Nov 23, 2012
The premise of the very need for health care reform of the nature of the Patient Protection and Affordable Care Act (Obamacare) is based on flawed analysis and myths.
Access to health insurance is synonymous to access to health care. Plenty of the uninsured get access to health care from numerous sources. This is not to say that our health insurance does not need reform, but it is false to assume that those without coverage do not get access to quality health care.
The number of uninsured is grossly exaggerated. For years we heard about 45 million uninsured. Yet when he heralded the passage of his signature bill President Obama claimed that thirty million would now have coverage. Did the mere passing of this bill reduce the uninsured by a third? In fact the 45 million number was inflated by those that could afford to buy insurance but chose not to, uninsured non citizens (are we responsible for everyone in the world who comes here having health insurance?), prisoners, those temporarily uninsured (between jobs) and those who currently qualify for government insurance programs but do not apply for them. The actual number of chronically uninsured may be around ten million. Would it not be easier to just provide them with either a policy or a voucher to buy one of their own choosing and not interfere with the preferred choices of the other 95%?
The high costs of health care in America is due to greedy and malicious intent on the part of the medical industry and the insurance industry.
As William J. Baumol noted in The Cost Disease, the escalating price of health care is a dynamic of the increase in productivity in other fields. While we may be paying a higher percentage of our of GDP in health care cost, it is not necessarily a bad thing, since the increase in productivity and the decline in the percent of GDP we pay for other necessities like food and transportation provide us with the means to pay for these higher costs. And we can not discount how much an increasing array of mandates and regulation have also increased our health care costs.
For the higher price we pay for health care we get an inferior product compared to the rest of the world.
In our collective gut we know this is not true. We have made some choices that increase our cost, such as the high percent of our health care cost that we spend for our elderly and the extent we will strive to save the high risk premature infants. In fact the big difference in the infant care statistics is largely distorted by the way we account for premature infants as live births.
But even the countries that have nationalized health care have encountered escalating costs. Their efforts to control costs have led to longer waiting periods to get essential care. In What the world doesn’t know about health care in America, Scott Atlas writes for Fox News, 11/19/12:
• Cancer screening: Confirming OECD studies, Howard in 2009 reported the US had superior screening rates to all 10 European countries (Austria, Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, and Switzerland) for all cancers. And Americans are more likely to be screened younger, when the expected benefit is greatest. Not surprising, for almost all cancers, US patients have less advanced disease at diagnosis than in Europe.
• Preventive care for heart disease and stroke: Wolf-Maier reported treatment of diagnosed high blood pressure, the focus of preventing heart failure and stroke, was highest in the US (53%), lowest in England (25%), then Sweden and Germany (26%), Spain (27%), Italy (32%), and Canada (36%). In 2010, drug treatment was higher in the US than all European countries, including Austria, Denmark, France, Germany, Greece, Italy, Netherlands, Spain, Sweden, and Switzerland. In 2011, nearly 70% of Britons with known hypertension were left untreated.
Cholesterol-lowering statins significantly reduce the risk of stroke. Of patients with high cholesterol in 2007, 88.1% of US patients received medication to control it, compared to only 62.4% in the ten European nations. In 2010, the US had the highest use of cholesterol-lowering drugs among all countries, including Australia, Canada, Denmark, France, Italy, Japan, Netherlands, and Spain.
From the facts, Americans enjoy unrivalled access to health care— whether defined by access to screening; wait-times for diagnosis, treatment, or specialists; timeliness of surgery; or availability of technology and drugs. And, gradually, Europeans are circumventing their systems. Half a million Swedes now use private insurance, up from 100,000 a decade ago. Almost two-thirds of Brits earning more than $78,700 have done the same. But what might really surprise those who assert the excellence of nationalized insurance systems is that throughout Europe, from Britain to Denmark to Sweden, when faced with their inability to deliver timely access, the government’s solution is increasingly to enable access to private health care.
In response to the unacceptable waits under European health care they are moving to private insurance such as ours. What is that telling us?
There are much needed reforms worth considering, but the encroachment on the individual market choices is a step in the wrong direction that does not address the the real problems we face. WE could start by getting a more realistic picture of what the problem is…. and what it isn’t.