|
Even though about 50 million people lack health
insurance, causing the deaths of well over 18,000 people each year, the
U.S. spends more on health care than it does on food. Not surprisingly,
pharmaceutical companies and HMOs (health-maintenance organizations)
are some of the most profitable businesses in the U.S.
While over 15 percent of the GDP is spent on
health care, inability to pay for medical expenses is the primary
reason for family bankruptcy, or the cause of over 50 percent of all bankruptcies
in the U.S. And in 2006, 25 percent of families had trouble paying for
medical expenses, most of whom had insurance.
While Republican John McCain’s utterances on
health-care reform have been almost non-existent, the views of his
Democratic Party challenger, Barack Obama, are developing in a similar
vein as the "health care for all" plan enacted in
Massachusetts in April 2006.
Aiming for "universal coverage" but
unwilling to threaten the profit rates of pharmaceutical companies and
HMOs, the Democratic Party-dominated legislature in Massachusetts
passed a law that made the purchase of health insurance mandatory, like
automobile insurance for those who drive. The penalty for violating the
law is $80 the first year; the second year it is half the cost of an
insurance plan, about $2000 per person.
Those eligible for free government-sponsored
insurance must be below the "poverty line," which
sociologists joke about because the line is simply a low-cost
breadbasket multiplied by three, taking nothing else into
consideration. Those making 100 percent to 300 percent of the poverty
wage would get partial assistance. Either way, it is great business for
the HMOs.
And working people get stuck with the bill,
since Massachusetts’ employers aren’t required to provide health-care
benefits. Instead of spending thousands annually for each employee,
they can pay a penalty of just $295 each.
While the Massachusetts
"experiment" stands as an example, the previously slightly
Republican-leaning pharmaceutical industry and HMOs have begun to
switch their political preference slightly to the side of the
Democrats. As of May in this election cycle, the pharmaceutical
industry gave $7 million to the Republicans and $7.4 million to the
Democrats. HMOs gave Republicans nearly $2.7 million and Democrats over
$4 million.
And the medical moguls do so for good reason
since Obama and the other Democrats oppose single-payer health care,
which would slash the pharmaceutical industry’s profits and cut the
insurance companies out of the loop.
(While Obama did say he supported
single-payer universal health care in 2003 during a speech to the
AFL-CIO, since then he has claimed that his comments were taken out of
context.)
After adjusting for differences in per capita
income, the U.S. spends $477 billion more on health care than peer
countries. But when Obama does expand on his vague plan for universal
health care he insists that the problem is mainly a technical one.
According to Obama, the problem can be fixed, at least in large part,
by new internet technology and by laying off thousands of health-care
office workers.
In 2007, he put it this way: "So where’s
all that money going? We know that a quarter of it—one out of every
four health-care dollars—is spent on non-medical costs; mostly bills
and paperwork. And we also know that this is completely unnecessary.
Almost every other industry in the world has saved billions on these
administrative costs by doing it all on-line….
"But because we haven’t updated
technology in the rest of the health-care industry, a single
transaction still costs up to $25—not one dime of which goes toward
improving the quality of our health care. This is simply inexcusable,
and if we brought our entire health-care system on-line, something
everyone from Ted Kennedy to Newt Gingrich believes we should do, we’d
already be saving over $600 million a year on health care costs."
"Another, more controversial area we
need to look at," Obama stated, "is how much of our
health-care spending is going toward the record-breaking profits earned
by the drug and health-care industry. It’s perfectly understandable for
a corporation to try and make a profit, but when those profits are
soaring higher and higher each year while millions lose their coverage
and premiums skyrocket, we have a responsibility to ask why. . ."
According to Obama, after we look at the more
controversial (!) record-breaking profits, and we ask why, "we
have to start looking at some of the interesting ideas on comprehensive
reform that are coming out of states like Maine and Illinois and
California, to see what we can replicate on a national scale and what
will move us toward that goal of universal coverage for all." The
plans referred to borrow to greater or lesser extents from that of
Massachusetts.
Obama’s plan calls for "pay or
play" where employers are fined some amount if they do not provide
health benefits, just like in Massachusetts. Also borrowing from the
Massachusetts plan, it calls for a "National Health Insurance
Exchange," where consumers could find out about different plans at
a central, presumably web-based, location.
All told, Obama’s plan is estimated to cost
$50 billion to $65 billion, bringing the $476.4 to at least $526.4 billion
more than what other peer countries pay. That is, if the plan comes in
at its estimated cost, which the Massachusetts plan has proven itself
incapable of. Moreover, in Massachusetts insurance is still
unaffordable for most families making between $60,000 and $110,000,
according to health-care journalist Robert Laszewski.
Meanwhile, the pharmaceutical industry and
HMOs are rallying to the Democrats, as they talk about health-care
provisions much more than Republicans. Since single-payer is out of the
question, the medical corporations will not be threatened. Instead,
they will likely have something like the Massachusetts deal to look
forward to.
One positive change the Obama plan calls for
is more generic drugs "by making it harder for drug companies to
pay off generic makers to stay out of their markets—a good idea that
also has bipartisan support," according to Laszewski. This will
not change things across the board, though, since some generic drugs in
the U.S. are already cheaper.
While the U.S. ends up paying $57 billion
more than peer countries for outpatient drugs, it pays $98 billion more
on administration and insurance, according to the McKinsey Global
Institute. In 2007, the U.S. spent $417 per capita on administration,
almost six times the average for comparable countries.
The Obama plan calls for techno-band-aids
without fundamentally changing the broken system. It would encourage
people to enroll in the current programs (after laying off thousands of
the medical office workers who deal with these people), fine the
employer a nominal fee for not providing health benefits, make
information about all the insurers available in a central location, and
sell some drugs for a little less.
Obama fails to address the main reason for
the high cost of health care in the United States—high profits for the
corporations involved. A rational solution for the vast majority would
be to simply nationalize the whole health-care
industry—pharmaceuticals, hospitals, and all. This could save hundreds
of thousands of jobs and make free health care available to everyone by
cutting all the superfluous expenses going to executives and investors.
The U.S. spends almost 250 percent of what
Britain, with its largely nationalized health system, spends per
capita, even though both countries treat the same types of cases. And
there is still plenty of meat to cut off with Britain’s private
pharmaceutical industries and hospitals, which make substantial
profits.
However, Obama has proven himself loyal to
the medical industry. Representing the interests he does, he is
incapable of nationalization to provide free universal, quality health
care to the American people.
|