Responding to a collection of letters broadly critical of a piece by right-wing columnist David Brooks in the NYT (republished here), the following letter was published today. I’ve put in a few words of commentary:
“The Health Care America Wants” (letters, Sept. 10) highlighted arguments of readers who advocate for the flawed and extremely controversial single-payer system.
It’s only in the US that single-payer systems (AKA comprehensive, free public healthcare) are controversial. There’s no clamor in the UK or Canada to abolish the health care systems in order to move towards a US-style model.
There is however a considerable number of ordinary people in the US who favor changing the US system. 54% of respondents in an NYT/CBS survey said that “fundamental changes are needed” in the health care system. Thus, it’s the US healthcare system that is controversial.
After reading their submissions, I’m convinced that these writers are oblivious to the problems that accompany government-run care.
Virtually all countries with a single-payer model have been plagued by perilous problems, including substandard care, long waiting lists, loss of physicians, forced outsourcing and health care rationing.
There are problems with all healthcare systems. Those alluded to are, however, exaggerated.
Problems in the US: Insurers find it in their financial interest to deny care to people with serious illness. The majority of bankruptcies in the US are caused by healthcare costs. Most of those who went bankrupt had health insurance.
US healthcare is substandard compared to other industrialized nations. If you’re a woman in the US you’re more likely to have an unnecessary cesarean (because it earns more for the hospital). If you’re a woman in the US you’re more likely to die in childbirth than if you live in the UK or Canada. One American mother in 2,500 dies as a result of childbirth complications, compared to one per 29,000 in Sweden.
Your child is more likely to die. If you’ve reached the age of 60 you are likely to die sooner in the U.S. than you would in other industrialized nations
Healthcare in the US is rationed — to those who can afford it. Close to 50 million Americans have no healthcare. It’s been estimated that 16,000 Americans die every year because of untreated illnesses. Even for those who are insured in the US, healthcare is rationed by HMOs who decide what treatments they will pay for. Remember the guy in Sicko who had to decide which of his two fingers he would have re-attached? Remember the guy in Canada who had all five of his reattached — with no bill?
More important, the supposed administrative savings occur in the first year. After that, we still have a higher than inflation trend in the cost of health care and nothing to address that.
Um, no. Healthcare costs per person in the US are higher than elsewhere, without showing any substantial health benefits. In fact in many respects the health of Americans is worse than in other countries and getting worse. Americans are shrinking (and it’s not due to immigration).
Per capita in the US in 2003, $5,635. Canada, $3,003. By all measures, Canadians’ health is better and they live longer.
Maybe it’s better to have the same rate of inflation on half the amount? Or maybe the faster-than-inflation growth in HMO’s profits is factored in there somewhere?
The bottom line is that single-payer ignores the fundamental issue: this is not a “health insurance” crisis, it’s a “cost of health care” crisis.
Well it’s neither. To be sure, health care costs tend to rise. But to say there is no health insurance crisis is to be completely out of touch with the financial realities of all but the richest Americans.
But this is a moral crisis. In Canada and the US people believe that we should take care of the poor, the sick, the young, the elderly. In fact we should take care of everyone. In the US many people believe that you should take care of yourself and leave others to sink or swim. Not all believe that, because a large percentage of those in the US support the idea of universal healthcare, despite all the propaganda they’re exposed to (I can’t believe this writer didn’t play the “socialized medicine” card).
The US needs to take a good look at what kind of country it is. Many people in this country think of themselves as Christians, but if they were to find themselves in the shoes of the good Samaritan they’d walk past the sick man (or more likely drive past in their SUVs) and suggest that he needed to make wiser lifestyle choices.
An approach is needed that addresses the poor lifestyle habits of Americans, which drive the cost of health care. Until then, we will always be facing a health insurance crisis.
Many of the poor lifestyle habits of Americans are habits of poverty, such as not being able to afford vegetables and other healthy foods. Those bad habits are compounded by a lack of healthcare. In the UK, where there is universal health coverage, doctors can encourage better lifestyle choices. And obesity levels in the UK are lower than in the US.
Daniel Colacino
East Greenbush, N.Y., Sept. 13, 2007
The writer is president of the New York State Association of Health Care Underwriters.
Ah, there’s the sting. As Upton Sinclair said, “It is difficult to get a man to understand something when his job depends on not understanding it.”