Despite Progress in Healthcare Access, the US Still Ranks Last Among All Other Developed Nations
Healthcare should not be a for-profit industry, like the auto or entertainment industry. It is a basic human right our government has a duty to provide, facilitate, and maintain.
Since taking office three and a half years ago, the Biden/Harris administration has:
•Invested $12 billion in new funding for women’s health research
• Capped out-of-pocket expenses for pharmaceutical drugs at $3,000
• Lowered the cost of hearing aids by allowing them to be made available over the counter;
• Launched the American Rescue Plan ARPA-H initiative for advanced
research on cancer and other diseases
• Reignited the “Cancer Moonshot” initiative with the goal of cutting the cancer death rate by at least half over the next quarter century
13 million families covered under the Affordable Care Act are seeing health insurance costs decrease by an average of $800 a year, and three million more Americans are now insured.
Most “surprise billing” medical charges from out-of-network insurance providers are now banned under the “No Surprises Act”.
Medicare is negotiating for more affordable pharmaceutical drugs.
Insulin costs are capped at $35 per month for almost four million diabetic seniors on Medicare.
These are just a few consequential health care accomplishments in a long and growing list the Biden administration can boast of as this election currently underway unfolds.
But while we are seeing progress on the healthcare front, the United States still ranks dead last in access to care and overall health outcomes, according to a recent report from The Commonwealth Fund, an organization that studies countries’ healthcare systems.
The study, titled “Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System,” ranks ten countries--Australia, Canada, France, Germany, Holland, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States — according to access to care, care process, administrative efficiency, equity, and health outcomes.
What the report finds is that, still, “The United States lags its international peers considerably on health system performance.” It concludes:
The U.S. continues to be in a class by itself in the under performance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.
The study explains that, while none of the aforementioned countries ranks highest in every performance area--and the US actually ranks second in care process — the nine other nations outpace the US in outcomes, particularly since we spend the most for healthcare of all the other industrialize nations with national healthcare systems.
The report explains:
The ability to keep people healthy is a critical indicator of a nation’ capacity to achieve equitable growth. In fulfilling this fundamental obligation, the U.S. continues to fail.
As a percentage to gross domestic product (GDP), the United States spends 16.5 percent. Australia, on the other hand, which received an overall top ranking, spends 9.8 percent — the least of all the nations.
As the report states:
The United States is not just an outlier on health system performance; it’s an outlier on health care spending as well. In 1980, U.S. expenditures were at the high end of the distribution among the 10 nations studied, but comparable to outlays in Sweden and Germany (8.2% of GDP). Since then, however, the U.S. has far outpaced other nations, spending more than 16 percent of its GDP on health care in 2022.
With the outrageous amount we spend on healthcare, one would assume our system is at least efficient.
But one would be wrong.
As the report delineates:
In the uniquely complex U.S. system of public and private payers — featuring thousands of health plans, each with its own cost-sharing requirements and coverage limitations — physicians and other health care providers spend enormous amounts of time and effort billing insurers. Denials of services by insurance companies are also common, necessitating burdensome appeals by providers and patients.
We also rank at the bottom with New Zealand on equity — “how people with below-average and above-average incomes differ in their access to health care and their care experience.”
“New Zealand and the U.S. rank last on equity,” the report details, “having the highest income-related differences in reported cost-related access issues and instances of unfair treatment or feelings that health concerns were not taken seriously by health care professionals because of their racial or ethnic background.”
According to Pew Research:
Today, some Black women specifically seek out Black obstetricians to avoid racial discrimination in medical care and improve their health outcomes. This history of mistrust provides the context for Black Americans’ beliefs about the health care system and medical research.
The majority of Black Americans (55%) said they have had negative experiences with doctors, including having to speak up to get proper care and feeling like the pain they were experiencing was not taken seriously.
“Okay, maybe,” skeptics reply, “But we can’t afford it. A ‘Medicare-for-All’ single-payer healthcare model will bring us Soviet-style Socialism!”
There is no shortage of counterarguments to knock down every one of these claims.
First, the reductive “We can’t afford it” fallacy.
That claim is seldom if ever proposed when we feel the need to increase the military budget, print money to provide $2 trillion in economic relief to keep corporations afloat, dole out perpetual subsidies to the world’s most profitable corporations, or permanently cut taxes on those same corporations and their overlords to the tune of $1.5 trillion.
Those who cry poverty are often the same who also boast about us being the richest nation in the world.
They can’t have it both ways.
We have always been able to afford to provide every man, woman, and child born in this country healthcare as a human right.
Consider that over the past dozen or so years we have spent in the neighborhood between $20–35 trillion on corporate bailouts.
All that time we could have been providing healthcare.
Right now, combining Medicare, Medicaid, insurance premiums, and out-of-pocket costs, we are expected to spend about $52 trillion on health care during the next decade.
But Medicare-for-All would eliminate premiums and out-of-pocket costs, reducing the price tag to between $20 trillion and $36 trillion over the same period.
That happens to be the same amount the federal government set aside for corporate welfare since 2008.
After the 2008 financial crash, we granted $700 billion to big banks. The Federal Reserve committed between $16 trillion and $29 trillion to large financial institutions.
Lawmakers handed $4 trillion in pandemic relief to large corporations.
Administrative savings could start by eliminating or significantly reducing the overhead produced in medical billing, on which the United States spends twice as much as Canada.
How much savings?
According to the nonpartisan Congressional Budget Office, Medicare-for-All could save the country up to $650 billion per year.
Another component: salaries and marketing expenses.
Health insurance companies are, fundamentally, just banks on which insurers spend more than 20% of total expenditures on overhead.
Medicare, on the other hand, spends around 2%.
Transitioning everyone away from private for-profit health insurance to a Medicare-for-All system would save around $200 billion in overhead alone.
The “Soviet-style Socialism” canard is just that.
No country included in the Commonwealth Fund study is a third-world banana republic where people are dying in the streets. They’re civilized liberal democracies— the same that outranked us in the last report three years ago.
And these countries are proud and fiercely protective of their national healthcare systems.
There are many permutations of national healthcare systems, and we do not need to follow Canada-or any other country’s-model in lock step.
Great Britain, for example, practices socialized medicine, in which the government owns and operates most of the healthcare providers and doctors are government employees. Although technically a single-payer system, it is just one model.
Canada and many other nations, on the other hand, contract with private providers in which doctors still run their own practices.
This is the difference between “socialized medicine” and “single-payer.”
They are not “rationing care,” as opponents often claim.
Arguably, healthcare costs being the primary driver of bankruptcy, a distinction we share with no other country, is a form of rationed care.
If you have ever tried getting an appointment with your primary care physician “as soon as possible,” you’ve experienced it.
If you’ve ever tried to schedule a test doctor ordered and had to wait weeks or even months, that’s rationed care.
It’s even worse when trying to get in to see a specialist--that’s if your for-profit insurance company approves the visit.
There are no waits for urgent or primary care in Canada.
Getting there won’t be easy, especially with well-entrenched special interest groups with unlimited funds pumping lies and propaganda into the media and our political arena.
But just as we have seen movement on same-sex marriage, marijuana legalization, police reform, voting, and the minimum wage, we will move the needle on this too — as long as we don’t cede ground to the other side buying into industry talking points.
The Affordable Care Act (ACA), aka “Obamacare” that Donald Trump and a republican House gleefully tried to repeal — despite his now claiming he “saved it” — is a major step in the right direction.
But it isn’t enough.
We need a single-payer national healthcare system.
We will have a single-payer national healthcare system.
We will end the danger, embarrassment, and fiscal irresponsibility of putting CEO profits ahead of people’s health.
Healthcare should not be a for-profit industry, like the auto or entertainment industry. It is a basic human right our government has a duty to provide, facilitate, and maintain.