The World’s Best Healthcare?

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Wednesday - August 05, 2009

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Now, class, move your desks forward and listen up while I offer a short lecture on what you get for your healthcare dollar in the United States of America.

First, you get “the finest healthcare system in the world.” For weeks, months, years and decades, you’ve heard our congressional ladies and gentlemen call it that - “the finest healthcare system in the world.”

They are demonstrating their gratitude. In the 2008 congressional elections, they collectively received $167 million in campaign contributions from healthcare industries.

Our congressional ladies and gentlemen also are demonstrating that they’re fast learners. In 2008, they listened to $484 million worth of lobbying by America’s healthcare industry - lobbying that invariably included the assertion that ours is the finest health-care system in the world.

Second, you get a health-care system that costs an enormous amount of money, much of which is spent on administration. According to Physicians for a National Health Program, “administration consumes at least 31 percent of healthcare spending” in the United States. How enormous are those costs? Administration of the the nation’s government-run Medicare system for old folks like me stands at 3 percent.

Put another way (in a 2007 Commonwealth Fund report), “U.S. health insurance costs as a share of total health spending are 30-70 percent higher than countries with mixed private/public insurance systems, and three times higher than in countries with the lowest rates.”

So when you pay your monthly healthcare premium - or the co-payment - remember all those lovely people you are helping to support who are neither doctors nor nurses nor anyone else who can fashion a splint for your broken leg or diagnose your ills.

Third, you get a healthcare system that is, indeed, No.1 - numero uno, ichiban, no ka oi - in three important categories: total healthcare expenditures per capita, total health expenditures as a share of gross domestic product, and rate of growth in total healthcare expenditures as a share of GDP over the past quarter century.

Aren’t you proud? We’re No. 1. Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Japan, Luxembourg, the Netherlands, Norway, Sweden, Switzerland and the United Kingdom all trail us.

Let’s hear a loud, collegiate cheer: USA! USA! USA!

Half of the countries listed above spend less than half per capita on healthcare than the United States does. The rest spend about roughly 55 percent to 65 percent as much.

But our healthcare system leads in other categories as well. For example, we lead in the number of people who do not have healthcare coverage: 46 million and growing. By the reckoning of the Commonwealth Fund, we should be using the number 75 million - which represents the uninsured and the underinsured. Either way, we lead.

Those other countries don’t even compete. They provide healthcare coverage, usually “single-payer” (also called by many of our congressional ladies and gentlemen “socialized medicine”) to all of their citizens.

And the list goes on. But I’ll mention just one more accomplishment we’ve achieved with our healthcare dollars. The United States can claim a higher infant mortality rate than all the countries I mentioned earlier: 6.26 deaths per 1,000 live births. Canada, with its system of socialized medicine, only has 5.04 per 1,000; France, yet another one of those countries that practices socialized medicine, just 3.33.

Aren’t you proud?

Class dismissed.