Det danske Fredsakademi
Kronologi over fredssagen og international politik 20. Juni
2012 / Time Line June 20, 2012
Version 3.0
19. Juni 2012, 21. Juni 2012
06/20/2012
Healthcare at a Crossroads
By Don Monkerud
America is beginning one of the most contentious presidential
elections in history, and few issues are as fraught with vitriol
and downright hatred as national healthcare. Meanwhile, other
nations wonder how we can tolerate such poor healthcare at such
high prices.
Of the industrialized nations, only Mexico, Turkey and the U.S.
lack universal healthcare. The U.S. spends 17 percent of GDP for
healthcare, yet one out of six citizens lack insurance coverage,
which leads to 45,000 deaths a year, according to Harvard Medical
School.
In 2011, most Americans got insurance through their employers,
which cost an average of $15,000 per family. According to the
Kaiser Family Foundation, this cost doubled since 2001, compared to
a 34 percent increase in average wages, and will double again to
over $32,000 by 2021.
Let's compare this with other countries. In 2010, the Organization
for Economic Co-operation and Development found that the U.S. spent
$7,538 per person on healthcare, 51 percent higher than the second
highest spender Norway at $5003. The average among 15
industrialized nations was $3,923.
Worse yet, the U.S. receives mediocre to poor care. In 1999, the
U.S. ranked 24th in the world for life expectancy; today we rank
49th. In 1960, the U.S. ranked 12th in the world for infant
mortality; today we rank 48th. For the past 20 years, we had the
lowest life expectancy and more "preventable years of life lost"
among the top 12 economies. In deaths from cancer and heart
attacks, we're in the middle; in deaths from all causes, we're the
highest. While spending the most, we do a poorer job than other
countries in caring for common cancers.
Americans are dissatisfied with the current healthcare system, and
generally support universal healthcare by a 2 to 1 majority, the
same margin that supports a government-sponsored single-payer
system. Despite this support, powerful lobbies defeat every attempt
by Congress to provide decent care for all citizens. The American
Medical Association is a major obstruction, and no wonder. They
have so much to lose: The average physician in the U.S. earned
$188,000 in 2010, while specialists such as orthopedic surgeons
averaged $442,450.
When Congress debated the Affordable Healthcare Act in 2010, eight
lobbyists worked every legislator, and the Center for Public
Integrity estimates that their salaries amounted to $1.2 billion.
Despite opposition from all but one Congressional Republican, the
bill passed. A bare majority of citizens supported the bill, while
76 percent of Republicans opposed it.
Passage of the bill accompanied the battering of President Obama as
Republicans conjured up images of socialism, government takeovers,
and denial of care. In the meantime, the Affordable Healthcare Act,
the first such proposal to pass Congress in 60 years, promises to
become a battleground in the upcoming presidential election.
While many liberals remain dissatisfied with the bill's lack of a
government insurance option and effective cost controls, the bill
includes important reforms. It's the first such program to extend
coverage to almost all Americans, covering 32 million more than
previously. Half will be insured by Medicaid, and half by the
individual mandate, the most debated part of the bill, because it
forces citizens to buy insurance from for-profit companies. The
bill is far from a left-wing ploy; the ultra-conservative Heritage
Foundation proposed it in 1989. Ironically, it's similar to the
plan Mitt Romney adopted when he was Massachusetts governor.
The bill also prevents insurers from denying insurance for
preexisting conditions, requires that companies spend up to 85
percent of premiums for medical care, compared to the current 70
percent; emphasizes preventive care; and allows parents to cover
children until they're 26. Unfortunately, the bill doesn't fully
implement until 2014 so Americans are unable to see the benefits of
healthcare reform.
In preventing any legislation favorable to Obama to pass Congress,
Republicans exploited ideological fears and petitioned the Supreme
Court to declare the healthcare reform bill unconstitutional. While
it's impossible to predict how the conservative court will rule,
most legal experts expect the law to be upheld.
Declaring the act illegal would mean Congress doesn't have the
power to find a workable remedy to one of our most vexing national
problems. The heart of the opposition revolves around forcing
Americans to buy insurance. This grates on many, yet all states
require drivers to buy automobile liability insurance, and forbid
the sale of certain products, as well as regulating all types of
behavior.
Everyone needs healthcare and requiring its purchase eliminates
freeloaders-the federal government requires hospitals to provide
emergency medical care to those who do not have insurance. In 2008,
uninsured patients cost $43 billion and ratepayers paid for it
through higher premiums. Additionally, citizens are required to pay
for police and fire, even though they may not use them. In reality,
there is almost no limit to the regulatory power of Congress,
despite conservative objections to loss of freedom.
If the conservatives win Congress and the presidency, American
healthcare will be set back for another 60 years. We will lose the
few advances of healthcare reform, and can look forward to worse
care, higher costs, and more people going without health insurance.
Copyright 2012
Don Monkerud is an Aptos, California-based writer who follows
cultural, social and political issues.
06/20/2012
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