One of the supposed advantages of privatized healthcare in the U.S. is
that, assuming that one isn't unlucky enough to be one of the 45.8 million U.S.-ers without any healthcare whatsover),
you can get treated efficiently and well for what ails you. Like so
many false dogmas of free-market capitalism, this claim seems to follow
practically a priori from the more basic capitalist dogma that
competition results in greater efficiency or better services. Of
course, that's a laugh: witness Enron, Halliburton, Diebold, the
corporate media, etc.
(What's that you say? The inefficiency and inferior products of these sorts of corporate
monstrosities is an indication that the markets aren't genuinely free?
That's another bit of dogma that's close to question-begging -- for how
could it be definitive of free markets (or free market capitalism) that
these result in better or more efficiently produced or distributed
goods and services than other economic systems? That's an empirical
claim, dude. Anyway, even if in Free Market Nirvana this would be the
case (which I doubt) the sad fact is that in The Real World what
happens when the winners of a few local competitions amass a bit more
capital (or are a bit more competitively ruthless) than their fellow
capitalists, the winners very quickly make it the case (via the usual
runs of money-driven influence) that in the future they won't have to
actually compete all that much, after all. BTW, it has always struck
me as ironic that free-marketers love to motivate their view by citing,
in a vague way, the supposedly insuperable pragmatic difficulties of
implementing a more egalitarian economic system (guess they never heard
of Cuba). But heaven forbid they should acknowledge the obvious fact
-- upon which most of the tragedies of history and the present can be
blamed, by the way -- that those who gain more capital (via
competition, theft, or honest toil) nearly always use their capital to game the system so that they won't be likely to lose it in the future.)
Anyway, as yet another case where we can run a modus tollens on the
idea that free markets lead to improved goods and services, it turns
out that the dogma about U.S. healthcare goods and services is just
another lie being sold in the increasingly non-free market of ideas to
gullible U.S.-ers. Reader J. N. sends along this article in which a
noted U.S. cancer expert who moved from Edmonton, Alberta to Houston,
Texas compares the two systems of healthcare, especially as relevant to detection and treatment of cancer and other life-threatening illnesses:
EDMONTON (CP) - World-renowned cancer specialist Eduardo Bruera is homesick for Canada's health-care system.
Dr.
Bruera left Edmonton's Cross Cancer Institute after 15 years in 1999 to
become chairman of the department of palliative care at the University
of Texas M.D. Anderson Cancer Center in Houston. After working in both
countries, Bruera, an oncologist, has a message for people who complain
about medicare or who want to expand the use of private health
insurance in Canada.
"The portability and the universality of health care in Canada are
unbelievably good. I think Canadians are not aware of that," said
Bruera, who was to compare care in the two countries in a speech
Wednesday at the annual conference of the Canadian Hospice Palliative
Care Association.
"Don't look at the United States. The public health-care system
makes it possible for patients to access palliative care in Canada
earlier and more effectively."
Additionally, Bruera observes that even those who are insured in the
U.S. often face an overwhelming financial burden as a result of
terminal illness:
Since moving to Texas, Bruera said he can't get over the spectre of
crushing debt that even upper-middle-class Americans face when a family
member is dying from an advanced illness.
Even premium private health insurance in the United States rarely
covers all the costs, which can lead to bereaved survivors facing an
almost never ending list of medical bills, he said.
Of every $100 spent by families on medical care at the M.D Anderson Centre, only $32 is paid for by private insurance, he said.
More than 41 million [JW: as above, should be 45.8 million] Americans don't have health insurance, he said.
Of those who are insured, one in three will lose all their financial
assets during illness.
"To me it is an enormous impact on quality of life. The burden of
dying in the U.S. of cancer is much heavier than the burden . . . in
Canada."
Unfortunately, Canadians don't realize how much better their system is:
Bruera's remarks come as the federal and provincial governments work
to come to grips with a Supreme Court of Canada decision in a Quebec
case earlier this year which approved some uses of private health
insurance.
Since the ruling, provinces such as Alberta have been actively considering expanding the use of private health insurance.
[...]
Premier Ralph Klein has said allowing private insurance firms to
sell policies would benefit Albertans who want to shorten their waiting
times for non-emergency medical procedures.
However, the province has yet to define exactly what it means by "non-emergency."
Bruera said he is "100 per cent sure" that private insurance would not improve palliative care.
"In general, services such as palliative care, that is not highly
profitable or high tech, are generally not insured very well in the
U.S.," he said.
Statistics about U.S. healthcare tell the story. Gross inefficiency at the national level:
- In 2003, the United States spent 15.3 percent of its Gross Domestic
Product (GDP) on health care. It is projected that the percentage will
reach 18.7 percent in 10 years. (3)
- Although nearly 45 million Americans are uninsured, the United
States spends more on health care than other industrialized nations,
and those countries provide health insurance to all their citizens. (4)
- Health care spending accounted for 10.9 percent of the GDP in
Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5
percent in France, according to the Organization for Economic
Cooperation and Development. (5)
Obscene, and obscenely rising, costs of insurance and out-of-pocket medical expenses:
- Health insurance premiums will rise to an average of more than $14,500 for family coverage in 2006. (6)
- According to the Kaiser Family Foundation and the Health Research
and Educational Trust, premiums for employee-sponsored health insurance
in the United States have been rising five times faster on average than
workers' earnings since 2000. (2)
- Employee spending for health insurance coverage has increased 126 percent between 2000 and 2004. (7)
- Since 2001, the employees' share of health insurance costs has
soared 63 percent for single coverage and 58 percent for family
coverage. (7)
Devastating financial consequences of illness:
- Almost 50 percent of the American public says they are very worried
about having to pay more for their health care or health insurance,
while 42 percent report they are very worried about not being able to
afford health care services. (10)
- A recent study by Harvard University researchers found that the
average out-of-pocket medical debt for those who filed for bankruptcy
is $12,000. The study noted that 68 percent of those who filed for
bankruptcy had health insurance. In addition, the study found that 50
percent of all bankruptcy filings were partly the result of medical
expenses (11). Every 30 seconds in the United States someone files for
bankruptcy in the aftermath of a serious health problem.
- One half of workers in the lowest-compensation jobs and one-half of
workers in mid-range-compensation jobs either had problems with medical
bills in a 12-month period or were paying off accrued debt. One-quarter
of workers in higher-compensated positions also reported problems with
medical bills or were paying off accrued debt. (12)
