Flowers, Walter Tsou, and Jill Stein of the Green Shadow Cabinet comment on the U.S. health system in light of the global epidemic and the first confirmed case in Texas, Thomas Eric Duncan, who tragically died this morning.

Dr Margaret Flowers, Green Shadow Health Secretary:

Ebola is going to test health systems around the world in the coming months, and as we’ve seen in Africa, the measure of the impact will correlate with the ability of nations to implement universal public health measures. Here in the United States, corporate interest and its control of the political process has created the most expensive and exclusionary health system in the developed world. This is a dangerous setting for an epidemic.

We have a system designed first and foremost for profit, not for better health outcomes. This has not only created a sub-class of millions without coverage, but has also fragmented the system into private institutions, all with different systems and technologies. A major outbreak in the U.S. of Ebola, or some other disease, would find fertile incubation conditions like those in poorer communities and would be compounded by an uncoordinated response.

If this happens there will be a call for Government intervention, and those private health profiteers who rallied against public health on free-market ideological grounds, will demand assistance - a taxpayer bailout. The risk of an epidemic and its potential effect on markets should shake Wall Street’s belief in perpetuating the cruel and inefficient for-profit health system.

Dr. Walter Tsou, Green Shadow Surgeon General:

Media outlets stated that the diagnosis was missed because crucial travel information was not relayed through the electronic medical records system. But it was not widely publicized is that Mr. Duncan was a Liberian national on a US visa. It is very likely because US disallows Medicaid coverage for the first five years of immigration that he was also uninsured. What role did Thomas Duncan’s insurance status play in his initial dismissal from the emergency room?

Unfortunately, this is not a rare occurrence. Crowded housing conditions and barriers to health care, there could be substantial risk - even potentially a perfect storm in the making for Ebola to take root in the U.S. There are several lessons being driven home within the U.S. as around the world:

• First, our health care system which explicitly discriminates against immigrants is a disaster that is ill equipped to deal with uninsured individuals with highly infectious diseases like Ebola. Only a true single payer, universal health care system, inclusive of all immigrants, documented and undocumented, will be able to stop an epidemic.

• Second, our reliance on a for profit pharmaceutical industry which concentrates its research dollars on the chronic illnesses of wealthy developed countries like the US means that tropical diseases and filoviruses like Ebola and Marburg get ignored with no research dollars for vaccines or treatment for decades while we spend billions on erectile dysfunction drugs. After long neglecting the developing world, we are suddenly scrambling, grasping for anything that could be a cure when we should have been working for a cure for the past 30 years.

• Third, we ignore public health at great peril to our nation. There is almost nothing that could bring a world power like China to its knees, but in 2003 SARS did precisely that. China, who like the U.S. had high health access inequality, found that people with SARS like symptoms were not seeking medical care because they could not afford the bill. Instead they were spreading SARS throughout the country. It was only after they instituted a policy that all patients with respiratory symptoms would be seen regardless of ability to pay were they able to stop the epidemic. In a recognition of how important public health was to their economy, they tripled the budget of their CDC and built them a new campus.

Green Shadow Cabinet President and physician, Dr Jill Stein, says the Ebola outbreak clearly demonstrated the need for health justice:

The discussion of Ebola in the US has been sorely lacking in a public health reality check, which Dr. Flowers has raised. In fact, the massive gaps in US health care create pockets of vulnerability, that could seed local Ebola hot spots in the US.

The missed diagnosis of the first US Ebola case in Dallas is a red flag. This signal event resulted in a tragic delay of treatment and isolation, exposing up to 100 contacts, and potentially contributing to the patient's death. The diagnosis was missed because crucial information was not relayed through the electronic medical records system. Unfortunately, this is not a rare occurrence. Add to that crowded housing conditions and barriers to health care, there could be substantial risk - even potentially a perfect storm in the making for Ebola to take root in the US.

The lesson is being driven home within the US as around the world: Health injustice anywhere is a threat to health everywhere. A truly health-protective response to Ebola should include urgent measures to implement a Medicare-for-all health care system to insure we are all protected from Ebola now and from future epidemics that inevitably lie ahead.

Canada Is A Good Model For Health Care

Regular readers of this blog will know that I do not believe the Affordable Care Act (Obamacare) fixed our broken health care system. While it made some improvements and will result in more people being covered with health insurance, it fell far short of what was needed to fix the health care system -- and provide all Americans with accessible, affordable, and decent health care. What is needed, in my opinion, is a government-run single-payer health care system -- something like extending our Medicare system to include all American citizens (regardless of age).

An excellent example of a good health care system would be that of Canada -- and it would work well in the United States too. But first, we would need to change our mean-spirited ideas that taxes are bad and health care is not a human right. There are simply some things that government (through taxation) can do better than private interests -- and one of those things is providing health care for all citizens. This has been shown by the health care provided in most other developed nations -- who have government-run and financed systems, and provide better health care to all their citizens for less than half of what it costs in the United States (per capita).

Philip Caper, a Maine physician, has written an excellent op-ed for the Bangor Daily News on this issue. I encourage you to read the whole thing, but here is part of what he had to say:

Many conservatives still characterize Medicaid as “welfare,” and many think of it as such. Presumably other types of health care coverage have been “earned” (think veterans and the military, highly paid executives, union members and congressional staff). We resent our tax dollars going to “freeloaders.” Until the slicing and dicing is ended, the finger pointing, blame shifting and their attendant political wars will continue.

In sharp contrast, our Canadian neighbors feel much differently. Asked if they resent their tax dollars being spent to provide health care to those who can’t afford it on their own, they say they can’t think of a better way to spend them. “Isn’t that what democracy is all about?” I’ve heard Canadian physicians say, “Our universal health care is the highest expression of Canadians caring for each other.”. . .

No other wealthy country relies on the exorbitantly expensive and divisive practice of insurance underwriting to finance their health care system. They finance their publicly administered systems through broad-based taxes or a simplified system of tax-like, highly regulated premiums. Participation is mandatory and universal.

Taxation gets a bad rap in the U.S. and consequently is politically radioactive. Yet it is the most efficient, most enforceable and fairest way to finance a universal health care system. . .

Canada’s tax-financed health care system covers everybody, gets better results, costs about two-thirds of what ours does and is far more popular than ours with both their public and their politicians. There is no opposition to it in the Canadian Parliament.

What’s not to like about that?

Oh yes, and the average Canadian is now wealthier than the average American. Their far more efficient and effective tax-based health care system is part of the reason.

Health Care Reform Didn't Go Far Enough

This is a rather interesting graph from the Gallup Poll. It shows that while 57% of Americans are happy with the cost of their health insurance (most of them because their employer pays some or all of that cost). But the people on Medicare (and Medicaid) have a much higher percentage of satisfied customers -- about 76% (19 points higher). It makes me wonder if people wouldn't have been happier if all Americans were just put on a government-run single-payer system like Medicare. Did the health care reform fall short of what should have been done? Absolutely!

Lying About Obamacare

The Republicans are still trying to pass that lie off as the truth. But it is not now, and never has been true. There is a federal law that prevents the federal government from funding abortions -- whether through Obamacare or some other way. This is just one more lie among many that the Republicans tell about the Affordable Care Act, because they have no legitimate argument opposing it. It may not be perfect, but it is much better than the Republican alternative (doing nothing).

The Failure Of Medicaid

The idea of Medicaid was a good one -- to make sure the poor are able to get the medical insurance that they cannot afford any other way. But in practice, the program is a failure in many states. That's because the states have been put in charge of deciding who qualifies for the program and how much a doctor will be reimbursed for treatment. Some states have made it very hard to qualify for Medicaid, leaving many people without any kind of medical insurance, and other states reimburse doctors at such a low rate that it just doesn't pay them to accept Medicaid patients -- and some states do both.

The top chart shows the national figure for doctors refusing to accept any new Medicaid patients (or any Medicaid patients at all). The sad fact is that as many as one-third of doctors nationwide are refusing now to accept Medicaid patients -- meaning even if a person is able to qualify for Medicaid, it can still be difficult to find a doctor willing to treat them for what Medicaid will pay ( which in some states can be half what private insurance pays, or less).

The bottom chart shows the percentage of doctors in each state willing to accept Medicaid patients, with the states in red having the best percentage and the states in blue having the worst percentage (you can click on the may to get a larger version). It should come as no surprise that the states in red are also the states that pay the highest fees compared to private insurance (usually 70% or even higher).

The health care reform (usually called Obamacare) was supposed to fix Medicaid's problems, by making millions more people eligible for Medicaid and giving the states more money to run the Medicaid program. But thanks to a Supreme Court decision and the failings of Obamacare itself, it looks like all the problems were not fixed. The Supreme Court decision allowed states to refuse the new Medicaid eligibility and the money that comes with it, and just continue the program already in place.

Sadly, several states where Republicans are in charge have already said they will refuse to participate in upgrading Medicaid, and will continue their current program (and too many of those states are the blue ones, like Florida and Texas). In those states, millions of the poor will still have to survive without any medical insurance at all -- and even those lucky enough to qualify will continue to have trouble finding a doctor willing to treat them.

The failing of Obamacare is to leave the Medicaid program to be run by the individual states. This allows governors and state legislatures to play politics instead of covering people with insurance and paying doctors reasonable reimbursement.

I believe two things need to happen. The first is to make Medicaid a federally-operated system (like Medicare). This will give people in all states the same opportunity for coverage. But that won't completely cure the program. Note in the top chart that over one in four doctors also refuse to accept new Medicare patients. That's because although Medicare reimburses doctors a little better than Medicaid, it is still inadequate. The second thing that must happen is to adequately fund both programs, so more doctors would be willing to accept patients with both Medicaid and Medicare.

Unless both of these things are done, the goal of Obamacare (to cover most American with decent and adequate medical insurance) will not be achieved. Of course the most sensible thing would be to just cover all Americans with a single-payer government-run health insurance program (regardless of status or income). But short of that (which will come someday), the best we could do is to move Medicaid to federal administration and fully fund both Medicaid and Medicare. Letting people die because they can't afford health insurance is not an option (and only a Republican would think it is).  

A Conservative's Experience With Canada's Universal Health Care System

The right-wing has told a lot of lies to Americans about how evil single-payer government-run universal health care is, and sadly, too many people believe them -- keeping the United States from joining the rest of the developed world in adopting such a system. The following post from the site Permission To Live is one that I wish all Americans (especially conservatives) would read. It was written by a right-winger who had to live in Canada for a few years, and tells what she learned about "socialized" medicine. She says:

When I moved to Canada in 2008, I was a die-hard conservative Republican. So when I found out that we were going to be covered by Canada’s Universal Health Care, I was somewhat disgusted. This meant we couldn’t choose our own health coverage, or even opt out if we wanted too. It also meant that abortion was covered by our taxes, something I had always believed was horrible. I believed based on my politics that government mandated health care was a violation of my freedom.


When I got pregnant shortly after moving, I was apprehensive. Would I even be able to have a home birth like I had experienced with my first 2 babies? Universal Health Care meant less choice right? So I would be forced to do whatever the medical system dictated regardless of my feelings, because of the government mandate. I even talked some of having my baby across the border in the US, where I could pay out of pocket for whatever birth I wanted. So imagine my surprise when I discovered that Midwives were not only covered by the Universal health care, they were encouraged! Even for hospital births. In Canada, Midwives and Dr's were both respected, and often worked together. . .


Fast forward a little past the Canadian births of my third and fourth babies. I had better prenatal care than I had ever had in the States. I came in regularly for appointments to check on my health and my babies’ health throughout my pregnancy, and I never had to worry about how much a test cost or how much the blood draw fee was. I didn't have to skip my ultrasound because of the expense. With my pregnancies in the States, I had limited my checkups to only a handful to keep costs down. When I went in to get the shot I needed because of my negative blood type, in Canada it was covered. In fact I got the recommended 2 doses instead of the more risky 1 dose because I didn’t have to worry about the expense. I had a wide array of options and flexibility when it came to my birth, and care providers that were more concerned with my health and the health of my baby than how much money they might make based on my birth, or what might impact their reputation best. When health care is universal, doctors are free to recommend and provide the best care for every patient instead of basing their care on what each patient can afford.


I found out that religious rights were still respected. The Catholic hospital in the area did not provide abortions, and they were not required too. I had an amazing medically safe birth, and excellent post-natal care with midwives who had to be trained, certified and approved by the medical system.


I started to feel differently about Universal government mandated and regulated Health care. I realized how many times my family had avoided hospital care because of our lack of coverage. When I mentioned to Canadians that I had been in a car accident as a teen and hadn’t gone into the hospital, they were shocked! Here, you always went to the hospital, just in case. And the back pain I had endured ever since would have been investigated and cared for with whatever X-rays, Physiotherapy or even Surgery that was needed, which would have been at no cost to me. In our particular province, even chiropractic care was provided after a car accident by the provincial care insurance.When I asked for prayers for my little brother who had been burned in an accident, they were all puzzled why the story did not include immediately rushing him to the hospital. When they asked me to clarify and I explained that many people in the States are not insured and they try to put off medical care unless absolutely needed, they literally could not comprehend such a thing.


I started to wonder why I had been so opposed to government mandated Universal Health care. Almost every western country in the world has Universal Insurance of some kind, except the USA. Here in Canada, everyone was covered. If they worked full-time, if they worked part-time, or if they were homeless and lived on the street, they were all entitled to the same level of care if they had a medical need. People actually went in for routine check-ups and caught many of their illnesses early, before they were too advanced to treat. People were free to quit a job they hated, or even start their own business without fear of losing their medical coverage. In fact, the only real complaint I heard about the Universal Health Care from the Canadians themselves, was that sometimes there could be a wait time before a particular medical service could be provided. But even that didn’t seem to be that bad to me, in the States most people had to wait for medical care, or even be denied based on their coverage. Depending on where one lived and how rural the area was, one's access to care could be limited, and that was regardless of what country one lived in. The only people guaranteed immediate and full service in the USA, were those with the best (and most expensive) health coverage or wads of cash they could blow. In Canada, the wait times were usually short, and applied to everyone regardless of wealth. If you were discontent with the wait time (and had the money to cover it) you could always travel out of the country to someplace where you could demand a particular service for a price. Personally, I never experienced excessive wait times, I was accepted for maternity care within a few days or weeks, I was able to find a family care provider nearby easily and quickly, and when a child needed to be brought in for a health concern I was always able to get an appointment within that week. . .


I also discovered that the Canadian government looked out for its families in other ways. The country mandates one year of paid maternity leave, meaning a woman having a baby gets an entire year after the birth of her baby to recover and parent her new baby full-time, while still receiving 55% of her salary and her job back at the end of that year. Either parent can use the leave, so some split it, with one parent staying at home for 6 months and the other staying at home for 6 months. I could hardly believe my ears when I first heard it. In America, women routinely had to return to work after 6 weeks leave, many times unpaid. Many American women lost their jobs when becoming pregnant or having a baby. I knew people who had to go back to work 2 weeks after giving birth just to hang onto their job and continue making enough money to pay the bills. Also every child in Canada gets a monthly cash tax benefit. The wealthier families can put theirs into a savings account to pay for college someday (which also costs far less money in Canada by the way), the not so wealthy can use theirs to buy that car seat or even groceries. In the province we lived in, we also received a monthly day care supplement check for every child under school age. I made more money being a stay at home mom in Canada than I do in the States working a part-time close to a minimum wage job. And none of the things I listed here are considered “welfare” they are available to every Canadian regardless of income. For those with lower incomes than we had there are other supports in place as well. . .


Since all of these benefits are available to everyone, I never heard Canadians talking about capping their incomes to remain lower income and not lose their government provided health coverage. Older people in Canada don’t have to clean out their assets to qualify for some Medicare or Social Security programs, I knew older people who went in for procedure after procedure, and we never heard about dwindling resources, kids paying for their parents medical expenses, or being forced to use up life insurance or funeral savings in order to get the health care they needed. I heard of inheritances being left even amongst the middle classes. Something I had only heard about in wealthy families in the USA.


And lest you think that the Canada system is draining the government resources, their budget is  very close to balanced every year. They’ve had these programs for decades. Last year Canada’s national debt was 586 billion dollars, the USA has 15.5 trillion dollars in national debt. Canada has about one 10^th the population of the US, so even accounting for size, the USA is almost 3 times more indebted. And lest you think that taxes are astronomical, our median income taxes each year were only slightly higher than they had been in the States, and we still got a large chunk of it back each year at tax time.


In the end, I don’t see Universal health care as an evil thing anymore.

We Still Need "Single-Payer" In The U.S.

If you've read this blog for very long, then you know I believe this country needs a government-run single-payer health care system -- Medicare for everyone. I have said it many times and in many different ways. For me, it is the only logical answer to our broken health care system. Obamacare was a good step in the right direction, but it falls far short of what is really needed.

A friend and fellow blogger, vjack of the excellent blog Red State Progressive, has written a very good post on this subject. I agree with every single word he has written, so I am reposting his intelligent analysis here:

The debate of health care reform in the United States has been focusing on the wrong questions. Obsessing over whether the Affordable Care Act makes President Obama (and Mitt Romney) socialists is pointless. Deciding whether an individual mandate is a penalty, a tax, or something else entirely is relatively trivial. We should be asking ourselves how to expand coverage, reduce costs, and improve patient care. Fortunately, there is an obvious answer.


Expanded Access to Healthcare


We need to reduce the number of uninsured people down to zero. Not only is this a moral imperative (i.e., health care should be a basic right and not a privilege), but our health care costs are higher because of the large number of uninsured people we now have. That is, those of us with health insurance pay much higher costs than necessary to subsidize the uninsured. The U.S. needs to join the rest of the industrialized world by providing universal healthcare.


Affordable Healthcare


It makes little sense that people would end up in poverty in the wealthiest nation on the planet simply because of a medical emergency. Our healthcare costs have gotten out of hand, and little relief is in sight. Expanding access is prohibitively expensive as long as we remain wedded to our current healthcare system. However, we already have two extremely effective models for how to simultaneously expand access to healthcare and control costs: Medicare and the VA healthcare system. 


Improved Healthcare


The U.S. spends more on healthcare than any other industrialized nation, and our healthcare outcomes are not particularly good. Other nations offer superior care for much less money. Too much of what we spend for healthcare does not go to patient care at all but to the insurance and pharmaceutical industries. Along with improving access to healthcare and bringing down healthcare costs, we need to focus on improving patient care across the system.


The Solution: Single-Payer


The solution is fairly obvious: the U.S. needs a national healthcare system. If you poll the general public, you will find that a majority support a single-payer national healthcare system. If you poll physicians, you will find the same thing. If you examine the data in other industrialized nations with single-payer systems, you find universal coverage, lower costs, and better patient outcomes.


The Obama administration shut down serious discussion of a single-payer system early in the process and killed the public option next. This is unacceptable. The Affordable Care Act may be a small step in the right direction, but it ignores the obvious reality that we need a single-payer system.

Socialized Medicine? - Not Even Close To It

Ever since President signed the health care reform bill into law (commonly referred to as "Obamacare"), the right-wing Republicans have been throwing a screaming fit about it. And the most popular epithet they use is to call it "socialized medicine". They know that the American public has been deluded into thinking that the word "socialized" (along with the words "socialist" and "socialism") could only refer to something bad. But is Obamacare really socialized medicine?

To understand whether Obamacare is really socialized medicine, we must understand what socialized medicine is. Here are two good definitions I found after googling the term:

The provision of medical and hospital care for all by means of public funds.


A government-regulated system for providing health care for all by means of subsidies derived from taxation.

The United States does have some programs that would qualify as socialized medicine, but they were around long before Obamacare was even being considered. They are Medicare, Medicaid and Veterans Hospitals -- popular programs that work well (when adequately funded) and which are supported by a large majority of Americans. Neither of these programs was changed by Obamacare, except to make them a little more fiscally sound (and to qualify more really poor Americans for Medicaid).

But those programs only affect those over the age of 65 and those who are destitute. The vast majority of Americans were not put on a government medical system by Obamacare. Most Americans will keep the private insurance plans they already have (whether employer-provided or privately purchased). The only real change (other than laying down some rules which private insurance companies must follow) is to make those who are trying to skate by without health insurance take responsibility by purchasing their own private health insurance.

That's a good thing because when those without health insurance pile up large medical bills and can't pay for them, then their care must be paid for by the rest of us (either through higher hospital and doctor charges or through increased private insurance premiums -- usually both). And to prevent this from being an onerous burden on those who can't afford the full cost of private insurance, the government will provide some people with subsidies to help them purchase private health insurance (and allow each state to provide insurance market groups to lower private insurance costs).

This is far from socialized medicine. Doctors and hospitals will still be private businesses. And while some more Americans (the very poor) will be added to Medicaid, the main effect of Obamacare will be to cover many more Americans with insurance provided by private insurance companies.

In fact, a good case can be made the the system of medical care in effect before Obamacare is much closer to socialized medicine than Obamacare is. Here is what Thomas L. Friedman says in his New York Times column:

 . . .socialized medicine is what we have now! People without insurance can go to an emergency ward or throw themselves on the mercy of a doctor, and the cost of all this uncompensated care is shared by all those who have insurance, raising your rates and mine. That is socialized medicine and that is what Obamacare ends.

Personally, I am in favor of socialized medicine. I believe the United States would save money and provide excellent care for all Americans by going to a single-payer government run health insurance system (similar to those of Canada or France). But Obamacare does not even approach that. The biggest effect of Obamacare is to increase the number of people covered by private insurance companies.

Obamacare is NOT socialized medicine. It is not even close. And the craziest thing about this whole argument is that the same party now calling it "socialized medicine" is the party that originally came up with the plan -- the Republican Party. Obamacare is virtually identical to the plan proposed by Republicans as an alternative to the health care plan proposed by the Clinton administration (which was much closer to socialized medicine).

Health Insurance And Republican Hypocrites

Many of the new Republicans elected to Congress about three weeks ago (and a lot of the Republicans re-elected) campaigned on repealing the new health care reform law.   Some of them even made repealing health care a centerpiece of their campaign.   In a few short weeks, they will be taking office and they are already being schooled on House and Senate rules and benefits of being a senator or representative.   One of those benefits is that they get free health care -- the very thing they campaigned on denying to millions of ordinary Americans.

To some people, including myself, it seems more than a little hypocritical to campaign on a platform of repealing government health care for millions of Americans, and then turn around and accept free government health care for themselves after getting elected.   Rep. Joe Crowley (D-New York) thought so and he challenged those opposed to government health care for ordinary citizens to be honest and refuse to accept it for themselves.

It looks like the American people agree with Rep. Crowley.   A Public Policy Polling survey taken from November 19th through 21st shows that a healthy majority of Americans think those senators and representatives who campaigned against health care should not accept the free health insurance offered to them by the government.

Now you may think this is just the feeling of some "sour grapes" Democrats trying to get back at those who want to repeal health care.   Not true.   The Democrats polled actually had a larger percentage that thought they should accept the health care than the general public or the Republicans.   In fact, it was the Republicans surveyed who had the biggest percentage thinking they should not accept the government health insurance.

It looks like these new (or old) Republicans might have campaigned themselves into being between a rock and a hard place.   Their own supporters believe they should stop the hypocrisy and opt out of government healthcare.   If they don't, they run the risk of irritating those who put them in office (and there could be a fringe teabagger opponent waiting for them when they run for re-election).   And if they do opt out, then they will have to pay thousands of dollars to buy their own health insurance.

Here is what the people said when asked if those who campaigned against government health care should accept or decline their own government-supplied health insurance:

GENERAL PUBLIC
Accept...............33%
Decline...............53%
Not sure...............15%

DEMOCRATS
Accept...............37%
Decline...............49%
Not sure...............14%

REPUBLICANS
Accept...............28%
Decline...............58%
Not sure...............14%

There have been a couple of the new Republicans that have decided to turn down the government insurance and buy their own.   I guess the hypocrisy was just a little too much for them to accept, and while I don't agree with their policy of denying health care to ordinary Americans, at least they are honest enough not to accept what they want others to do without.   The two Republicans who are turning down the government health insurance are Rep. Mike Kelly (R-Pennsylvania) and Rep. Bobby Schilling (R-Illinois).

But it looks like all of the other incoming and re-elected Republicans will be accepting the free government insurance.   I just have one word for them -- HYPOCRITES!   The government shouldn't provide anything for a senator or representative that it's not willing to provide to all Americans.

Meanwhile, it doesn't look like the Republicans have the mandate they are bragging about to repeal health care reform anyway.   A new McClatchy/Marist poll shows that a majority of Americans want to either keep the new health care law as it is or make it even stronger.   It's a minority of those polled who would weaken or repeal the law.

This may confuse some since many recent polls have shown a majority are not happy with the health care reform law.   But many of those who don't like the new law, like myself, are unhappy because it didn't go far enough, not because it went too far.   When you add those who think the new law didn't go far enough to those who like the new law, it is a majority of Americans.   This shows there is no mandate given Republicans to repeal the law.

Here are the poll numbers:

Keep it or expand it...............51%
Weaken it or repeal it...............44%
Unsure...............5%

Government-Run Health Care

As the health care reform debate heats up, we've heard all sorts of ridiculous things from the Republicans and right-wingers about "socialized medicine" -- the name they give to the government-run health care systems adopted by almost all industrialized countries. They call it "evil" and tell all kind of horror stories about how bad it is.

In fact, they've told so many lies about the government health care in other countries, that some of those countries are starting to get angry. When the right-wing put Canadian Shana Holmes on American TV to lie about the Canadian system, tens of thousands of Canadians were incensed, and let it be known they don't appreciate Americans lying and spreading falsehoods about their system.

The English are starting to react also. They have started a Twitter group expressing pride in their National Health System (NHS), and tens of thousands of people have expressed their support for the NHS. Prime Minister Gordon Brown even joined the fray, twittering, "PM: NHS often makes the difference between pain and comfort, despair and hope, life and death. Thanks for always being there." His wife then added, "#welovetheNHS -- more than words can say."

An American business magazine recently said under the British system, scientist Stephen Hawking would be dead. Evidently they didn't know he was born and lived all his life in Great Britain. Hawking himself says, "I wouldn't be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived."

You might say those are the liberal views, but what do the conservatives think? Well, here's what Conservative Party leader David Cameron has to say, "Millions of people are grateful for the care they have received from the NHS -- including my own family. One of the wonderful things about living in this country is that the moment you're injured or fall ill -- no matter who you are, where you are from, or how much money you've got -- you know that the NHS will look after you."

In Canada, Great Britain, France, Sweden and most other industrialized nations, the people like their "socialist" health care that gives all citizens decent health care. Some politicians might like to tweak the system to make it even better, but none would dare suggest doing away with it and going to a system like ours. If they did, they'd be voted out of power in a heartbeat (and they know it).

That poses a question. Since all of these countries love their government-run systems that covers all their citizens, and most Americans agree that our own system is badly broken, why is health care reform so difficult in America? Why are we so sure none of the systems used by other nations would not work here? And why are we so terrified of the word "socialism" -- especially since most Americans don't even know what it is?

MediCare is socialist, and it has done a pretty good job of providing health care for our elderly. The fact is that there are some things government can do better than private industry (regardless of what Republicans may tell you).

Would you want the police or military to be private and only work for those who can pay? How about the fire department -- should they let your house burn because you can't meet their profit expectations? The same is true of health care. The government can eliminate the profit and the overhead and provide cheaper and better health insurance. That's a fact even the private companies recognize (which is why they're fighting it so hard).

Government-run health insurance is not evil. It's just the fairest and least expensive way to give all citizens decent health care. And that's what we should be trying to do.