March 28, 2008

Some Facts on Health Care in the U.S.

Uninsurance: Currently, about 47 million Americans are uninsured.

Underinsurance: Millions more are underinsured, meaning they are just a car accident, heart attack, diabetes diagnosis, or baseball-to-the-face away from a financial meltdown. As one reader recently commented, losing one's job also puts you just two steps away from that catastrophe. 

Death by denial: Every year 10,000 Americans die preventable deaths because they were denied care by insurance companies. To clarify, these deaths are DIRECTLY caused by denial of claims, e.g. a patient needs cancer drugs and the insurance company says "no, your policy doesn't cover those drugs because they aren't approved by our administrative board" or "we've discovered you have a gene that predisposes you to this type of cancer, so we are canceling your policy for failure to disclose a pre-existing condition."

Insurance company practices: Currently, what insurance companies do is "cherry-pick," meaning they only insure the young and healthy who won't need much medical care, and deny insurance to older people and those with pre-existing conditions.  This can include people who are otherwise quite healthy, but weigh too much, or have a gene that could cause disease in the future.  The thing with genes is they don't always turn into disease.  Genes are like words in a dictionary.  They might be in the book, but that doesn't mean that every word gets looked up in the lifetime of that book.  Similarly, not every gene is expressed in a person.  In fact, many genes don't get expressed.  So denying insurance to someone simply because they have a particular gene is very shady.  But that's all par for the course because insurance companies make their profits by denying medical care, not by paying for it.

Insurance company costs: When the sick but uninsured finally get sick enough to need care, where do they go? The ER. Emergency care costs way more than preventative care. And guess who pays the ER doctors and hospitals to treat people who don't have insurance? You. It's called taxes. It's also called "out of the ER doctor's paycheck" because they never get paid for the services they render. And insurance companies get away with not covering those expensive individuals by pawning them off to the ERs-->ER doctors/taxpayers. Even the insurance that is supposedly paid for by employers, do you think they are really paying extra? No, they're taking it out of money that would otherwise be included in your paycheck. Let's not kid ourselves. Employers don't pay for our health insurance, they merely play middleman. Covering all Americans under a Universal Health Care plan would widen the pool and spread the risk/cost of insuring the very sick onto everyone, so each person's health spending burden is decreased. That's more money in your pocket from (the cost of insurance your company no longer has to pay for you) + (the money in taxes you no longer have to pay toward emergency care for other people). And let us note: insurance companies' administrative costs run 31 cents to every dollar you spend buying a policy from them. If a family is paying $1000 a month in premiums, that's $310 that goes toward hiring people to fill out a dizzying number of forms, put you on hold for half an hour before hanging up on you, or mailing you cryptic "coverage checks."  Why not choose a system that puts that 31%, or at least a good portion of it, toward paying for your medical care?

World rankings: Even though the U.S. is ranked #1 in money spent on medical costs, we rank #37 in the world - between Ukraine and Costa Rica - in terms of overall health, measured by several standard variables. Our infant mortality rates are the highest, and our life expectancy is lowest of any developed country. We are the only developed country that doesn't have a universal health plan for all its citizens. To be sure, American medicine has amazing drugs, technology and procedures. But guess who gets that great care? It certainly is not the uninsured or even the underinsured.

Other systems: Some of the best systems in the world - Britain, Japan, France - perform much better on most, if not all, heath indicators for less expenditure per capita.  They cover everyone.  And last I checked, they were not scary communist or socialist countries like many are afraid we'll turn into if we insure everyone.

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