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Title: The United States Does Not Have The Best Health Care System In The World
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Published: Aug 3, 2009
Author: Examiner.com
Post Date: 2009-08-03 18:37:34 by Brian S
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Views: 257
Comments: 20
In fact, it's not even close to being the best health care system in the world. Republicans have fought President Obama on every bill he has worked on and health care reform is no exception. Senator Richard Shelby (R), Alabama, said that President Obama's health care plan is the "first step in destroying the best health care system the world has ever known." Senator Chuck Grassley (R), Iowa, told a constituent in a town hall meeting that if he wanted health insurance to get a job with the government. Perhaps Grassley would like the government to provide 47 million jobs to solve the problem of the uninsured in America. There are several important aspects about the United States health care system that make it one of the worst of all the industrialized nations. First is the cost: The truth is that Americans pay more for health care than any other country in the world and yet the health care Americans receive is ranked by the World Health Organization (WHO) 37th in overall performance and 72nd in overall level of health of the 191 nations included in the 2000 study. It's not all bad however, the U.S. is ranked high in catching rare cancers early. In 2008, a report by the Commonwealth Fund ranked the U.S. last in the quality of health care among the 19 countries compared. The United States has the highest infant mortality rate of all develped countries. And yet, the Commonwealth Fund reports that the U.S. "leads all industrialized countries in the share of national health care expenditures devoted to insurance administration. The United States is the only wealthy, industrialized, developed country in the world that does not offer health care to all of its citizens. Medical bills prompt more than 60% of all U.S. bankruptcies according to CNN. Bankruptcies attributed to medical bills increased by nearly 50% from 2001 to 2007. 75% of all people who went bankrupt because of medical bills had health insurance. Private health insurers are in the business of making money and they do, lots of it. One of the ways they continue to make such large profits when the rest of the country is suffering an economic crisis, is by denying people medical care through the use of loopholes. In Texas, a woman with breast cancer needed to have both breasts removed to save her life and her insurance company refused to pay the cost of her surgery due to her pre-existing condition of acne. This is just one example among thousands that have bankrupted Americans who had private health care insurance. Another way the private health insurance companies keep making record profits is by charging Americans more. Insurance premiums have risen at more than twice that of inflation. Worse, according to the NCHC (National Coalition on Health Care), the average employee contribution to company-provided health insurance has increased more than 120% since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115% during the same period. Though Republicans like Senator Shelby insist that America has the best health care system in the world, the facts show that that the United States has one of the worst health care systems of all the developed countries in the world. It is clear that cost factors heavily into why the U.S. has one of the worst health care systems in the world. Senator Shelby himself, is a recipient of a public option, though he would deny it to his constituents in Alabama and in the rest of the nation. All federal employees have access to the Federal Employees Health Benefits Program which is a system of managed competition. Though private insurance companies provide health care insurance to federal employees, so do labor unions and other employee associations. This creates competition but more importantly, the government pays the greater bulk of your senator's health insurance. In other words, you and I, as taxpayers are paying the bulk of the health care given to Senators and all federal employees, why can't we have the same option? To get an idea of how much your Senator and Congressional representatives in Washington pay for their health insurance premiums, you can find out here. Your senator can choose between an HMO or a Fee for Services insurance plan and there are a large number of options available. Here is just the first page of choices that Senators Shelby and Grassley can choose their public health option from: Health care reform is crucial to the economic success of the United States. When most bankruptcies are caused by medical crises, and 75% of those who went bankrupt because of medical crises had private health insurance, the system is broken. It's certainly not "the best health care system in the world." The second aspect that makes the U.S. health care system one of the worst of all developed nations in the world is the quality of health: The United States ranks only 27th in life expectancy of 189 countries. Of the 30 OECD (Organization for Economic Co-operation and Development) nations, the United States ranks only 22nd in life expectancy. Only Portugal, South Korea, the Czech Republic, Mexico, Poland, Slovakia, Hungary and Turkey have lower life expectancy rates than the United States. The United States ranks 25th in infant mortality rates among the 30 OECD nations. Only Turkey, Hungary, Slovakia, Poland, and Mexico have higher infant mortality rates than the United States. Conservatives like to compare the U.S. health care system to the health care systems of the U.K., Canada and France as if the Canadian, France and British health systems are not as good as the United States health care system. Canada's life expectancy average is 82.1 years. The life expectancy for citizens of France is 80.9 years and the average life expectancy of those living in the U.K. is 78.9 years. In the United States, the average life expectancy rate is 78.1. But more importantly than life expectancy averages is the fact that in each of those nations, every single citizen has access to health care. The United States is the only developed country in the world that does not offer health care to all of its citizens. The third aspect of why the United States does not have the best health care in the world ties the first and second together and is tremendously important to the future of the United States' economy: Because there are 47 million Americans (and that number will continue to climb) who have no health insurance coverage, emergency rooms are clogged with people who have no other way to get treatment for illnesses such as ear infections, flu, and strep throat. Not only does this contribute to a lower efficiency in emergency rooms for true medical emergencies such as heart attacks, it is enormously expensive. Uninsured Americans have little choice and often turn up in emergency rooms for simple illnesses. Treating a patient in the hospital emergency room for strep throat is very expensive and taxpayers shoulder the burden. While some are afraid that if every American has health insurance through a public option such as the one their Senators enjoy, they will pay the price in taxes, what they should know is that they are already paying the price and the price is much higher than it would be to offer simple public health care options that veterans, government employees and the elderly have. If we continue to ignore the growing number of uninsured people in this country, we are going to continue to pay more in taxes for their care when they end up in the emergency room with a fever and a sore throat than if they were insured with a basic health insurance option like Senator Shelby and Senator Grassley enjoy. One would think that uninsured people could visit a family doctor when they have a fever and sore throat and pay the doctor in cash. But it doesn't work that way. A few years ago, my health insurance company fled the state in the middle of the night leaving me uninsured for several months. As a small business owner, I must pay for my own insurance and I pay more than twice what Senator Shelby does for his entire family for a single person in good health. When I was sick, I tried to get in to see a doctor when I had what turned out to be pneumonia. Even though I told each doctor's office I called that I would pay the bill in cash, none of the physicians would see me because I didn't have health insurance. The United States does not have the best health care system in the world. Even if you have what you think is excellent health care insurance, you cannot be sure that if you have a devastating illness that your insurer will pay for your health care expenses as over 60% of those who had to file bankruptcy found out. Insurance companies are in the business of taking health care premiums from the insured and working doubly hard not to pay out when the client is sick. Former senior executive of Cigna, Wendell Potter told a Senate Committtee in July, "I worked as a senior executive at health insurance companies and I saw how they confuse their customers and dump the sick: all so they can satisfy their Wall Street Investors." Potter was the company's top PR executive and reported, "This is a very wealthy industry and they use PR very effectively. They manipulate public opinion and the news media and they have built up these relationships with all these politicians through campaign contributions." The United States does not have the best health care system in the world. The United States ranks behind all other developed nations in the world in life expectancy, infant mortality rates, efficiency, cost and overall care. If the United States continues to deny health care coverage to the 47 million people that are uninsured, the burden of cost on taxpayers will continue to rise as more and more desperate people rely on emergency care at hospitals for routine illnesses. Unless you make $250,000 or more a year, your taxes will not be affected by offering health care coverage to the uninsured in this country. If you are so unlucky as to make a quarter of a million or more a year, I'm afraid your taxes will increase by about 3%. But if we continue to refuse health care services to the 47 million people who are uninsured, your taxes will be much higher in the future as 47 million people rely on hospital emergency rooms for their routine health care needs. It is time for Americans to have a public option like Senator Shelby and Senator Grassley have.
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#1. To: Brian S (#0)
Private health insurance is useless. There are too many "quacks" overcharging patients for shoddy medical care in this country.
what do you think is a better option?
#4. To: christine (#3)
Unconscionable Math July 28, 2009 by Taunter The House hearings on rescission – the retroactive cancellation of individual health insurance policies – were over a month ago, but after its initial run through Daily Kos it seems to have waited a bit before popping up on Baseline and Slate. James Kwak at Baseline described the practice as rare, affecting only 0.5% of the population. The faint light bulb above my head began to flicker: could that be true…that’s not rare – that is amazingly common. It is. In fact, from Don Hamm’s (CEO of Assurant) prepared testimony, with the company logo nicely on the front of it in the original: Rescission is rare. It affects less than one-half of one percent of people we cover. Yet, it is one of many protections supporting the affordability and viability of individual health insurance in the United States under our current system. What tangled webs we weave… To understand why 0.5% of the people Assurant covers is a lot of people – a jarring, terrifying, probably criminal lot – you need to understand a little bit of math. You need to understand just enough math to understand what Don and his legal team are not telling you. You need to understand conditional probability. And the folks at Assurant are counting on the fact that you don’t. A typical job interview question for aspiring finance folks is the Monty Hall Question. As typically phrased, you go on a game show and are asked to pick one of three doors. Behind two of the doors are goats. Behind one is a shiny new car. You pick a door. The host ceremoniously opens a door that you did not pick, and behind it is a goat. He turns to you while the audience giggles at the goat. Do you want to change your pick? As I have pointed out on the Idea Locker comments, this typical phrasing is a bit unfair. If you haven’t seen the show, you might think the choice of what door the host opened was random, unrelated to the door you picked. Since there is no correlation, you don’t see why you should change your pick. If someone asked you to call the third of three coin tosses in a row, you wouldn’t change your pick if the first two were heads, would you? But the nuance of the game is that the door is not random. The door that is opened will always meet two conditions: It is not the door you picked originally (or else what would be the point of carrying on) It is not the door with the car (that would certainly bring things to a close) You had a 1/3 chance of being right in your initial pick. That means there was a 2/3 chance the car was behind “not your pick”. Well, if you change your pick now, you cover the entire “not your pick” set – you have seen one of the two doors, know that it’s empty, and now have the payoff from the other. You should change your pick. Here’s the health care nuance (2005 HHS report based on 2002 data): Half of the insured population uses virtually no health care at all. The 80th percentile uses only $3,000 (2002 dollars, adjust a bit up for today). You have to hit the 95th percentile to get anywhere interesting, and even there you have only $11,487 in costs. It’s the 99th percentile, the people with over $35,000 of medical costs, who represent fully 22% of the entire nation’s medical costs. These people have chronic, expensive conditions. They are, to use a technical term, sick. An individual adult insurance plan is roughly $7,000 (varies dramatically by age and somewhat by sex and location). It should be fairly clear that the people who do not file insurance claims do not face rescission. The insurance companies will happily deposit their checks. Indeed, even for someone in the 95th percentile, it doesn’t make a lot of sense for the insurance company to take the nuclear option of blowing up the policy. $11,487 in claims is less than two years’ premium; less than one if the individual has family coverage in the $12,000 price range. But that top one percent, the folks responsible for more than $35,000 of costs – sometimes far, far more – well there, ladies and gentlemen, is where the money comes in. Once an insurance company knows that Sally has breast cancer, it has already seen the goat; it knows it wants nothing to do with Sally. If the top 5% is the absolute largest population for whom rescission would make sense, the probability of having your policy cancelled given that you have filed a claim is fully 10% (0.5% rescission/5.0% of the population). If you take the LA Times estimate that $300mm was saved by abrogating 20,000 policies in California ($15,000/policy), you are somewhere in the 15% zone, depending on the convexity of the top section of population. If, as I suspect, rescission is targeted toward the truly bankrupting cases – the top 1%, the folks with over $35,000 of annual claims who could never be profitable for the carrier – then the probability of having your policy torn up given a massively expensive condition is pushing 50%. One in two. You have three times better odds playing Russian Roulette. People lie on their insurance forms, of course, and that is a serious problem. But let’s not forget that the very nature of the forms is designed to create inaccuracies, and it doesn’t matter in the slightest how minor the error may be once the company comes looking to get out of its policy. Back to Don Hamm: I mentioned a story in my comment on the Baseline article, and it’s a favorite of mine, so I’ll repeat it here: Years ago I was walking a casino floor with a casino executive. It was an incredibly detailed tour, and we got to talking about pretty much everything that came to mind about crowds and gaming. Now, a clever observer might notice that even the tolerant people of Nevada will not allow alcohol in vending machines – wouldn’t want the little ones to be able to get a Bud Light without a human being verifying their ID. But there we were in the middle of acres of blinking lights, with absolutely no one making sure that underage kids weren’t walking up to a slot machine. Indeed, they don’t card for the table games. The executive told me you are free to play if you are underage, you just aren’t free to win. You can sit down and pump your money into the slots, and if you look presentable you can drop some chips on blackjack or craps. However, if you should happen to start winning, the pit boss or security team will come over and check your ID. The house edge is 100%. Conditional probability is tough for the human brain. We tend to think of things as either completely correlated (once the market tanked, McCain had to lose) or completely uncorrelated (coin tosses). To a certain extent, we make the calculations in everyday speech: when someone says that pancreatic cancer is exceptionally lethal, he doesn’t mean that it is likely to kill an enormous number of people; he means it will kill an enormous percentage of the people who contract pancreatic cancer. Get a bit more tangential and even very smart people with Nobel Prizes miss things; one of the reasons Long Term Capital Management melted down was that once they started sustaining heavy losses, people bet against LTCM’s other holdings – LTCM itself was the correlation. Low frequency, high severity events are also difficult for us to process – look at how much we invest fighting air piracy versus the sacrifices we are unwilling to make on drunk driving or domestic firearm violence. Put them together and the guys with the actuaries working for them have a nearly insurmountable advantage. I tend to think of traditional banking and traditional insurance as mirror images: when you take out a mortgage, you get a lump sum and make a series of payments; when you get life insurance, you make a series of payments and get a lump sum. Health insurance is somewhat similar to life insurance, except the payout happens sometime during the payment stream instead of at the end. When a person intentionally defaults on consumer credit, he is called a “ruthless defaulter” and the system, to the extent that it operates with any sort of efficiency, is designed to try to flush him out of the credit market in the future. Society can tolerate taking the risk of inadvertent defaults – the people who through some sort of misfortune are unable to make good their promised payments. The folks who do it on purpose…do it enough and the FBI might step in. The insurance industry has a bit of a historical difference, in that pretty much everything in health insurance is similar to a liar loan. I tell the company if I have been sick, just like stating an income on a mortgage application. For a host of administrative and medical privacy reasons, the insurance industry has not historically wanted a comprehensive inventory of medical records before taking a client. Few people could probably deliver such a record even with the best of intentions. There is a problem with liar loans, and it was well described by Tanta (Calculated Risk’s late writing partner) here: Well, with Number 1 [a liar loan that has gone bad], it’s “clearly” the borrower’s fault. He or she lied, and we can pursue a deficiency judgment or other measures with a clear conscience, because we were defrauded here. We can show the examiners and auditors how it’s just not our fault. The big bonus, if it’s a brokered or correspondent loan, is that we can put it back to someone else, even if we actually made the underwriting determination. No rep and warranty relief from fraud, you know. It is in the health insurer’s interest to have application fraud, not only because it saves time and expense on the front end, but also because it lets them get out of any policy that isn’t going well for them. If the health insurer had to verify the information – if, in essence the insurance company had to behave as an accredited investor with adequate expertise to make a decision without reliance – it wouldn’t have the opportunity to bail out. It would catch more genuine liars, but many of these liars would have turned out to be healthy, profitable customers, and what the carrier really wants is a population devoid of expensive claims, not devoid of liars. Years ago, the shameful business was the tobacco industry. There was a certain roguish charm to them; they had great ads and were fun outgoing people, and of course they made a product that if used as directed would kill you. Say this for the tobacco folks: they printed the dangers right there on the pack. Few people who took up smoking after World War II did so with ignorance of the health consequences. Society wants tobacco, it might as well be produced in clean factories and wrapped in cellophane as opposed to sold on street corners. I hope we legalize marijuana and let Altria and RJR make joints and put the Mexican cartels out of business. No, the health insurance companies sneak around. They have nice facades, they speak in the bureaucratic language of statistics few understand, and they make the eminently reasonable argument that they just need to protect themselves. They promise great coverage, and when many years later it comes time to pay out and the petitioner is sick and unable to function, sorry, wish we could do better, but there was an error and rules are rules. We’re keeping the premiums. It’s actually far more like this guy: Bernie Madoff made people promises, and people believed them, because was it really possible that the former chairman of the NASD was running a scam? Come on. But he was, and his reputation was no more a shield to the defrauded than the huge balance sheets of the health insurance companies mean an individual claimant is going to get covered. The minute he began transferring money from one account to another and then raising external capital to try to square the numbers, he knew exactly where this was going. The insurance companies know too; they just know well enough to avoid outrunning the law. I don’t know if this case is going to be the lever the Democrats need to get meaningful healthcare reform. The Democrats don’t even seem to be able to line up on the same side, which is probably a necessary precursor to getting something passed. The Taunter Drug Plan for lower prescription drug costs doesn’t seem to have taken the Internet by storm, so I give this post low odds of breaking through. But I will make this simple point in the hope some speechwriter pressed for a deadline picks it up: if a bank manager went to half of his highest net worth clients and said “sorry, you misspelled your address when you opened your account, I’m confiscating your balance,” he would be lucky to get himself assigned to minimum security. -------------------------------------------------------------------------------- Possibly related posts: (automatically generated) I’ll have the, ummm, health care please. Mandated health care Paul Krugman: The Conscience of a Liberal Obama, Democrats Shift Health Debate to Target Insurance Companies
Om mani padme hum
I think the main problem with the health care system is the "allopathic" cut, burn and poison medicinal monopoly and that is in most nations weather practicing Socialist (single-payer) or "capitalist" (multi regulated Insurance company and "managed care" company payer) systems.
Top • Page Up • Full Thread • Page Down • Bottom/Latestmost bankrupcies are caused by medical crises, and 75% of those who went bankrupt because of a medical crises had private health insurance, the system is broken.
#3. To: sizzlerguy (#1)
Replies to Comment # 3. tauntermedia.com/2009/07/28/unconscionable-math/
#6. To: christine (#3)
better option
#19. To: christine (#3)
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