America, sick of its health care system
03 November 2008 à 21h29
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The American health care system is one of the most expensive in the world. One of the most inegalitarian and ineffective too.
Obama’s plan is more progressive. He wants to increase government participation and regulation, but his project is not obligatory and universal health insurance, like Hillary Clinton’s was. His goal is to expand eligibility for the government programs that already exist. One of his main measures would be a “pay-or-play” mandate. Providing health insurance would be a requirement for all but the smallest employers. Those who didn’t would be compelled to pay into a national fund covering uninsured workers.
Obama’s plan is more expensive. It would cost $50 billion to $60 billion, offset partly by rolling back Bush Administration tax cuts. McCain’s plan should cost $10 billion a year. But it’s considered as a bad plan for cancer patients and others with chronic diseases. With the kind of insurance he proposes, the melanoma cancer survivor McCain might well be dead today.
Susan Meyer is a divorced children’s book illustrator. She owns her house and has no particular money problems. But she’s diagnosed with a tumor. Without health insurance in America, she’s potentially ruined, if she wants to be treated. Maybe dead if all her fortune isn’t enough to pay for the hospital. Luckily for her, Susan is a fictional character in Desperate Housewives and the writers of this successful soap opera find an unusual solution to save their main character: she remarries her ex-husband to benefit from his health insurance…
If we had to evaluate a country in relation to its health care system, America would be classified as a feudal state. Health care is not considered as a public good, neither as a right, like in France: it’s first and foremost a market. It leans mainly on private insurance.
Two thirds of Americans are insured thanks to their job. Employers negotiate with private insurance companies. Proposing good health coverage is a way to keep the best elements. But small companies cannot afford such benefits for their employees. And the evolution between 2000 and 2005 shows a global diminution of employer-provided health insurance.
Even for people with health insurance, getting sick can mean losing everything. Private insurances companies are reluctant to cover every cost: franchises can be very high and you have to be careful not to use an option you didn’t take: you’ll pay full price for it. In 2004, 54% of personal bankruptcies were due to medical bills.
F. D. Roosevelt, Harry Truman and more recently Bill Clinton failed to impose a universal and obligatory health care system. They had to face the very powerful health insurance lobby and the idea, widespread among Americans that private companies are always more effective than the government. According to Professor Paul Dutton, interviewed in lesechos.fr (04/15/2008), it isn’t true for health care. The administrative cost of private insurance rises to 15 % of their annual budget, whereas it represents 3,5% in the Medicare annual budget and 5% in the French Social Security.
Americans are not particularly healthy but the cost of health care in the US is one of the highest in industrial countries: 15% of the GDP (vs. 10% for France). Private insurance policies are not the only reason for this situation. Pharmaceutical labs have the freedom to fix the price of their medicine. And they keep a 20-year exclusivity on all sales. They argue it enables them to finance research. Forgetting to say that a majority of pharmaceutical discoveries are made in public universities. Which means with public money.
McCain and Obama’s plans for health care
McCain is against more government intervention. His reform proposal is based rather on competition. He wants to develop individual health insurance and free companies from the heavy cost of providing coverage. His main idea is to give a $2,500 annual tax credit to individuals and $5,000 to families. According to McCain, private insurance companies would have to become more competitive and propose better prices to win this new business.Obama’s plan is more progressive. He wants to increase government participation and regulation, but his project is not obligatory and universal health insurance, like Hillary Clinton’s was. His goal is to expand eligibility for the government programs that already exist. One of his main measures would be a “pay-or-play” mandate. Providing health insurance would be a requirement for all but the smallest employers. Those who didn’t would be compelled to pay into a national fund covering uninsured workers.
Obama’s plan is more expensive. It would cost $50 billion to $60 billion, offset partly by rolling back Bush Administration tax cuts. McCain’s plan should cost $10 billion a year. But it’s considered as a bad plan for cancer patients and others with chronic diseases. With the kind of insurance he proposes, the melanoma cancer survivor McCain might well be dead today.
If we had to evaluate a country in relation to its health care system, America would be classified as a feudal state. Health care is not considered as a public good, neither as a right, like in France: it’s first and foremost a market. It leans mainly on private insurance.
Two thirds of Americans are insured thanks to their job. Employers negotiate with private insurance companies. Proposing good health coverage is a way to keep the best elements. But small companies cannot afford such benefits for their employees. And the evolution between 2000 and 2005 shows a global diminution of employer-provided health insurance.
50 million Americans uninsured
Public health insurance does exist, but it is focused on the more vulnerable people: Medicare on the old people, Medicaid on the poor. « Many Americans fall through the growing gulf between employer-provided insurance and government health programs » writes Elise Gould in « Health insurance eroding for working families » (article published in the Economic Briefing paper, Sept. 28, 2006). In 2008, almost 50 million Americans were living uninsured. They were 32 million in 1987 and 40 million in 2000.Even for people with health insurance, getting sick can mean losing everything. Private insurances companies are reluctant to cover every cost: franchises can be very high and you have to be careful not to use an option you didn’t take: you’ll pay full price for it. In 2004, 54% of personal bankruptcies were due to medical bills.
F. D. Roosevelt, Harry Truman and more recently Bill Clinton failed to impose a universal and obligatory health care system. They had to face the very powerful health insurance lobby and the idea, widespread among Americans that private companies are always more effective than the government. According to Professor Paul Dutton, interviewed in lesechos.fr (04/15/2008), it isn’t true for health care. The administrative cost of private insurance rises to 15 % of their annual budget, whereas it represents 3,5% in the Medicare annual budget and 5% in the French Social Security.
Americans are not particularly healthy but the cost of health care in the US is one of the highest in industrial countries: 15% of the GDP (vs. 10% for France). Private insurance policies are not the only reason for this situation. Pharmaceutical labs have the freedom to fix the price of their medicine. And they keep a 20-year exclusivity on all sales. They argue it enables them to finance research. Forgetting to say that a majority of pharmaceutical discoveries are made in public universities. Which means with public money.
