Newspaper logo  
 
 
Local Stories, Events

Ref. : Civic Events

Ref. : Arts & Education Events

Ref. : Public Service Notices

Books, Films, Arts & Education
Letters

Ref. : Letters to the editor

Health Care & Environment

11.18 How Extreme Weather Is Shrinking the Planet

11.18 Air pollution levels ‘forcing families to move out of cities’ [like from desertification, lack of drinkable water and rising oceans, there will also be pollution-caused immigration until humans fix things]

11.17 Policies of China, Russia and Canada threaten 5C climate change, study finds [Climate catastrophe is increasingly likely without worldwide organization, funding and commitment to winning THE WAR AGAINST GLOBAL WARMING.]

11.16 Scotland was first Industrialized Country to Run wholly on Wind in October

11.16 How pesticide bans can prevent tens of thousands of suicides a year [how many thousands more die early from eating pesticide-laced food?]

11.15 The Earth is in a death spiral. It will take radical action to save us [fossil fuel burning, un-recyclable plastic production/use and methane gas release must cease ASAP.]

11.15  The long read:  The plastic backlash: what's behind our sudden rage – and will it make a difference? [the world wants to throw-up...]

11.15 Claws out: crab fishermen sue 30 oil firms over climate change [workers are waking-up...]

11.15 Trump administration to cut air pollution from heavy-duty trucks

11.14 Backed by Ocasio-Cortez, Youth Climate Activists Arrested in Pelosi's Office Demanding Democrats Embrace 'Green New Deal'

11.13 What would a smog-free city look like?

11.13 Global report highlights Australia’s renewables potential amid mixed signals for coal

11.13 Interior department whistleblower: Ryan Zinke hollowed out the agency

11.12  This Land is Your Land:  The Zinke effect: how the US interior department became a tool of industry [behaving ignorantly again...]

11.12 Planned Parenthood's new president warns of 'state of emergency' for women's health

News Media Matters

11.19 The Biggest Threat to Free Speech No One Is Talking About

Daily: FAIR Blog
The Daily Howler

US Politics, Policy & 'Culture'

11.19 Last Week Tonight with John Oliver 11/18/2018 (HBO) [29:26 video]

11.19 Michael Bloomberg: Why I’m Giving $1.8 Billion for College Financial Aid

11.19 Trump’s Diminishing Power and Rising Rage

11.19 Trump Says He Was 'Fully Briefed' and Also 'Not Briefed Yet' But Either Way Saudi Crown Prince 'Absolutely' Not Involved Because Trump Knows 'Everything That Went On' Without Listening to Tape of Khashoggi Murder

11.19 'We Need New Leaders, Period': Progressive Newcomers Urge Democrats to Embrace Bold Agenda or Face Primary Challenges [Current Democrat leaders are highly compromised by corporate donations]

11.19 SNL explains Jeff Bezos and Amazon’s HQ2 strategy: trolling President Trump [2:55 SNL video]

11.18 Trump says Pelosi deserves speakership, offers Republican votes [An affirmation of Pelosi's unsuitability]

11.18 Khanna to Pelosi: Don't Just Create Green New Deal Select Committee, Make Ocasio-Cortez Its Chair [Will Pelosi earnestly change, or end her career in disgrace?]

11.18 Chuck Schumer, Feckless Hack [Neoliberal Democrats must go!]

11.18 What the State of the VA Tells Us About Trump’s War on Welfare [Privatizing often results in outright fraud and higher costs by private prisons, privatized health insurance and health care, privatized public schools and online "colleges" like Trump University]

11.17 What the State of the VA Tells Us About Trump’s War on Welfare

11.17 As Energy for Medicare for All Explodes, Steny Hoyer's Plan Includes Waiting for Trump to Help Make Obamacare Better [Another who is unfit to be Democrat leader]

11.17 'A Staggeringly Bad Idea': Outrage as Pelosi Pushes Tax Rule That Would 'Kneecap the Progressive Agenda' [Unfit to be Democrat leader]

11.17 Trump Is Starting to Panic

Justice Matters
High Crimes?

11.14 The Guardian view on Yemen’s misery: the west is complicit [WAR CRIMES]

Economics, Crony Capitalism

11.19 Bankrupt Sears wants to give executives $19 million in bonuses [blatantly immoral and sick to richly reward those who led the company into the bankruptcy]

11.18 Big Pharma Bankrolled Pro-Trump Group As Trump Pushed Pharma Tax Cut [Corruption Central!]

11.16 Amazon’s HQ2 Will Get a Tax Break Designed to Help the Poor [a Republican program that directly helps participating wealthy companies—but only helps workers if and when 'trickle-down' occurs.]

11.16 Trump doesn’t want to punish Saudi Arabia over Khashoggi. His new sanctions prove it. [George W. Bush made a similar immoral decision for the same oily reasons after 9-11, protecting Saudi defense contracts while facilitating the slaughter of poorer Arab "terrorists" in the region.]

International & Futurism

11.18 New Evidence Emerges of Steve Bannon and Cambridge Analytica’s Role in Brexit

11.18 France demands UK climate pledge in return for Brexit trade deal [Excellent!]

11.17 Saudi crown prince's 'fit' delays UN resolution on war in Yemen

11.17 Thousands gather to block London bridges in climate rebellion [We're losing WWIII because the enemy is invisible while we're like frogs slowly cooking. We aren't informed enough to be alarmed, but must get organized and motivated to fight back. We need a War Plan to ruthlessly pursue the fight of our lives!]

11.17 CIA finds Saudi crown prince ordered Jamal Khashoggi killing – report

We are a non-profit Internet-only newspaper publication founded in 1973. Your donation is essential to our survival.

You can also mail a check to:
Baltimore News Network, Inc.
P.O. Box 42581
Baltimore, MD 21284-2581
Google
This site Web
  The Health Care Elephants in the Living Room
Newspaper logo

ISSUE ANALYSIS:

The Health Care Elephants in the Living Room

by Alice Cherbonnier

In Germany, where everyone has health insurance, the per-capita annual cost of health care is $3588 per year—10.4% of their GDP. By contrast, Americans are spending 16% of GDP on health care, or $7290 per person per year.

The Wall Street Journal published a telling story on November 18, 2009: "Germany Strains to Fund Health Care for All." Its author, Vanessa Fuhrmans, does a fine job of reviewing "the world's oldest publicly-sponsored health-care system," founded in 1883 when Bismarck was in charge. We are told that costs there are escalating rapidly, as fewer younger workers are paying into the system while large numbers of people are reaching retirement age. The Germans are having to consider making changes to a system they like as it is. Could be they'll have to move to a two-tiered system: everybody gets basic insurance, and anyone wanting more than that would buy supplemental coverage. The Germans, reports Ms. Furhmans, are resisting this idea because they consider universal health care to be "a basic right."

Accompanying the story is a chart sourced from the Organisation for Economic Co-operation and Development (OECD) showing the percentage of gross domestic product that member countries are spending on health care. In Germany, the per-capita annual cost of health care is $3588 per year—10.4% of their GDP. By contrast, Americans are spending 16% of GDP on health care, or $7290 per person per year—the highest of all the OECD countries.

Yet unlike the other OECD countries, the U.S. healthcare "system" does not cover all its citizens—not by a long shot. Why is it that the U.S. spends so much more than its peer countries, and still cannot manage to assure that all Americans have decent health care coverage?

Who, what, when, where, how, why, and how much: These are the essential questions any journalist or politician, let alone ordinary citizen, should be asking about this economic disconnect. Strange, isn't it, that these questions aren't being addressed? Have American reporters gone brain-dead, or is something else going on that could explain this extraordinary oversight in reporting?

Well, consider that the overall costs calculated by OECD include such things as expenses for advertising for medicines and medical services. Think how many advertisements we see on TV and in print media in the U.S. that boost the alleged virtues of prescription and over-the-counter medicines. How much revenue would our media lose if costs were contained by not permitting such advertisements, or at least capping these expenses? Pretty substantial, right? We could call this the Don't kill the Golden Goose reason for failing to report the costs related to medical advertising, which of course is paid for by consumers through the costs of the medicines, either directly or through their insurance plans.

Then, too, there's the fact that the "health insurance industry" is mammoth; it represents over 12% of the U.S. economy, according to William J. Baumol, a New York University economics professor, among others. Some of that "industry" is related to fluff: advertising, profits, public relations and lobbying costs, and so on; but it's not all fluff. Related industries include, according to Yahoo Finance's Industry Center, biotechnology, diagnostic substances, drug delivery, drug manufacturers (generic and patent), drug-related products, health care plans, home health care and related insurance plans, hospitals, long-term care facilities, medical equipment (appliances, instruments and supplies), medical labs and research, medical practitioners, and specialized health services. All of these sectors' combined products and efforts are added to the overall health care cost per person, driving up the per-capita cost. To which we can add the prison and military industries, because our tax dollars cover the health care of inmates and military personnel, too. These industries represent lots of jobs, of course, and no one—especially not in today's challenged economy—wants to suggest taking steps to pare down the "industry" in a significant way. We could call this the Don't Kill off the Workforce argument for justifying keeping the status quo as much as possible.

In 2003, Harvard University's then-president, Lawrence H. Summers, delivered a lecture on the economics of heathcare during which he asserted that, according to an article by Harvard Gazette staff reporter Alvin Powell, "health care...is the most important force in the nation's economy, when one considers not just its direct economic impact, but also the role it has played in increasing life expectancy and improving overall health." Curiously, while Summers called for improved efficiencies to reduce costs, he didn't mention that many peer countries provide better health care than the U.S., and have longer life expectancies, despite our spending so much more to support the "industry." This would be the Don't Look for Solutions Anywhere Else argument.

Reducing healthcare costs while preserving jobs would be difficult, but we must do it. Jobs that may be lost in the healthcare field because of these economies could be made up for by creating more jobs in other sectors of the economy once businesses no longer carry the heavy burden of providing such expensive health insurance for employees.

First off, we could establish fees (as Medicare does) or cap profit margins of the for-profit healthcare industries. This is done by peer countries, most notably Japan. Or we could phase in extra taxation as profit margins exceed certain limits, with the additional tax going to offset, for example, costs for Medicaid. Or we could cap dividends that could be issued to stockholders. All of this would be painful, and intrusive, but healthcare is often about pain for individuals who lack it. Pain is pain; share it.

Some observers focus on the inefficiencies of dealing with the bureaucratic differences of dealing with the myriad of private healthcare insurance providers. Administrative costs in the U.S. are about 31%, versus 16.7% in Canada, which has a single-payer system. Adopting such a system could go far to alleviate such waste in the U.S., but the single-payer option dropped off the radar screen early on in the current health care insurance debate. Again, jobs could be lost in the process, but would be balanced by insurance affordability and broader access to care (more customers needing service).

How much could we save by finding other ways to punish criminals, including decriminalizing certain non-violent drug offenses? By scrapping the draconian three-strikes-and-you're out rule? By discharging from prison anyone over, say, the age of 70? Keeping minor offenders out of the criminal justice system (another U.S. "system" in desperate need of reform, but that's a story for another day) would make them more employable; they could contribute to the overall budget with their taxes, and provide for their families, lifting that cost from the public.

How much could we save in medical costs by limiting involvement in military conflicts to defensive maneuvers only?

How much could we save by breaking out the costs of health care industry lobbyists and political contributions, and putting caps on such spending?

We—or at the very least, our media—should be asking all these questions, but they're not. The "healthcare debate" has blinders on it: it's all about kicking, or protecting, the "for-profit" insurance companies, but many other aspects of this issue also need reform if we are to bring down health care costs.

We need a common-sense overhaul of the health care system so we can get maximum value for the money spent. Instead, we're getting a piecemeal picture that prevents us from coming together as a nation to do the right thing.

We need a common-sense overhaul of the health care system so we can get maximum value for the money spent. Instead, we're getting a piecemeal picture that prevents us from coming together as a nation to do the right thing. We're diverted by charlatans and alarmists who are fanning fears of change, of "rationing," of huge costs increases.

We need to go to the "Goals Grid" approach:

What do we want to achieve? An equitable, high-quality and cost-efficient healthcare system that covers everyone.

What do we want to preserve? Freedom of choice of providers, jobs, and quick access to care when needed.

What do we want to avoid? Substandard care, a system that doesn't cover everyone, major cost increases, overblown ad budgets for medicines, an ongoing increase to the federal deficit.

What do we want to eliminate? Duplication of services in saturated markets, waste of all kinds, inefficient administrative bureaucracies.

This focusing exercise is only the beginning, but it makes a good start. Only when we gather the facts and see how they fit into the big picture will we be able to move forward in a logical and effective way.

And while we're at it: could we please make this a fun exercise? Because all this stress over "health reform" is, well—going to make some of us sick. Not to mention that failing to do this reform will result in tens of thousands of premature deaths of our fellow citizens due to lack of access to care, or because they seek care too late due to lack of health insurance coverage.


Alice Cherbonnier is the editor of the Baltimore Chronicle.



Copyright © 2009 The Baltimore News Network. All rights reserved.

Republication or redistribution of Baltimore Chronicle content is expressly prohibited without their prior written consent.

Baltimore News Network, Inc., sponsor of this web site, is a nonprofit organization and does not make political endorsements. The opinions expressed in stories posted on this web site are the authors' own.

This story was published on November 19, 2009.
 

Public Service Ads: