Sunday, January 25, 2009

America's Dismal Health Care System

A January 19 episode of BBC One's Panorama, the world's longest running television documentary show, tackles the dismal state of health care in the United States, the estimated 45 million uninsured citizens, the pharmaceutical industry's rigged pricing against the American patient, and the insurance industry's efforts to deny care whenever possible.

Due to licensing restrictions, the episode, "What Now, Mr. President?," is only officially available to view online from connections within the United Kingdom. However, it has also been uploaded to YouTube, where it appears in three parts at left.

The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita.

Yet our system performs poorly in comparison and still leaves 47 million without health coverage and millions more inadequately covered.

This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar.

Our health care system has come to the point where none of the many incremental reforms will work. The business model of insurance has failed, and we need to rebuild the system on a social insurance model.
  • Premiums alone for private health insurance have grown by more than 100 percent since 2000, and are projected to consume all of average household income by 2025, clearly an impossibility way before then.
  • According to the Milliman Medical Index, the typical American family of four spent $15,600 on total health care costs in 2008, fully one-quarter of the typical combined family income of $60,000; most consider 10 percent of family income to be the threshold of underinsurance.
  • The administrative overhead of private insurers is five to nine times higher than not-for-profit Medicare (average for commercial carriers 19.9 percent, investor-owned Blues 26.5 percent, Medicare 3 percent).
  • The inefficiency and bureaucracy of our 1,300 private insurers are not sustainable (e.g., according to the Blue Cross Blue Shield Association, there are 17,000 different hea1th plans in Chicago).
  • Private insurers offer much less choice than traditional Medicare; there are near-monopolies in 95 percent of HMO/PPO metropolitan markets, enough to trigger anti-trust concerns by the United States Department of Justice.
  • Because of costs, about 75 million Americans are either uninsured of underinsured, with large segments of the population forgoing necessary care and having worse health care outcomes; the United States now ranks nineteenth among nineteen industrialized countries in reducing preventable deaths from amenable causes.
  • Wall Street is already questioning the future prospects of the private insurance industry; as of November 18, 2008, the average share prices of the top five private insurers were down by between 60 percent and 77 percent, compared to the Standard and Poor’s 42 percent.

Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans. The Physicians' Proposal endorses a fundamental change in America's health care - the creation of a comprehensive National Health Insurance (NHI) Program. Such a program - which in essence would be an expanded and improved version of Medicare - would cover every American for all necessary medical care.
Americans should not have to turn 65 years old or become disabled to have access to a public health care program that controls overhead costs, provides broad, affordable access to care and protects patients against big bills. By almost every measure, Medicare is cheaper and more effective than private plans, according to government and academic research. Medicare spends 2% on overhead; private insurers typically spend 25% to 27% for overhead and profit.

A recent Congressional Budget Office report comparing health care reform options found that allowing Americans to buy into Medicare before turning 65 would lead to more people with coverage at lower costs. A UC Berkeley study last month found that a public option like Medicare could result in $1 trillion in national savings over 10 years by driving down costs, improving efficiencies and fostering innovation. [LATimes]

Big health insurance corporations and too many Democratic lawmakers do not agree; Democratic House Whip: "health care is off the table for 2009" - Posted: 01/25/09 04:05 PM
A prominent House Democrat said he doesn't expect a comprehensive health care reform bill to pass Congress in 2009, saying an incremental approach to covering the uninsured would be better "than to go out and just bite something you can't chew."

House Majority Whip James Clyburn's (D-S.C.) time line on tackling health care is at odds with the timetable proposed by Senate Democrats [and President Obama] and could represent a major shift in the House Democrats' strategy of dealing with the uninsured.

During an interview on C-SPAN's "Newsmakers" program that aired on Sunday, Clyburn said he doesn't anticipate that comprehensive health care legislation will be approved in 2009.
No one should be very surprised at congressional foot dragging on this issue; 533 members of Congress, out of 535, have received campaign contributions from within the health sector and lobbyists are putting their money to work to prevent reforms from taking place.
"We plan on mounting a national campaign," warned health insurance industry lobbyist Angela Hunter, "and what we hope to do is to, number one, get some articles in the newspaper explaining what the problems are that we see with the plan. Two: Educate lawmakers, people who are members of our organizations, their clients--to go and lobby members of Congress--call them on the phone, visit them in their offices, and to just do everything that we can possibly do to preserve the freedom of choice for individuals in health care in America."
Write, call or email both U.S. Senate and U.S. House leadership and tell them to pass a single payer national health insurance program this year.

You can find the contact information for the U.S. House and Senate at the following links:
U.S. Senate U.S. House
Note: U.S. Senators for Texas, John Cornyn (R) and Kay Bailey Hutchison (R) as well as Collin County's Texas 3rd district Republican Congressman, Sam Johnson, and 4rd district Republican Congressman, Ralph Hall, are on record as being adamantly opposed to any national health care program. (3rd and 4th districts: Map)
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