Health care in America: best of all possible worlds?

By Elena Rumiantseva
Examiner, May 6, 2013

SEATTLE – The Western Washington chapter of Physicians for a National Health Program (PNHP) held its annual public meeting on May 4 at the University of Washington’s Kane Hall. The theme was “Health care is a human right.” PNHP adheres to this philosophy and pushes for universal health coverage in the United States.

The meeting was opened by Dr. Jim Squire, president of the Western Washington chapter of PNHP, who argued that health care should be organized as a fire department. People who had fires before don’t pay a larger premium if their house sets on fire again (read, no pre-existing condition). Everybody gets the same protection in case they need the services of the fire crew. It should be this way for health care needs. When a person has to go to the doctor, he should be able to do it without thinking twice about the cost.

Dr. Andy Coates, national president of PNHP, stated that health care is tied to caregiving. It is continuous: today your neighbor needs it, and tomorrow you might need it. That is why it has to be available to everybody. Coates said, “Social solidarity is the only foundation for quality health care.” Right now our country lacks this foundation. Incomes have shrunk in real dollars since the recession began, and some families face a choice whether to buy food or necessary medications. Income inequality exacerbates the problem, creating “second class” citizens with low expectations of their basic rights of health and well-being.

Corporate ownership of health care services is also stunning. There are for-profit hospices and ambulances; private equity firms own the majority of nursing homes. Single-payer is the first step of stopping this madness. Then we need transformation of caregiving, Coates reiterated in the end of his presentation.

While Coates and Squire talked about health care from a philosophical point of view, there was an economist on the panel, who crunched the numbers for the audience. Gerald Friedman is the professor of economics at the University of Massachusetts, Amherst, and he researches questions about labor history and the economics of health care. He was the keynote speaker at PNHP’s annual meeting last October.

Statistics that Friedman offered to the people’s attention supported the general message of the meeting that health care is a human right. On average, a person pays $6,000 for health care per year and lives to 80 years old. If this number is compared to numbers of other developed nations, it turns out that for this money a person should live until 84 years. That is significant if we think in terms of the whole population in the U.S. For data from OECD, click here.

According to statistics presented by Friedman, in 1960, 7 percent of total wages went to cover medical costs. In 1970 it went up to 11 percent, in 1980 to 17 percent, in 1990 to 26 percent. In 2010 the share of wages that went to cover health care costs was 39 percent. Unfortunately, the Affordable Care Act (also known as “ObamaCare”) will not fix the problem of rising costs. The number of uninsured is also expected to rise. In 2017 it will be 29 million people, in 2023 – 30 million.

Of course, the ACA deserves some kind words. It will ultimately remove the words “pre-existing condition” from use by insurance companies and more people will receive coverage through expanded Medicaid if the states choose to have it. However, the underlying problems of inequality and high costs with ever-shrinking benefits will not go away. “Shared risk,” “consumer-directed health care” and “pay for quality” are euphemisms that mean more costs will be shifted to the consumer.

To fix these problems, this country needs to cover everybody and remove the profit motive from the equation. It can and will be done, as all the speakers at the program stressed. So, the question is, do we live in the best of all possible worlds, as Leibniz quipped, or can we improve ours to be more just, fair and equal?