Our Healthcare System: Too Broke to Fix?

| Nov 21, 2007

According to a May 2007 CNN opinion poll, 64 percent of us think that our government should provide a national health insurance program for all Americans, even if it would require higher taxes. So what's in the works?

A group of 83 House Democrats, led by Rep. John Conyers of Detroit and joined by an alliance of nurses, physicians, and labor unions, is sponsoring a measure to create a national health plan that would abolish private insurers and make all hospitals non-profit. It's called HR 676. And it's supported by a grand total of one presidential candidate: Dennis Kucinich.

None of the other Democrats want to give the Republicans the chance to compare them to Karl Marx, the way they did to Hillary Clinton when her health plan was crucified in 1993. In fact, candidate Edwards even pooh-poohed the single payer concept, also known as "Medicare for All," which would pay for doctors, hospitals, and other healthcare providers from a single fund. (The Canadian healthcare system and Medicare are single-payer systems.)

In a comment worthy of a Republican, Edwards told Rolling Stone, "Do you think the American people want the same people who responded to Hurricane Katrina to run their healthcare system?" Obama has said that if he were starting from scratch he'd support a single-payer system, but given the morass we've got now, it's just not feasible.

The plans of the three front-running Democrats are all fairly similar: Obama has come right out and said as much, and Edwards has actually accused Clinton of copying his health plan. The plans of all three pretty much agree to keep private insurance, provide tax incentives to make healthcare more affordable, and offer the uninsured a program something like Medicare. The idea is that everyone would end up with some coverage somehow.

Republicans, who bleat about "socialized medicine" whenever the Democrats approach the issue, are all for tax incentives to help people buy their own policies. Some have called for doing away with the employer-based system of health insurance and replacing it with tax breaks, so that people could use all that extra money to buy their own coverage. Of course, those who don't make enough to pay big taxes might have a problem there.

Clinton says that her idea won't need any new government agencies, which is always a big bugaboo, and that people will be able to keep their current health plans. She plans to fund her program by dumping Bush's tax cuts for the wealthy and by, optimistically enough, using electronic files, and she would cap premiums at a percentage of income. According to a speech by John McCain, Hillary's plan is "eerily reminiscent of what they tried back 1993. I think they put some lipstick on the pig, but it is still a pig. And, second of all, it is the liberal outline-let government do it." The insurance companies, of course, are pressing for a "public-private" partnership, apparently so they could cover all the profitable patients and leave the rest (like people with diabetes) to the government.

One plan that's getting a lot of play is California's. Nineteen percent of California's residents are uninsured, the highest in the nation. Governor Schwartzenegger has proposed a plan that calls for a four percent payroll tax on businesses with ten or more employees that don't provide health insurance. Employers would also have the option of dropping their coverage for their employees and instead paying the four percent tax to the state. The plan requires that all residents buy health insurance or face a tax penalty, but only people making under $25,525 would get help buying their insurance. Schwartzenegger's plan would also force insurers to sell policies to people with preexisting health problems like diabetes, but the companies could set prices based upon age and geographic area.

So how do we measure up to the rest of the world? The United States has the honor of being one of the only two industrialized nations in the world without universal coverage; South Africa is the other, and even South Africa is working on it. Germany, for instance, has had a mandatory healthcare system since Bismarck in the 1880s. Even India has partial universal healthcare, run by local governments.

As it stands now, around 84 percent of us have health insurance, about sixty percent from an employer. In 2004, sixteen percent (45.8 million people) had no health insurance. Those who are covered usually pay 16 to 28 percent of their premiums, and they kick in for co-pays as well. And sometimes they just go under: Medical bills are by far the most common reason for bankruptcy in the United States. Since 2001, premiums for family coverage have increased 78 percent, while wages have risen 19 percent, according to a Kaiser study.

We spend more on healthcare than any other nation in the world: fifteen percent of the gross domestic product. New Zealand, for example, spends one third per capita of what we spend on healthcare, but beats us in every marker of efficiency and care. Germany, the UK, Australia, and Canada also hammer us in nearly all healthcare quality issues. But our system costs two to three times what they spend. American employers, companies, and individuals will spend about $776 billion on healthcare this year, up 56 percent from 2001. And still only ten percent of diabetics receive diabetes education.

Why do we spend so much for so little? Well, for one thing, insurance companies have big offices and make big profits. In 2006, the five biggest health insurers reported a combined net income of $10.6 billion on revenues of $188.4 billion. Proponents of universal healthcare say that insurance companies use 31 percent of their revenue for administration and profit, more than a thousand dollars a person every year. That's nearly double the administrative overhead in Canada.

Government contributes about 45 percent of all payments for healthcare already, making it the largest insurer in the land. Why not go a little farther?

Sources: San Jose Mercury News, October 2007; Wikipedia; Bloomberg.com;

Healthcare Table Courtesy of Wikipedia

Country Life
expectancy
Infant
mortality
rate
(a)
(b) (c) (d)
Australia 80.5 5.0 2,519 9.5 17.7 67.5
Canada 80.5 5.0 2,669 9.9 16.7 69.9
France 79.5 4.0 2,981 10.1 14.2 76.3
Germany 80.0 4.0 3,204 11.1 17.6 78.2
Japan 82.5 3.0 2,662 7.9 16.8 81.0
Sweden 80.5 3.0 3,149 9.4 13.6 85.2
UK 79.5 5.0 2,428 8.0 15.8 85.7
USA 77.5 6.0 5,711 15.2 18.5 44.6

Legend:
(a) = Per capita expenditure on health (USD)
(b) = Healthcare costs as a percent of GDP
(c) = % of government revenue spent on health
(d) = % of health costs paid by government

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Categories: Beginners, Diabetes, Diabetes, Health Insurance, Hospital Care, Professional Issues, Type 1 Issues


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Comments

Posted by Anonymous on 21 November 2007

as a nurse without the ability to afford health insurance due to pre-existing conditions, I am here to say that I am ashamed of my own country. It seems out government cares only about the health of the wealthy, and then only because of the money they pay to get it. The right to life, liberty and the pursuit of happiness has to include good health. Time to can the money grubbing insurance companies and start over with a reasonable symstem for ALL Americans. Stop subsidizing health care for illegal immigrants and take care of our own.

Posted by Anonymous on 21 November 2007

Our government taking on individual or small business healthcare is a joke. They cannot manage the programs that they now control. I am a self employed, type 1 diabetic and currently pay $1,600+ per month for my family (husband, child and myself.) If any one is looking for a better plan, it's me. More government is not the answer!

Posted by MiltJ on 21 November 2007

Nice Statistics, but do you want catastrophic care, or basic care, and no prescription drug ads on TV. If you took all the administrative costs out of our current system you could only decrease cost about 10%. Where is the rest going to come from?

Posted by Anonymous on 21 November 2007

Great article!
We have the most expensive and least efficient medical system in the developed world: all the other countries noted have single payer and that is simply more efficient. The results, as shown by the life expectancy etc., statistics, is better health.

Posted by ricklude on 21 November 2007

Sorry! I do NOT want a social form of health care in the USA.
First off, this is a capitalist based form of republican government and has no place messing about in the privet business sector. Socialized medical care is a horrable joke as is witnessed and told by citizens of the USA and of other countrys.
Second, I've EARNED and still must PAY for my oun excellant health care thank you and I REFUSE to pay one red cent in ANY tax for someone else! Way too much of MY money is wasted on medicare & medicade frauds becouse of the way these programs are run by the government now! Forget about another one!
Third, The root cause of having so much non-health care should be adressed and NOT the resulting signs or symtoms of it.
I have not and shall not vote for ANY politician whom may support ANY form of socialized medical care!

Posted by Anonymous on 21 November 2007

I totally agree, ricklude!!!
Socialized healthcare at ANY level goes entirely against the principals and ideals this country was founded upon. If people want socialized medicine so bad, they can move to another country!!

Posted by Anonymous on 21 November 2007

National Healthcare is a great idea and should not be called "socialized" medicine, because many democratic/capitalist countries DO have National Healthcare -- it is not a "socialist" issue.
Our current Healthcare system is a joke. I work in Healthcare as a diabetes educator, and I have good Health Insurance with a good HMO, but I know that one catastrophic medical problem in my family could bankrupt me despite my great insurance plan. Michael Moore's movie "Sicko" is very true from what I see from the inside.
Thank you for a great article!

Posted by Anonymous on 21 November 2007

Thank you to Diabetes Health for such an important, informative article on the current health care system!

As a CDE, I find it is disturbing that only 10% of people with diabetes will get comprehensive diabetes management education, the cornerstone of sucessful blood glucose control.
If a patient has a heart attack or stroke, most insurances will cover the medical expenses(or at least a portion), but many will not cover diabetes education.
It has been demonstrated that education can help get the Alc less than 7.0 and thereby reduce the risks of serious complications.
With the current epidemic of obesity and diabetes, if there is not an emphasis on prevention of complications, the current health care system (inefficent as it is) will fall apart.
I am a Canadian citizen and observe strong feelings against "socialized medicine".
Perhaps a compromise could be found: would people be interested in talking to their elected officals about the importance of preventative care as a way to reduce costs and improve the morbidity/mortality of individuals in America living with diabetes?

Posted by Anonymous on 22 November 2007

As a nurse working with alot of diabetics and people with chronic conditions I am so fed up with insurance companies gouging us on premiums and then telling my patients "that particular service isn't covered" I could scream. What is really making my blood boil is those people who fall throught the cracks-they have some insurance (but not much coverage), they are trying to work to make a living, so they make too much for medicaid-and we can't help them. Maybe it's time to scrutinize the insurance industry and the way our health care dollar is spent. Way too much on administration and meeting some medicare or JACHO standard-and very little on actual patient care and education . Call me fed up and waiting to retire-oh but then I'd have to have Medicare with all of that red tape!!!!

Posted by ricklude on 22 November 2007

OMG!!!!
An "anonymous" poster who agrees with Mr. Moore, the all too well known "intellectual extream left wing liberal socialist", producer of anti-american, anti-US government garbage movies, wanna be writer and poster boy for the US communtist party!? HA!

What do you think the government operated, medical programs of Medicare & Medicade are? The're socialized forms of federal gov. sponcered medical programs which, are so mismanaged and full of loop holes that, even compleatly healthy and working NON-U.S.CITIZENS, {illegals from ALL nations} who just happen to NOT PAY ANY TYPE OR FORMS OF INCOME TAX OR PROGRAM FEES, can and do apply for and do recieve benefits, for themselves and their familys!

The feds can't even run the Veteran's health care system OR the Veteran's disability programs right! {One vet collects disability to the tune of $30,000 a year. . .for freakin' hemmoroids!!!!}

Even every state's and county's "Social Services" is so mismanaged and corrupt that, you'd be better off burning your tax dollars instead of buying fuel this winter to keep warm! At least your taxes would be producing someting productive and worth while!

And the unknowingly mesmerized socialistic liberal fools, want MORE of the same working stiff tax payer funded, government run "socialized" junk programs!?

GEEZ!!!! I guess liberalisem is as incureable a disease as diabetes is.
So. . .What other privet businesses should be socialized and run by the government? How about car insurance? Vehicle manufacture? Transportation? Energey production? Food production?{The're already doing a bang up job on this one already.}Education?{They already have a hand in it.}Banking?{Someting akin to the euro dollar maybe in your pocket soon.}

Let's just change the United States of America to the United Socialist States of America.

Hope YOU can afford to pay more and higher taxes for them! And IF it happens, PLEASE, no moaning and groaning about it after becouse, you dolts were warned well ahead of time. {Aw heck. Just have them run another program to watch and fix all the other programs. DUH!}

Posted by ricklude on 22 November 2007

P.S.

By the way, Any "National Health Care System" IS a socialistic, thereby, by it's very being, a socialist program, regardless of where it's located.

I would like to add that my wife, a nurse, and I, a professional EMT-D in the third largest city in New Jersey, have also seen the problems from both within and without.

KEEP GOVERNMENT OUT OF PRIVET BUSINESS!!!

Posted by Insurance_Tease on 23 November 2007

We at InsuranceTease.com have decided to throw our collective voices in this great health care debate. Just looking at the current news about one insurance provider, (I won't mention them by name), we find they were fined $1,000,000 for dropping patients coverage and providing bonuses to the insurance adjusters for having done so. No laughing matter for one woman, Patsy Bates, who was receiving chemo treatments for cancer. But here's the punch-line, this company admits to saving $35,500,000 by having dropped those patients. Of course after paying the fine their profits were only $34,500,000. That's right, the jokes on us. It's not so funny now, but it is true. How does any medical institution, be that hospital or insurance company, find it conscionable to withdraw treatment after it had already been started?

Several of the respondents above keep writing about socialist medicine as if they knew anything about it. I suppose they would object to our socialist fire department coming to put their house fire out. Or perhaps they would object to the police coming to their rescue during a robbery, another socialist institution. Maybe they object to having legal representation supplied to them when they are accused of a crime when they can't afford an attorney. Or maybe they just don't like the postal service. As it just so happens some of the world's best medical discoveries come from outside the United States. Japan is the source of the new discovery that skin cells can be turned into embryonic stem cells, not the U.S. of A. Canada has the honor of inventing the world's best non-surgical scoliosis treatment called SpineCor, and there are more. The point is that this prosaic attitude that the U.S. is the best in everything just doesn't stand up to the light of day. It could, but doesn't. We would like to see that change. We want America to be a world leader in all areas of medicine, not just a few. We want America to be number one in patient care, patient respect, patient recovery, and patient rights to treatment. Those of us who grew up speaking the pledge of allegiance every morning before class take exception to the deterioration of our countries standards in everything from education to what we expect from our medical treatments. We don't want to continue to be known as the one country where getting sick means you loose everything you worked for your entire life. To quote our president George Bush (A.K.A. shrubby boy) "That's uniquely American, isn't it?"

The World Health Organization (WHO) has ranked the U.S. health care system 37th out of 190 countries. At the top of the list are France and Italy. Japan is tenth. People are wary of adopting a system akin to the ones currently in place in Canada and Britain, 30th and 18th respectfully, but why on God's green Earth would anyone object to us adopting the best aspects from the top ten countries when they have the world's best health care systems? Are they insurance shills trying to sway public opinion? Why else would they be supporting a system that is ripping off the American people?

The world health organization has also ranked the average health of the people in every country they studied. The average health status of the people in the U.S. is ranked 72nd. To put this in perspective the health status of the people of Iraq has been ranked 75th. So we are doing about as well as the people in Iraq. Since the World Health Organization is the one group doing this research no one else has anything to compare these global stats too, but the scientific community in the U.S. basically agrees with what the WHO has said. We need a new amendment to the constitution, one that secures our peoples right to descent medical care, paid for out of apportioned taxes instead of premiums. No one should ever be denied care because they have ever been sick. No one should ever have to worry about choosing treatment over a roof over their head.

Posted by Anonymous on 7 December 2007

Amen! I agree Ricklude! 1st get rid of all the administrative waste in health care with insurance (private and public). 2nd let everyone be able to purchase catastrophic health coverage (even those with preexisting conditions). Then let the marketplace drive pricing for healthcare. When doctors and hospitals don't have to pay for all of the overhead of dealing with insurance and Medicare/Caid, they can direct that extra money towards offering sliding scale payment policies to subsidize people who don't have the money to pay for health care.

Posted by Mikesgirl95 on 18 January 2008

This was written by a firend of mine and sent to all the local news stations and to everyone she had asked for help from. When she dies we will see just how broken our Health Care system is!


I am desperate for your help with a major problem that I am having with filling my diabetes and asthma prescriptions. I was diagnosed with Type I (Juvenile Diabetes) 16 years ago, at the age of 8 and asthma at the age of 12. I depend on insulin to live, w/o it I will die. I am also dependent on an insulin pump that delivers my insulin to me. I'm currently unable to afford my prescriptions, because I am without prescription coverage. I have contacted numerous community agencies and each of them has turned me down, including Juvenile Diabetes Research Foundation, American Diabetes Association, Medtronic Minimed, Eli-Lilly, Sepracor, Astra-Zeneca, Northeast Memorial Hermann Hospital, Grace Community Church of Humble, Wal-Mart pharmacy, Walgreens pharmacy, Randalls, CVS, Krogers & HEB pharmacies, Legacy Community Health Services, Sisters of Charities, Sheltering Arms, United Way, Catholic Charities and several others. I was informed that I did not qualify for assistance for a number of different reasons. Some of which include: I am not pregnant, I am not HIV positive, my income is too high and I am not a veteran. I have emphasized to these agencies that the monthly costs for all of my prescriptions (including meds, pump supplies and glucose testing supplies) is approximately $1, 680. I currently make $15.00/hr working through a temp agency, I bring home approximately $1800 a month. The difference between what I bring home in pay and the expense of my prescriptions is only $120. At this time I am doing without everything other than insulin. And the only reason I have insulin is because several of my friends put their money together to pay for part of my last prescription. However, that will be gone in about 2 weeks and I am not sure what to do from there.

I am 24 years old, single and have lived a hard life. I grew up in foster care and at the age of 18 they cut me off. Since then, I have worked very hard for employers that offered health coverage, struggling to support myself. And then in December 2006 I went out of work on short-term disability following a car accident. The driver of the other vehicle was faulted for the accident, however I had two compound fractures to my left arm, requiring surgery. Upon my surgeon releasing me to return to work in April 2007, my employer dismissed me, stating that my position had been filled. Upon dismissal I lost insurance coverage. I have never gone without health insurance before and I now know that I cannot afford to be without coverage. I have done the best I can do to find a job that would hire me long-term and provide health insurance, but at this time I have not been successful. I have been working through a temporary agency since October; I work 40 hours a week, every week. I really don't know where else to turn, but I NEED assistance with the costs of all of my prescriptions. Again, the difference in what I bring home in pay from my job and the costs of my prescriptions is only $120. Unfortunately, I cannot pay my rent/utilities, put gas in my car and buy groceries off of $120, so I have been doing w/o some of my prescriptions as well as many other things! But yet all of the community agencies continue to deny my applications for assistance! I am now at the point of being homeless or being w/o medications. I know that I can go to the emergency room and be treated when I am out of insulin, however if I am admitted I will lose pay from work and possibly even lose my job! I am doing the best I can do to help myself, to overcome the life that I was raised in, but because of the expenses of medical care/prescriptions, my best still is not enough.

Can you please help me live a longer, healthier life? I have overcome so much in my life and I have so much to offer to everyone around me, please help me live long enough to do so.
Sincerely, Tracie

Posted by Anonymous on 14 April 2008

So what if socialized medicine is a socialist system? That's not an argument in its own right. By the same definition every law enforcement agency in the US is a socialist system. And I don't see anyone, especially not right wingers, rejecting the whole concept of tax financed policing just because it's a socialist system.

These so called horror stories from socialized medicine systems, which includes just about every other developed country but the US, are nothing more than conservative propaganda. In reality the people of these countries receive high quality medical treatment whenever they need it. Every single one of them. That's why socialized medicine, as a matter of fact, is immensely popular in countries with socialized medicine. The true health care system horror stories are American ones.


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