By DOMENICK BUSCEMI
The Morning Call
March 15, 2007
”Rationing in the U.S. system is based on income: If you can afford care, you get it; if you can’t afford it you don’t.”
Local op-ed columnist John Brinson wrote last month about Gov. Ed Rendell’s ”Prescription for Pennsylvania” proposals and health care in general. I see things much differently.
He asserted that this country has the best health-care system in the world. But a 2000 study by the World Health Organization based on various indicators (including disability-adjusted life expectancy, child survival to 5 years of age, social disparities in care, experiences with health-care system and out-of-pocket health care expenditures) found the average ranking of the United States to be 15th out of 25 countries. In another study of 11 Western countries, the U.S. was ranked last with respect to its primary care base and its per capita health care expenditures (the highest).
He said that problems in health care today are due to government interference in the marketplace. I think the truth is quite the opposite. A single-payer system would dramatically reduce administrative costs. Under our current market-driven system, administrative costs, including all paperwork and billing, are about 24 percent of our health-care budget. Our Medicare system overhead, on the other hand, is less than 4 percent. More than half of our health dollars are already tax-supported (Medicare, Medicaid, government employees, military, tax breaks to providers, etc.), and any new taxes needed would be offset by decreased insurance premiums and out-of-pocket costs.
Brinson also said government mandates and price controls result in long waits and lower quality. Statistics prove him wrong. The reason we hear more about these stories in the other countries is because their health care systems are publicly accountable, while ours is not. So, problems are aired in public. In the United States, no one is ultimately accountable for how health care works. Rationing in the U.S. system is based on income: If you can afford care, you get it; if you can’t afford it you don’t. This is the reason many Americans die needlessly every year. No other industrialized nation rations health care to the degree that the United States does. Yet, a number of studies, notably by the General Accounting Office in 1991 and by the Congressional Budget Office in 1993, show that there is more than enough money in our health-care system to serve everyone, if it were spent wisely. One example is administrative costs, which are far higher in the United States than other countries.
His statistics on the uninsured don’t give the reasons why people eligible for Medicaid haven’t signed up. (Perhaps the regulations are too confusing.) He also doesn’t take into account that the cost of COBRA insurance ($800 to $1,200 a month) is prohibitive for many unemployed people. He mentions people who have no insurance for two years or less because they can’t afford it, or worse, are uninsurable, but he brushes over this injustice as if it were insignificant. I say these are reasons why we need universal coverage.
His solution is to give employees tax deductible money to buy insurance. Isn’t this, in effect, government-sponsored health care? Can you imagine the pressure and misinformation to which the average person would be subjected by competing health insurance agents? It also adds to the cost of overhead to pay for the brokers and insurance agents who sell the coverage. He doesn’t elaborate on the amount or kinds of insurance that would be purchased by a $200-a-month policy. His suggestion about people turning to charitable hospitals for care has little respect for a person’s dignity. Furthermore, his claim that it’s efficient to pass the cost of care for the uninsured on to people with insurance is absurd. This care is frequently provided by expensive emergency rooms, when a preventative care visit to a doctor’s office would be more efficient.
The obvious solution to the problem is to stop making a profit from the sickness and misery of human beings. Facts point to a single-payer, universal health care system where everyone pays his or her fair share and everyone receives equal access.
Domenick Buscemi of Lower Mount Bethel Township is the organizer for the Lehigh Valley Healthcare Reform Meetup Group (http://healthcare.meetup.com/26/ ) and is the former president of Teamster Local 773 in Allentown. His e-mail address is buscemi@ptd.net.
