Tag: single payer healthcare

The Democratic Party and Healthcare – Preserving Obamacare Cannot Be The End Game

While our current attention is on the Republican Party’s transfer of wealth to the rich and corporations through the charade of a healthcare reform, the Democratic Party needs to face up to its future and the future of our healthcare system in particular.

The Global Context

The chart shown here tells you everything you need to know about the outrageous amounts of money we pay versus the astonishingly poor outcomes for our health. Basically we pay twice (200% more) than almost every other developed country in the world for healthcare that is distinctly second rate.1 To put it simply we have a healthcare system that is ripping us off and laughing all the way to the golf course. It is a market system that incentivizes tests, procedures, and prescriptions, not health. It is a market system in which the providers, doctors, hospitals, insurance and pharmaceutical companies set prices as they wish.  Our healthcare system consumes just shy of 20% of our economic output. Our developed country competitors use 8%-10% of their output.

click for large size.

Preserving Obamacare is not enough to bridge these gaps.

Obamacare addresses the lack of access to healthcare in a significant but hardly comprehensive manner. It only hints at changes to the incentives and pricing that drive the unhealthy outcomes. Obamacare is not the solution. Better than nothing, but given the enormous resources being spent and the fundamental failings of the outcomes it is not sufficient.

Health Not Profits

In order to create a world class healthcare system we need to focus it on health not profits. Every other developed country long ago recognized that a market based system would not work because health is not a commodity like corn, cars, or cell phones. It is complex, multi-dimensional, and emotional. It requires a system capable of a holistic approach to people and the society they live in. Each of the countries with universal healthcare approaches implementation very differently in the details, but all have some sort of national/regional health budget that is negotiated with the various constituents. This amounts to a lump sum per person with which the health system operates to deliver health outcomes. The proof that it works is in the chart above. 

Outrage and Political Will – Stop Taking Big Money from the Rich and Corporations

The Democratic Party must absorb the reality of our situation. We need to develop and express some outrage at the current healthcare providers. It will not be a simple task to bring a sector of the economy that consumes nearly a fifth of economic output to understand that we cannot allow this to continue. We need them to evolve to a system that consumes a tenth while vastly improving healthcare for the entire population. A basic truth here is that we as a society cannot and should not allow one sector to consume so many resources, so inequitably, for such poor outcomes. In the global context this is not sustainable and makes us less competitive and less flexible to meet the changes. 

None of this will happen as long as Democrats are taking money from the rich and corporations. If there is a single lesson from the Bernie Sanders campaign it is that with messages and programs that reflect the needs of the vast majority of Americans, you can raise enough money to fight off the Republican Party and its wealthy and corporate sponsors. Time to start now.

  1. The US ranks 56th in infant mortality out of 225 countries; 48th in maternal mortality out of 184; and 42nd in life expectancy at birth out of 224. – source Current CIA The World Factbook – https://www.cia.gov/library/publications/the-world-factbook/ accessed 5/13/2017 []

The Republican Party – vicious at the edges

A brief review of how the so-called moderates and the fundamentalist right wing of the Republican Party are reacting to the Senates healthcare bill demonstrates how fundamentally vicious and immoral the whole party is.

Though facts may be out of style lets just take note that we live in one of the wealthiest countries in the world. Also take note that the rest of the developed world provides universal high quality healthcare at roughly half the cost or less of our system which ranks near third world in performance.

The “Moderates”

Susan Collins, Senator from Maine, finds solace in what she perceives to be increases in support for low income people but is “concerned about the long-term cuts to Medicaid funding.” Senator Dean Heller of Nevada is likewise concerned about Medicaid cuts. Senator Lisa Murkowski of Alaska doesn’t want Planned Parenthood defunded. Senator Rob Portman of Ohio- “I continue to have real concerns about the Medicaid policies in this bill….”

The Conservatives

Senator Rand Paul of Kentucky never saw anything except the military and police to be the proper subject for government. Senator Ted Cruz of Texas wants outright repeal of Obamacare and lower premiums. Likewise for Senator Mike Lee of Utah.

Vicious to the Core

Here we have a bill that is designed to throw millions of people out of the healthcare system, give the rich a huge tax break, allow doctors, hospitals, insurance and drug companies to continue to set prices and make huge profits while delivering lousy healthcare to only part of the population.It throughs the definition of basic healthcare into the free for all of the mostly Republican dominated state legislatures. This bill continues the decades long assault by the Republican Party on women. Beyond the perpetual war against women’s right to choose the bill defunds Planned Parenthood entirely. Even the recent upsurge in opioid addiction among white people gets the short end of the dollar. 

Despite the outrages of this bill (and its brethren bill in the House),  the so-called moderates are just complaining at the edges. No one in the Republican Party is talking about how to solve our healthcare disaster. The Republican Party is not thinking of how to improve healthcare at all. They are fulfilling the imperatives of their anti-government, pro-rich program. While the rest of the developed countries in the word devote 8-10% of the economic output to healthcare we spend 19%. While the rest of the developed world manages to provide healthcare to every single person with top flight results our healthcare system ranks 48th in longevity and 54th in infant mortality. Near Third World results.

None of this outrages the vicious Republicans. They hate poor and middle class people, they hate black and brown people, they hate government, they love to make the rich richer. That is the essence of the Republican Party.

Brandon Weber, new to me but clearly troubled by similar incongruities, offers up the following comparison with the UK health system:

 

The Global Context of the US Healthcare Debate

The solution to our healthcare fiasco is first to recognize its true nature and then to face down those who are consuming a fifth of our economic output while producing profoundly bad results. We need to take a much broader view in order to see that, compared to the rest of the developed countries, a) our current healthcare results are abysmal and b) our current healthcare costs are obscene.

Trump Loves Australia’s Universal Government Paid Healthcare, “Better than ours”

Trump loves Australia’s universal healthcare:

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.

  1. https://www.google.com/amp/s/amp.theguardian.com/us-news/2017/may/05/trump-healthcare-australia-better-malcolm-turnbull []