Our 6th rate health care system

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 — 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." – 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 – 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 didn’t read the fine print attached to that statement – it is the world’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.


  1. Sandra Price

    Again, I see the answer to the problem is for more federal government to step in. The federal government is the reason our insurance and healthcare is out of control cost wise.

    It is seen (CSPAN)on some sessions on Congressional discussions how our House and Senate nit pick every tiny item when it comes to how long the insurance companies will pay for mastectomies. I took out a petition to send to D.C. demanding that the Doctors determine how long a patient stays in the hospital. One site here on the internet called it my plea for “Dialing for Breasts” and I was highly criticized for bringing it to their attention.

    Yesterday the fight was on whether a rape victim should be offered the morning after pill as it was against the Pope’s desire. This is your government in action.

    Are we willing to turn all of this over to our federal government? Will it simply take the responsibility off our own precious time to discuss so we can return to American Idol? It seems that every discussion on health care and coverage sends the problem to the House and Senate and will end up being just one more of our freedoms handed to the corrupt Congress and White House.

    If Americans want socialized medicine then say so! If Americans are eager to give illegal aliens free health care paid for on the backs of the rest of us then say so! We sit around and wait to see what the government wants and then we pick up the crumbs of what is left. Many of you want this to be used as a redistribution of wealth. Yes, America has fallen that far into greed.

    Everybody has limits on what they consider solving the problem but it all comes down to how much freedoms the government will give us. It’s similar to the plans that men desire on the subject of abortions. They want limits set on when and why an abortion is done and of course they look to the federal government for those limits.

    What the hell has happened to individual choices and decisions? Are we incapable of making these on our own? Must we look to big daddy for everything including our health insurance?

    We saw this week the solution to our oil costs. The government issued a mandate to the automobile manufacturers to increase the number of miles to be expected per gallon in 2020.

    The voters in 2008 will find a candidate who will offer us free health care. Do we care what the real cost is to this plan? Or will it simply stop the discussion so we can spend our time doing important things like playing poker or watching television?

  2. Thomas Bonsell

    Comment to Sandra Price:

    No one has suggested socialized medicine. Socialized medicine would require that government employ all the physicians, surgeons, nurses, therapist and others, such as in military hospitals.

    Socialized medicine would require that government own all hospitals, clinics, and such as with the VA hospitals.

    Socialized medicine would require that government own all pharmaceutical companies. No one has suggested any of this.

    What has been suggested is a method to pay for medical care in a way that it serves all Americans, not most Americans. What has been suggested is a way to get quality health care at an affordable price, like the rest of the civilized world has managed to do.

    What has been suggested retains HMOs as private companies, such as Kaiser and Group Health. What has been suggested is that hospitals remain private entities.

    It seems that people on the political right have no problem with outsourcing American jobs to nations that pay slave-labor salaries and leaving millions of Americans destitute, but suggesting a health-care system that serves all Americans ~ including those who had their jobs sent to India, Vietnam, China, etc. etc. etc ~ draws conniption fits because it may cut into profits of corporations and the seven-figure compensation of inept executives.

    Please explain how some government involvement has caused health-care coats to skyrocket in the United States while having the exact opposite effect in every other advanced nation.

    This hatred of government must stop. Government exists to benefit the entire people of a nation, not just the “special” people.

  3. kent shaw

    It is either every woman for herself or we are all in this life together. Pick a side.

    We already have a single payer system that works very well (although there is lots of room for improvement, especially in the area of FRAUD committed by medical PROVIDERS), with around 4% administrative costs, and it is called MEDICARE at the federal level and MEDICAID at the state level. It would be a simple matter to expand Medicare/Medicaid to cover everyone. Why is this such a big deal? All of Thomas Bonsell’s comments above apply. We can spend a trillion dollars attacking a country which has never been and never would be a threat to the United States, but we can’t pay for a kid’s broken leg out of our tax dollars? We can’t pay for granpa’s prostate surgery? PUH-LEEZ!!!! Of course there would no longer be obscene profits accruing to corporations with their 25 to 35 percent “administrative costs” and multi-million dollar salaries to CEO’s and 50 thousand dollars to a surgeon for a liver transplant (maybe $10 thousand) … ummm … just cry me a river.

    Get over your “capitalist dreams” you who are downtrodden and still voting Republican in spite of the fact that they are screwing you to the wall.

    Read Joe Bageant’s “Deer Hunting With Jesus”.


  4. pondering_it_all

    The whole idea of insurance is to spread the costs of known risks over a large pool of individuals. If insurance companies are allowed to cherry-pick their customers, and then drop anyone making a claim, that IS NOT INSURANCE! It’s a con game!

    Even if the only reform we could get was a law requiring insurance companies to treat people fairly, it would be a great advance. The other great advance would be to form state-wide pools, so that anyone could get coverage at the same price as large companies do now. Insurance companies that wanted to get the state pool business would have to agree to accept all applicants (and keep covering them even if they get sick), and charge everyone the same per capita or per family rates.

    Health care reform doesn’t require socialized medicine. It just requires honest companies. And apparently the only way to keep them honest is by close oversight and regulation.

  5. Sandra Price

    We have the choices of HMOs now and if they are working efficiently then why aren’t they more in use?

    Those of you who want to redistribute the wealth and give it to the poor will find that in 10 years the rich will regain their wealth and the poor will continue to whine. It is not the wealth that is at fault here but the lack of incentives, goals, training, education, you name it; is keeping too many Americans under-employed.

    I see no correction for any of these problems including health insurance that could equalize our coverage. How many more Katrinas do we have to witness before we get off our collective butts and get our American citizens educated?

    Pondering, you want government control over private enterprise and it is socialism whether you call it that or something else.

    I am aware that the GOP wants government controls over everything. This is why I am no longer a Republican. But the Democrats have nothing but wanting government controls over our industries like the Insurance and Pharmaceutical companies.

    When I lived in California I had a very affordable supplemental coverage to protect me for 90% of any medical needs. I moved to Arizona and discovered the coverage did not cover the area. So I paid $120 per month for supplemental on top of $98 taken out of my SS check and simply gave up my television cable costs. When I moved to this area I found that my old company did offer me the same costs which at the time were under $75 a month (on top of the $98 taken out of my SS check. I connected to cable again. These are choices we all make in our daily lives. I am on a fixed income and make these choices every damn day. I do not ask you to cover my costs.

    At this time my choices would be to stop the costs of this damn war and continue to protect our borders and security instead of putting innocent people in a state of terror of the government. Cut back the damn government, release the people from the debt of IRS and let us take care of ourselves and our communities. Once we start educating the next generations, our problems will be solved.

    Teach some survival skills as well as occupational skills and the change would be amazing. To look to the government to solve all our problems is cheating. Quick fixes never solved a single problem.

    At this time, the government has no choice but to over the authority of our medical costs, hospitals, medicines and emergency care. The Democrats will be running on free health care and they will win.

    Another generation of helpless under-employed Americans will be living off the labors of those who took control of their lives. Somehow I think our founders would be horrified. Many factors in our lives have dumbed us down and we are all victims of the government programs.

  6. kent shaw

    “Those of you who want to redistribute the wealth and give it to the poor … ”

    “So I paid $120 per month for supplemental on top of $98 taken out of my SS check and simply gave up my television cable costs.”

    SS = Social Security? Is that the same Social Security which is clearly a “redistribution of wealth”?

    “I do not ask you to cover my costs.”

    The please stop accepting those Social Security checks. If I am wrong about the definition of “SS” then I apologize and take it all back.

    “The Democrats will be running on free health care … ”

    Nothing is “free”. A single payer system’s payments come out of tax dollars paid by all, with the risk spread over the entire pool of taxpayers. Free health care would involve hospitals and doctors providing care for free, without compensation, and no one is asking for that. Any candidate who says they will provide “free health care” is not speaking responsibly and should not be voted for.

  7. nuQler Ostrich

    Jeez, I remember when….

    When “Blue Cross Blue Shield” was decried as “Socialism.”

    “And $120 on top of $98…” How about $585 a month with $2,800 deductible for a single 52 yo male?

    That’s so my provider’s CEO can get his $15 million.

    GoD help me if I really get sick. Because I surely can’t count on Michael B. McCallister helping little old me.

    I’ll lose my house and everything else I have worked for all of my life. And eventually, it will happen. It will happen to most of us. At least most of us who aren’t getting $15 Million compensation packages.

  8. kent shaw

    nuQler wrote: “I’ll lose my house and everything else I have worked for all of my life. And eventually, it will happen. It will happen to most of us. At least most of us who aren’t getting $15 Million compensation packages.”

    It is already happening all over the country. Many of us, even with insurance, are one medical emergency away from bankruptcy and homelessness. But at least the good news is the CEO is getting his hard earned $15 mil.

    It sure is too bad the government regulates the insurance corporations because otherwise they could REALLY gouge us and the CEO could make a well deserved $30 million. But not to worry. Some of us advocate for government abandonment of regulation of corporations so the future is not totally bleak.


  9. Jim C

    Miss Price , your derogatory and ( in my opinion ) mean spirited comments about the poor speak for themselves . This conservative wonderland you pine for has been tried ” it doesn’t and never will work ” except for the fortunate few . Your statement ” the government is why prices are high ” to paraphrase is amazing . Would you be so kind as to explain how ? If that is the case , why is medicares overhead at somewhere around 4% ? The VA was a model of efficiency through the 90’s until they did guess what ? If you guessed started privatizing it you are correct . When you privitize the prices go up the quality of care goes down , but the amount of money siphoned off for upper management goes through the roof . I also keep reading posts going on and on about the horrors of socialized medicine . Guys check out the facts , it just ain’t so . Before you start screaming commie , look up some facts . Which countries with socialized medicine are having all of these problems ? Find me one , not Germany , not Sweden , not France , Denmark , Finland and no not Canada . Even Cubas health system takes pretty darn good care of its people even though their dirt poor they have the best healthcare system in the caribbean . All of the countries I mentioned pay a fraction of what we do and get better care . If this system of ours is such a great model , show me an example of where it works ( for the average citizen ) and not your opinion or personal story please . The information is fairly easy to find so I’m sure you’ll have no problem finding a greed driven healthcare plan in some country that takes great care of the average citizen ( yes Miss Price , even the lazy , stupid poor ) . When you do please tell me where it is . You might start by looking at Mexico . Their system is what ours is going to be if we stay on this path .

  10. Jim C

    Please pardon the speelling and punction errors in my last post . At present I am battling bronchial problems . There seems to be something about the combination of medication and lack of oxygen that makes me want to misappropiate vowels and commas .

  11. gene

    So more good news, don’t you just love it. Hey we could probably almost elimenate many health issues if (we the people) could get the (fat) off of all those big (fat asses) I see at walmarts and else where. Young and old.

    This planet has got to be off of its axis (slightly) with all the added (BIG FRIGIN FAT PEOPLE) that now populate this (has been) nation of ours.

  12. Wayne K Dolik

    Believe it or not the entire system is “mobbed up” with special interests. If you do not have health insurance and or forced out because you desire different treatment, like your diabetic and do not want your leg amputated but prefer a lower amputation, you are screwed again, because out of pocket expenses are triple what insurance companies pay. Most physicians say patients have a voice in their health care; try it some time. Even if you pay cash, you are no match for insurance companies.

    As far as the court system is concerned they are mobbed up with the “medical mafia” in this country. Firstly, if you are in fact wronged, you, as a citizen can’t find a decent attorney because all the good ones are bought and paid for by the “medical mafia”. This includes the pool of expert witnesses as well. And, Judges like the “medical mafia” because they are repeat customers. You are not. So, where is the ordinary citizen? Nowhere! You are a one timer and that is why arbitration in malpractice should be a crime. I could write a book on this subject.

    Don’t take my word for it. Check it out for yourself. There are alternatives if you are willing to go to a foreign country, as costs are much lower if you must pay cash. There are alternatives and that, includes drugs.

    Lastly, I must give some reference to our Congress of the United States. Firstly, let me tell you I do have respect for the writers of E.R.I.S.A and Medicare in Congress. Their intentions were noble. I read a lot of stuff that John D. Dingall wrote in Congress and passed. Their intentions were noble. The real problem is that, when the folks in the “medical mafia” system got it, and folks in our Court System got it, and the the rest in the Medicare Appeals process in Pittsford New York got it, it was in fact “gamed” by them, and that is where we are at. The whole system is gamed for profit.

    If you want to know my story, please follow this link:


    Wayne K Dolik
    Caregiver to Marjorie
    And Adam Dolik

  13. incog99

    I am Wayne’s Brother and lived through the experience annotated above. I am posting a note I sent to a friend about that experience because, in spite of the poor system, we can and will transcend the system because we are human and have one thing no one can take away, our dignity, our hope and our secret.

    Here is the letter written just a few days ago:

    Unplugging a Loved One:

    I am watching a Youtube from your website. This lady is mentioning how the doctors suggested she unplug her loved one. We were told to do the same. We could and would not do this.

    2 years into Dialysis my Mom who was just so great was paralyzed and had diabetes. She was also on a feeding tube. We were determined to allow her to live out her life with dignity and quality. When she came into the dialysis unit, she was 80 years old, and much sicker than the young folks in the unit, she inspired the younger patients to have hope. She came into the unit with a smile on her face regardless of how she felt. Somehow she had a glow which I cannot explain to this day. We had her made up nicely and dressed beautifully because we knew she would want it that way. She outlived many of the younger patients because she wanted to KNOW what would happen tomorrow and she believed that God would take her when He deemed time. Her faith was uncompromising at all times. She gave all the patients hope.

    A Doctor in year two gave her 6 months to live. She was not pleased. I asked her if he should be fired. She was unable to speak due to the brain surgery but she shook her head yes. I told the doctor he was fired!!!! She lived another 4 years in spite of him because she loved life and was interested in tomorrow. I have experienced being in the presence of a person who had transcended her physical being. It took an amputation of her leg and 4 more years of dialysis to force her to leave this earth. I know what it means to have faith and believe it will sustain one. I have seen if first hand.

    My brother and I determined to make her life meaningful and decided to take her to Church every Sunday for the rest of her life which is an activity she loved. So for the next 6 years we got her ready and took her to Church. Her life was vastly improved by this.

    One Sunday we had Mom at the Crystal Cathedral (where we are all going to buried) and Mom was in her wheel chair and Reverend Schuller made a B-Line for her. His drive-in church was founded because of a woman who had had a stroke and could not attend services inside the Church. He saw Mom and somehow saw history repeating itself. He came over to her and blessed her. Mom was ecstatic and in tears. This tale gets even odder.

    When I was 17, I worked at the Orange Drive-In Theatre for a Mr. Norman Miner. He was the man who gave Schuller his first break allowing him to preach on the top of his snack bar inside the Drive-In theatre on Sunday Mornings. In the Crystal Cathedral there is a patch or roof of the snack bar and a Drive-In speaker as a monument to his first break. I was reading the biography of Robert Schuller to Mom in dialysis one night and lo and behold Norman Miner’s name was mentioned in the book. I don’t know about you but this is not an accident. All of these things happen for a reason. This book appears to be unavailable at this time but I have the limited edition hardcover.

    Now for the strangest part. Reverend Schuller had the same injury that my Mom had, a subdural hematoma. Schuller came through it without a disability. Mom was not so lucky and he knew it. “There but for the grace of God go I” he must have thought after my brother and I told him that she had had the same injury.

    A year later my brother and I were at the Christmas service at the Crystal Cathedral seated comfortably. Schuller was observing all. Then a woman with her Mother appeared outside the glass doors. Her Mom was in a wheel chair. The Cathedral was filled to capacity and the fire marshal said no more folks could enter. My Brother and I abandoned our seats and told the ushers to let the woman and her Mother into the service and we left. We saw Schuller smiling at us, as he knew who we were, and we left allowing the woman and her Mother to attend. It was the best Christmas we ever had.

    We can transcend the system and we can improve it by feeling positive about our challenges and showing others we will not be defeated.


  14. Sandra Price

    We must not get involved in equating medical insurance with the “Death with Dignity” movement that gives the patient the right to pull the plug over medical or family input. This is a dangerous subject to introduce to Phil’s honest desire for debate on the subject of insurance coverage for Americans.

    When my husband and I were divorced and he left the state, I was let with 2 kids and no health insurance. In order to be home with the kids, I worked a series of part time jobs and did not expect free insurance.

    I immediately took health classes at the local college to understand the basis of living a healthy lifestyle. I had it down before this happened but changed much of the way we ate and how I prepared our meals. I explained to my kids to not even consider cigarettes or drugs as it would hurt their health. No alcohol in our home and we doubled our exercise programs.

    My girls attended the University of California and for the first time in their lives, had full health insurance and we felt we had survived and our efforts to live healthy lives paid off. Now, none of us are diabetic, smokers, drinkers, or drug users. I realize we may be just plain lucky.

    I look forward to this commentary by Phil and hope we can come up with our own solutions to work as a team to solve the problems.

    There is a thread on Reader Rant where Issodhos has asked for input on the Canadian system. I am delighted that CHB and RR are finally in discussion over the lack of insurance coverage in America.

  15. michaelstephenlevinson

    My idea is to take away the tax deduction Bush put in for the rich. That would put the benefactors – Dr.’s dentists, and lawyers back in their own tax bracket, instead of crowding us. Then, as president, with a simple Executive Order, along with a speech to the nation, ask the congress for a simple, further change in the tax code, that being the allowance of as much as $50,0000 in charity work in the practice of medicine by all Dr.’s, Dentists, and other care providers. In exchange foe this voluntary work, after all their tax deductions, take an additional $25,000 off the bottom of their tax returns.

    I expect every non-HMO Dr and dentist will sign up, and work the uninsured patients into their schedules. The uninsured will be expected to come up w/ a $20 to pay off -set their initial visit. Blood work, etc., comes out of the Dr.’s pocket, unless the blood analysts are also doing charity.

    Then the recipients get a letter from Uncle Sam asking for a $5 or $10 out of their pay check (say working the counter at Burger King, and new on the job, so no potential coverage. In allowing the $5 or $10 voluntary deduction, to put into the treasury what was taken out, they will have an A+ credit rating, instead a bankruptcy because the baby was kept in the hospital overnight.

    The real issue is supply and demand. My program calls for free medical education for Dr.’s dentists, and all related personal, so Dr.s with walk in offices are everywhere. As the society ages people need more attention, so coming ailments are properly diagnosed. How to pay for the free medical education is food for another post, but suffice to say I see a way. Have a good day. My computer screen is really screwed up and i have to fix this window. Punch holes in my plan. :)

  16. nuQler Ostrich

    There is ONE candidate for President who has been advocating a Single-Payer Not-for-profit health care system since he ran for President in 2004.

    Nobody gave him any credence back then, but now nearly all candidates on the Democtratic side are calling for “Universal” health insurance. Yes, they are still selling insurance. At least they are using the word “Universal.” That’s an improvement, but not by much.

    But the ONE candidate who got it right on the Iraq War, has it right on this issue as well.

    And for them who will say that’s “Socialized Medicine” I say WE ALREADY HAVE SOCIALIZED MEDICINE.

    Just go to any Emergency Room at any hospital to see the scores of Illegal Aliens there getting their free socialized health care. The costs that are put upon the local home owners in the property tax bill under the Hospital District Taxing Authority. Yes, we are paying for their free medical care while we can’t even afford it for ourselves. How fair is that?

    So if you believe that our health care system needs a complete overhaul to get the profiteers out, support the ONE candidate who promises to do something about it.
    House Res 676.

    Otherwise shut your pie-hole.


  17. Joe Lawrence

    To paraphrase Shakespeare, “First, kill all the liars.”

    Those who, daily, take to the airwaves to claim that adoption of universal, single-payer health care insurance will surely bring about the death of The Worlds Greatest Healthcare System are merely liars. They all know the telling statistics which prove beyond any doubt where the USA ranks, whether it is infant mortality, appropriate care outcomes, timeliness of delivery or any other measure, and they rely on our being polite enough to refrain from simply calling them liars. And they are liars, in that they repeat the same baloney even after having the statistic thrust in their faces.

    For so long as we permit this barnyard politicking and pandering to go on, there will be no meaningful action taken.

    Joe Lawrence

  18. geyser

    I wasn’t sure what I should comment about, my own tale of woe or my overall feelings of our Health Care System if that is what you want to call it.
    Mr. Hoskins article was on the mark, everything he told is true. Today, if you want to have a chance of getting what you need, there is little you can do, depending on your condition you can be as loud as you want to be or stay in bed and take your chances. The only way to fight that is to have an Advocate on your behalf. They will do whatever is necessary to get you what is needed.
    In the mean time, Health Care must be made a major issue for this election. Every candidate must have a plan for it.
    The one candidate that has spoken out on Health Care before being a candidate is Ms. Clinton. Every American might as well accept the one part of having a good, solid system, you will be paying a part of it. To want the government to pay for it all, simply won’t do the job.

    Taking One Day at a Time

  19. Thomas Bonsell

    A clarification needed on one item. Nobody gets “free” medical insurance coverage from an employer. That coverage is paid for by what is called “deferred compensation”; that is, the employee earns the money through his or her labor, but the money is paid to a third party ~ an insurance company ~ rather than to the person who earned it.

    This “deferred compensation” can be used to provide every American with coverage. With health-care costs running up to 100% more in the US than in other advanced nations we could cover the 15% presently uninsured easily by reducing administrative costs of the present system, which run 25-33% of the total while running only 2-3% in Medicare. Plus we won’t have to pay seven-figure salary and bonuses to the top executives.

    But we don’t need a universal single-payer system, we need a dual system. That is, every state should enroll every resident in an HMO, which would practice preventative medicine, diagnostic services and outpatient treatment. A Federal system could use Medicare for hospitalization, recovery and recuperative treatment for all. That would eliminate half of the present Medicare program, saving money.

    Medical care such as elective and vanity procedures would remain in the private sector.

    All the proposals now being formulated are complex, burdensome messes that will only only make the tax system more complicated.

    The dual system is simple and easy to pay for.