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46 million Americans have no health care at all. Most of us still receive health insurance through our employer, and most have seen sharp increases in premiums, deductibles and the coverage limits of such policies meaning we have less coverage than ever before at higher costs. Yet health insurers see record profits. It is time to pull ourselves up from the bottom tier and actually DO something about our criminally deficient system. It is time for the candidates running for President to come forth with solutions not more platitudes.
"The U.S. spends more on medical care than any other nation, and gets far less for it than many countries. According to the 2006 analysis by the Organization for Economic Cooperation and Development, the U.S. spends an annual $6,102 per person â€” more than any other country and more than twice the average of $2,571. Yet Americans have the 22nd highest life expectancy among those nations at 77.2 years compared with the analysis’ average of 77.8 years. People in Japan, the world leader in longevity, live an average of 81.8 years." â€“ Los Angeles Times
Yes we have some of the latest innovations and are the envy of the world in certain medical procedures, but the net impact is not translated into better health for the American public. European nations and Japan are much more effective at lower cost than our patched together system of for profit health care. If you have enough money you can afford the premium care procedures and travel to the institutions that offer them. The vast majority of Americans cannot afford this level of care and instead must accept what their insurer will pay for.
Under our system, if you do not have health insurance you are left to the care of the emergency room unless you are poor enough to qualify for Medicaid. That means the most cost effective health care â€“ prevention, is not available to those who need it most. Even those with coverage are finding they often must trade health care costs for food and living costs. Premium costs alone often costs over $500 per month for a family of four.
Add to this the steeply increasing cost of prescription medicines and the picture for most Americans is getting worse every year. While the percentage of people without health insurance edges upward slowly, the actual number increases more rapidly. Add to this that the effectiveness of insurance has dramatically dropped with higher co-pays, deductibles and exclusions, and our system is failing the grade.
Part of the problem is that our system has unacceptably high costs of administration. On average, insurers allocate over 25% of their premium income to administration. This compares with rates in the single digits in most other major systems. Another part of the problem is that American health care providers have failed to enter the digital age, meaning there is a level of inefficiency built into the system that is correctable.
For many of us, coverage is not there when we really need it. Blue Cross was recently sanctioned in California for illegally terminating insurance coverage when people actually used their policy for major illnesses. One of the complaints about European-style systems is that they end up rationing health care and exclude certain coverage. But that is what happens in private insurance as well, so it is not a matter of rationing but who does the selecting.
Whether the remedy for our failed system is single-payer or some combination of government and private coverage is less important than the urgent need to find a way to universal coverage now, not ten years from now. Any solution must impose limits on administration costs, effective bargaining to lower prescription costs, and, yes, some form of rationing of benefits.
Americans have been told for so long that we have the best health care system in the world that it may come as a shock to many that they didnâ€™t read the fine print attached to that statement â€“ it is the worldâ€™s best only if you can afford it. Most of us cannot. Some cannot afford anything but emergency care.
It is costing us dearly in lives lost too soon, difficult choices between medical care and the basics of life, and even with all the significant failures, it costs us more than anywhere else. Best health care system? No if you are part of the vast majority of Americans. Yes if you are an insurance company.