Tuesday, October 22, 2013

Sick in America: What Today's Reactionaries Don't Want You to Know

Sick in America: What Today's Reactionaries Don't Want You to Know

Much of what we hear about health care is pure propaganda with no basis whatsoever in fact.   The purpose of propaganda is to manipulate, not to enlighten or inform, so it's no surprise that the partisan fight over health care in Congress has generated more heat than light.   The baleful effect is to deceive and thereby perpetuate the status quo -- and an ever-greater inequality that threatens to destroy the fabric of our society.  

Among the false impressions created by libertarians, FOX news, and reactionaries of all stripes is that Americans far more freedom to choose physicians, hospitals, and treatments than people in Europe and other advanced societies with single payer systems.   Most anyone who has lived abroad and experienced a single-payer system in operation knows that's simply not true.   Nor is it true that people in these countries get less personalized attention from doctors than we do.   (Ask anybody who's spent a few days in a hospital lately how much time the doctor spent with them.)   It's what the Corporatocracy tells us, and many of us are only too eager to believe, but it's not true.

The US is NOT the leader in health care in the modern world. 

In fact, the US is not even in the Top Ten. According to the World Health Organization (WHO), the health care system in the US ranked 38th in the world in 2000.   If you're thinking that was over a decade ago, maybe we're doing better now, think again.

Americans DO NOT LIVE LONGER than people in many other advanced countries.

Don't trust UN figures?   How about Bloomberg?   According to a Bloomberg study of the most efficient health systems in the world, the US ranks 46th, just below Iran (oops!) and just above Serbia.   Among the top ten (Hong Kong, Singapore Japan, Israel, Spain, Italy, Australia, South Korea, Switzerland, and Sweden),   life expectancy is significantly higher (and infant mortality is lower), as it is in the UK, Austria, Canada, France, Finland, the Netherlands, Portugal, Greece, and Germany, among others.   Amazingly, getting better results costs a lot less in these countries than we have to shell out.

Medical treatment in the US is BY FAR THE MOST EXPENSIVE in the world. 

Health care costs in US account for over 17% of total GDP every year -- roughly $2.7 trillion in 2012.   By itself, that's a very big number, as big as the entire GDP of France and bigger than Brazil's, but it takes on a whole new meaning when compared to what people in other advanced societies spend on health care and what they get in return.    Among the top ten most efficient health care systems in the world, health care costs as a percentage of GDP ranges from a low of 3.8% in Singapore to a high of 11.5% in Switzerland.   The average for the top 25 countries, all of which rank above the US in health care efficiency, is 6.54%.   That's 6.54% of GDP for a better result than we get in the US spending 17.2% of GDP.

   On a per capita basis, we don't fare any better.   Canada, for example, devotes 10.8% of GDP to health care, or $5,630 on average.    The per capita cost of health-care in the UK, with its "socialist" National Health Service, is $3,609.   In South Korea with a higher life expectancy than we have, it's only $1,616.    In the United States the figure is a budget-busting $8,608.

The American health care system IS NOT A FREE MARKET.

There's no such thing as a free market and the exorbitant price of health care in the US is a glaring example. "In reality, per-capita state-sponsored health expenditures in the United States are the third-highest in the world , only below Norway and Luxembourg. And this is before our new health law kicks in."   The quote is from an article in The Atlantic (March 8, 2012).   The title   speaks volumes: "The Myth of the Free-Market American Health Care System."   As the author a libertarian journalist named, Megan McArdle, points out:  

The thing to remember in America is that we have single-payer health care for the elderly and for the poor: the two costliest groups. In addition, the relatively healthy middle class has heavily-subsidized private health insurance, in which few individuals have the freedom to choose the insurance plan they receive. Neither of these facts commend the American health-care system to devotees of the free market.

   McArdle is manifestly NOT a proponent of state-financed health insurance.   She points out that two of the world's best health-care systems are found in Switzerland and Singapore.   Both are essentially market-based systems, but the Swiss get subsidies (on a sliding scale tied to income) to purchase health insurance and Singapore has a system of mandatory health savings accounts.   But note that in both countries, coverage costs far less than in American, health care efficiency and life expectancy are higher, and coverage is UNIVERSAL.

Prescription drug prices in the US are the HIGHEST IN THE WORLD.

Pharmaceuticals cost far less in most countries than they do in the US; most prescription drugs patented, manufactured, and sold here in the United States are sold abroad at much, much lower prices.   Here are a few facts about prices for 200 of the world's best selling drugs across 13 therapeutic areas:

-    Fact: European prescription drug prices average just 50% of U.S. prices.  
-    Fact: Japanese drug prices average 66% of U.S. prices.
-    Fact:  In price-comparison studies weighted for volume, brand-name prescription drug prices are often higher in the US than other OECD countries; a US government study found that patented drug prices cost 18-67% less in OECD countries than in the U.S.
One eye-watering example:   The exact same medicated eye drops that cost $125 in the US cost $4 in Greece.
   Drug prices rose 3.6% in 2012, twice the 1.7% inflation rate.   Individual drug prices roses even faster.   In the first 9 months of 2012, a heartburn drug called Nexium jumped 7.8% (a $262 average prescription); Abilify, for bipolar disorder, increased 10.4% ($642 per prescription); Crestor, a cholesterol-lowering drug, went up 9.7% ($193 per prescription).   At this rate, if the insurance companies don't bankrupt government and the middle class, the drug companies will.

   Conclusion #1:   There's no perfect health care system anywhere in the world, and whether the best system possible is one that is state-funded or market-based is debatable.
   Conclusion #2:   "Among advanced economies, the U.S. spends the most on health care on a relative cost basis with the worst outcome."   Bloomberg

   Conclusion #3:   The US health-care system combines the worst features of both state-funded and market-based systems with none of the advantages of either.