The Affliction in American Health Care
In the United States, we live under the perpetual delusion that everything here is the best in the world. We believe we have the best economy, the best education, the best healthcare. You name it- we think we’re the best. But in terms of per capita GDP, the United States ranks 7th, lagging behind socialist nations like Norway. But if that revelation feels like a kick to the nether regions, buckle up and get ready for even more pain in the loins because when it comes to education, the United States ranks 12th according to the 2018 UNESCO Education Index. Worse yet, when it comes to comparing American high school students’ achievement scores to their global peers in reading, math, and science, U.S. 15-year-olds rank 24th, 36th, and 28th respectively. Ouch! But even that frank reality check doesn’t hurt nearly as much, literally or figuratively, as where we rank when it comes to healthcare. According to the CEOWorld Magazine‘s Health Care Index, we place 30th when it comes to national healthcare outcomes, falling right below our neighbors to the South in Mexico and well below our neighbors to the North in Canada. The result is that we have the 58th longest life expectancy in the world, falling behind such health stalwarts as Costa Rica, Greece, Chile and yes, even Puerto Rico. That’s right- the country where I had to attach two electrical wires directly to the pipes in order to generate hot water for a shower, ranks well above us when it comes to relative life expectancy. So just where have we gone so wrong? How is the American health care system failing this badly?
Well, if you look at what each of these nations who rank above us has in common , it comes down to one thing: each of them has some form or another of universal national health care. In fact, the United States is the only modernised nation that fails to provide its citizens with guaranteed access to health care. Instead, we rely on privatised insurance, a system that has two inherent drawbacks. We may lead the world in our technological development and health care procedures, but unfortunately, due to the nature of the insurance industry, those advances are only actually available to a select few, leaving the rest of us wishing we could go to Mexico for better health care.
The first issue when it comes to privatised insurance versus universal health care rests in the idea of eliminating the middle man. I learned this basic lesson when it came to buying weed back in my college days. I didn’t know anyone who grew marijuana or smuggled it over the border, so instead I had to buy it from a guy who knew a guy who knew a guy who knew a guy who…well, you get the idea. And none of these guys provided their service for free. Rather each of them wanted their own small cut of the action, thus driving up the price each step along the way, so that by the time I finally got my hands on my weed, it literally cost more per ounce than gold. In fact, because legalisation has cut out the middle men when it comes to the production and distribution of marijuana, weed is the only product I can think of that is actually less expensive now than it was back in 1991. Well, in this analogy, insurance companies are the middle men drug dealers each taking their cut before you get your health care. In most industrialised nations, citizens pay taxes to their governments who, in turn, use that tax money to provide the health care services their people need. That’s it. But in our perverted, dysfunctional system, we pay tax money to the government who then turns around and gives that money to insurance companies who then sometimes use that money to provide healthcare. Far too often, though, that money instead ends up in the pockets of the shareholders and CEO’s who want to get their greedy little snouts into the sty. Do insurance companies make healthcare better? Do they revolutionise medical science or improve treatment procedures? Of course they don’t. In fact, they often make them worse.
I know that many of my columns might make you think otherwise, but I am actually a fan of free market capitalism. That’s because profit motive provides the incentive to make companies provide better products and services. But when it comes to insurance companies and their involvement in the healthcare industry, the exact opposite is true. Think about it- what drives profit for insurance companies? They make money by bringing in revenue while at the same time reducing expenditures. The problem is that those “expenditures” come in the form of providing you with quality health care. They are incentivised to deny health care as much as humanly possibly. I had a colleague years ago who spent her last remaining days fighting the insurance company tooth and nail for reimbursement of almost every single procedure she needed to fight off the cancer that was invading her body. I have another friend who was told by his insurance company that the knee brace his doctor prescribed after his surgery was “not medically necessary”. We all have stories like these. That’s because, as any heath care provider can attest to, inviting insurance companies into medical decision making is antithetical to the very notion of providing quality heath care. It is in their better interest to see you dead than healthy, and yet they get to decide which treatments you will get and which on
es you won’t. That’s like asking the debt-ridden heir to decide if you remain on life support. Insurance companies would rather pull the plug than pay the bill.
Folks who remain opposed to universal health care for all American citizens will point to countries like Canada, England, and France and say that people there have to wait forever to receive necessary medical procedures. But ask people from those countries how they feel about their health care system, and the vast majority of them would never trade what they have for what we do here in the United States. In fact, when it comes to patient satisfaction surveys, the United States ranks 21st, falling well behind all of those nations (U.K. is 4th, France 8th, and Canada 10th). This is despite the fiscal reality that we spend more than any other nation on per capita health care expenditures. At just under $13k per person, we are more than $5k higher than Germany, the next leading country, and more than double the aggregate world average of just over $6k. So we pay more and get far less thanks to insurance companies who are pulling most of their $1.25 trillion in revenue (yes, that’s trillion with a T) out of the system in order to justify their $69.3 billion profit margin for 2022. Insurance company profits have risen 287% since 2012, but how has that led to improved health care for the rest of us?
To this point, our health care outcomes have become some of the worst amongst industrialised nations. Just look at the maternal and infant mortality rates in the United States versus other nations. When it comes to maternal mortality, we trail only Costa Rica, Mexico, and Colombia with a rate of 23.8 deaths per 100,000 births. And infant mortality statistics rank the U.S. 56th in the world behind nations such as Serbia, Uruguay, and Macedonia. The truth is that the inclusion of privatised insurance in the American health care system is enough to make one sick. Just don’t look for treatment here in the United States.
Steven Craig is the author of the best-selling novel WAITING FOR TODAY, as well as numerous published poems, short stories, and dramatic works. Read his blog TRUTH: In 1000 Words or Less every THURSDAY at www.waitingfortoday.com
