Americans may well get the best health care in the world--if they
can pay for it. When in 2000 the World Health Organization (WHO) compared
the systems of health care in its 191 member countries, it found that
health care in the United States was more expensive than anywhere else.
Per capita annual health spending in the U.S. was $4,178, in Germany
$2,424, in Britain $1,461. As a percent of gross national product (GNP),
the U.S. spent 13.6 percent on health care, Germany 10.6, Britain 6.7.
These proportions have not changed in the past six years. It is difficult
to believe that these huge differences in health care spending reflect
proportionately lower quality of medical services in Germany and Britain.
Could it be that American health care is less cost-efficient?
In its most recent annual report, the private, nonpartisan Commonwealth Fund
details the state of health care in America. It shows that the complex mix of
employer-financed, government-financed, and privately purchased health insurance
greatly increases the cost of health care administration. The inflated insurance
bureaucracy takes an estimated 20 percent of health care costs, according to
the WHO. Other reasons for the high price of U.S. health care are the soaring
costs of medical technology and prescription drugs.
Arguably the biggest burden on the health care industry are the 47 million (16
percent) Americans, including 8 million children, without health insurance at
any one point during the year. These uninsured include non-citizens as well as
millions of illegal immigrants. For charity sake, they tend to get unpaid and
expensive treatment, often only, however, when their condition has reached crisis
proportions.
Fourteen million of the uninsured are Hispanics, 7.5 million African-Americans.
Since 2001, the number of uninsured Hispanics has increased by more than 2 million.
In addition to the 47 million uninsured, an estimated 16 million more Americans
are considered “underinsured” because they cannot afford required
co-payments.
Regrettably, the high cost of medical care does not always buy good health. On
average, for example, Americans die at a younger age than Japanese and have 6.9
deaths per 1,000 live births, compared to less than 3.5 in Japan and Sweden.
The obesity rate among adults in the U.S. is 30.6 percent, the highest among
the developed countries, nearly 21 percent higher than the rate in Mexico, the
second most obese society.
Should the United States adopt universal health care for all of its citizens,
or even all of its residents, as it exists in all other developed countries?
Some libertarians argue that in a free society individual and family welfare
is a private responsibility, not the function of the state. In opinion polls,
however, up to 80 percent of all respondents thought that they had a right to
health insurance.
By signing the Declaration of Human Rights of 1948, the U.S. agreed to its Article
25: "Everyone has the right to a standard of living adequate for the health
and well-being of himself and of his family, including food, clothing, housing
and medical care, and necessary social services, and the right to security in
the event of unemployment, sickness, disability, widowhood, old age, or other
lack of livelihood in circumstances beyond his control."
The overall cost of health care in the U.S. doubled from 1993 to 2004, according
to the Center for Medicare and Medicaid Services. In 2004, Americans spent almost
$140 billion more for health care than the year before. The nation’s health
care bill continued to grow substantially faster than inflation and wages.
All available estimates indicate that any system of universal health care would
be less expensive than the present non-system. Advocates of single-payer health
care claim savings on paperwork alone would amount to $161 billion.
If we want more cost-efficient medical services for all Americans, health care
reform is indeed the most urgent issue on the nation’s domestic agenda.