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“The Best Health Care in the World”

By PAM BERNS
  Martin Luther King Jr. once said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
   Arizona, in an effort to save a few million dollars in its budget, had their Arizona Health Care Cost Containment System (AHCCCS) deny 98 life-saving transplants to low-income patients and patients who couldn’t get insurance because of pre-existing conditions. This is shocking. This is immoral. Have we really come to this? We should all be outraged.
   We all know that the United States spends more on health care than any other country. In a new publication called the World Fact Book published by the Central Intelligence Agency, our country is ranked 49th in life expectancy, according to the New York Times. And in a recent issue of the journal Health Services, the reasons that we have such low life expectancy is not because of the typical culprits—smoking, obesity, murder, or traffic accidents—it is because of our health care system. For those who keep pontificating that we have the “best health care in the world,” it is time for them to look honestly at what is broken with our ailing health care system.
   The Times reports that researchers at the Mailman School of Public Health at Columbia University compared the statistics of health care expenditures and survival of those living in other industrialized nations of Austria, Australia, Belgium, Britain, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden and Switzerland. The researchers, Peter A. Muennig and Sherry A. Gleid, measured each country’s achievement at preventing and treating some of the most common causes of ill health including cardiovascular disease, stroke and diabetes. They examined data from the World Health Organization from 1975 to 2005. While the researchers found that life expectancy increased over those years in all countries examined, so did the health care costs. And the U.S. had the lowest increase in life expectancy and the highest increase in health care costs.
   One of the most troubling findings of this study was that the U.S. was close to average in health care costs and last in 15-year survival in these countries for 45-year-old men in 1975. But by 2005 health care costs had tripled and the survival rate was still last; for 65-year-old men in the U.S., 58 percent could be expected to live 15 years, while 65 percent of men in Australia, Japan and Switzerland could be expected to survive that long. Women fared worse. While 80 percent of women in France, Switzerland and Japan were expected to survive 15 years, only about 70 percent of American women were expected to survive 15 years.

Spiraling Premiums
  A friend of mine called the other day and was shocked that her company’s health insurance premiums went up 60 percent. How high will these premiums keep soaring?
  The Patient Protection and Affordable Care Act (ACA) requires that state insurance departments and the Department of Health and Human Services (HHS) work together to conduct a yearly review of “unreasonable increases in premiums.” If plans seek unreasonable rates, they must provide a justification for the increases to the HHS and post their justification for the rate increases on their websites, reports the Kaiser Family Foundation. The foundation found that in many states, the rate reviews are opaque and lack the resources to conduct adequate reviews. While it sounds good that health care insurers must justify why their premiums are so high, it does little to impact premium rates.
   We all know that the high rates are due to costs of the middlemen, including marketing, absurdly high salaries and profits for shareholders—costs that bring no benefit to the patient. Our incredibly expensive health insurance system earns us the title of first in the world in health care costs. And the price we pay is a shorter life in order to keep feeding the profit-driven insurance system that keeps in place ridiculous administrative costs while rationing or delaying treatment for the very sick. According to Wendell Potter, author of Deadly Spin and CIGNA’s former head of corporate communications, health insurance companies make consumers big promises that they have no intention of delivering.

Cutting the Deficit on the Backs of the Elderly
  Meanwhile, Congress is toying with the idea of asking our elderly to contribute more to their health care in order to reduce the federal deficit. Illinois’ members of Congress have been vocal about raising the amount that Medicare beneficiaries will be asked to pay in order to reduce the deficit. Rep. Jan Schakowsky has objected strenuously, claiming that in regards to Medicare beneficiaries, “already 30 percent of their income is going to health care costs. I think is is absolutely the wrong way to go when we do have other options. I put on the table, not as an if-all-else fails, a public option to reduce health care costs.”
   According to Physicians for a National Health Program, the only effective way to cut costs is through an improved Medicare-for-All program. The physicians cited the idea of greater out-of-pocket costs for seniors will result in their delaying or forgoing visits to their doctors, while increasing the incidence of more costly hospitalizations.
   Surely, many of us fail to see the wisdom of cutting preventive health care only to pay more for costly care down the road. But why we are trying to cut the deficit by squeezing the elderly at all? Why were we able to bail out the powerful big banks without hesitation? Why do we keep fueling the private profit-driven insurance companies at the expense of living longer...to keep their their CEOs earning hundreds of millions of dollars a year? Why don’t we have a public option for health insurance?
   And it is simply intolerable in a country like ours for a state to deny life-saving treatment to those who need transplants. We have lost our way.


Published: February 10, 2011
Issue: February 2011 Heart Health Issue