Speaking to Australian Prime Minster Trumbull, Trump said, “We have a failing healthcare. I shouldn’t say this to our great gentleman and my friend from Australia, because you have better healthcare than we do.” A day later Trump repeated his praise for the Australian healthcare system, “Of course the Australians have better healthcare than we do – everybody does,” he wrote on Twitter. “Obamacare is dead! But our healthcare will soon be great.”1 Of course in a rare moment of speaking the truth Trump is right about both assertions. Everyone in the developed world has better healthcare than us and at a shocking fraction of the cost.
Trump told Malcolm Turnbull: ‘We have a failing healthcare. I shouldn’t say this to our great gentleman and my friend from Australia, because you have better healthcare than we do.’ Photograph: Jonathan Ernst/Reuters
Does Trump know Australia spends $5,495 per person per year vs our $9,990 (yep 66% more!!) for healthcare that ranks in the top ten in the world? Our rank?? 42nd for life span and 54th for infant mortality (see 2015 CIA World Factbook on this). Exactly how the Republican healthcare bill will improve on this performance is unknown. They passed it through Congress without even waiting for the Congressional Budget Office to grade it for cost and effectiveness. Better to vote out of religious fervor than be bothered by how many millions would be thrown off health insurance.
BTW – Australia is not an outlier in spending and results . All of our developed world competitors have a similar showing.
Jacob S. Hacker, Yale professor and author of many books and article critiquing the American political system, economy, and the fate of the poor and middle classes, reviewed a new book, AN AMERICAN SICKNESS: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal (NY: Penguin Press, 2017). Most of the review takes up the question of why healthcare is not like other commodities and does not fit into the “let the market solve the problem” ideology of the last 40 years. If you are unpersuaded now, this is useful territory. towards the end of the review Hacker turns to our developed country competitors’ approaches to healthcare.
“The difference between the United States and other countries isn’t the role of insurance; it’s the role of government. More specifically, it’s the way in which those who benefit from America’s dysfunctional market have mobilized to use government to protect their earnings and profits. ….. But in every other rich country, the government not only provides coverage to all citizens; it also provides strong counterpressure to those who seek to use their inherent market power to raise prices or deliver lucrative but unnecessary services — typically in the form of hard limits on how much health care providers can charge.”
This is a great summary statement. Using a variety of tools and institutional arrangements every other government controls prices and healthcare budgets. They do not allow a one-sided market to focus on delivering as many procedures and prescriptions as possible without any systematic focus on health. My criticism is that Hacker should have provided two further data points to put the outrage of American healthcare in its true global setting: US healthcare spending compared to other developed countries and health outcomes relative to other developed countries. As the chart below demonstrates, the US spends more than 25% more than our closest competitor, Switzerland, and twice as much as most including japan, France, Australia and Canada. The health outcomes are woeful. We rank 42 in the world for longevity and 56th for infant mortality. ((see https://www.cia.gov/library/publications/resources/the-world-factbook/)) These facts need to be front and center in our thinking about healthcare. The developed world is filled with universal healthcare systems with many different structures and approaches, all with several decades of experience at delivering better healthcare at much less expense. The only question is how will poor and middle class people in the united states gain enough political power to end this great rip-off??
Dan Udell videotaped a presentation on the US healthcare system by Rob Bujan on 3/25/17. I could not attend so I watched Dan’s YouTube video –
The discussions towards the end of this presentation (about minute 50) concerning single-payer systems would have been more vigorous and perhaps useful with a little international context. We live in a world where every other developed country has universal healthcare and has had for decades. So, there is plenty of experience with a range of different structures to deliver healthcare to every person as a right. Continue reading →
The rhetoric about our health care system continues to center around market religions of one sort or another. For all of the blathering about “Obamacare” taking us over the edge into the territory of socialized medicine, it remains, like it’s progenitor dreamed up by Romney while governor of Massachusetts, a market focused policy. Even now Massachusetts is struggling to come up with policies to restrain the growth of costs to the rate of inflation plus 1%. At the national level it will be years before Obamacare can begin such considerations in real terms.
What is missing is a willingness by the political system to engage the undeniable truths about our health care system. Continue reading →