When it comes to the availability of private health care in the U.S., chiefly provided by employers, the news gets worse and worse.
By now, many are aware that the number of Americans without health care insurance (private or public) totaled 45 million – 15.6 percent of the population – when the Census Bureau surveyed the nation last year.
That represented an additional 1.4 million people, mostly those who were unemployed, worked for an employer who didn’t offer a health care plan or who chose not to participate primarily because of increasing employee premiums, deductibles and co-pays.
The United States is the only industrialized nation to rely on employers to offer health care to employees, accounting for a little more than 60 percent (and falling) of people with some form of coverage.
With costs rising 12 percent to 15 percent annually over recent years, most employers are cutting back their financial contribution to employee coverage while some are dropping it altogether. Higher costs also are taking a toll on hiring decisions. Some economic analysts point rising health care costs as a factor in the summer’s sluggish hiring rates.
Union-management contract negotiations increasingly are becoming stalemated over how to divide the health care cost pie. Unions are resisting, as long as possible, management insistence to shift the increasing burden for health care onto employees, some who have enjoyed full coverage at no cost to them.
As stated repeatedly in this space, the employer-employee health care delivery system is broken, with little chance of recovery in sight.
Clearly, nothing systemically will be done to fix it until after the November presidential election. And even then, neither candidate’s plan adequately addresses the basic inequities, inefficiencies and performance issues of the U.S. health care “nonsystem.”
President Bush relies on the 2004 report of his economic advisers who concluded the nation’s current health care establishment is fundamentally sound, if not close to perfect, except that it’s too affordable for most consumers. High health care costs exist, they argue, because consumers have too much insurance and purchase too much health care.
They suggest a forced health care diet (though they avoid the word “self-rationing”) by raising deductibles and increasing use of tax-deferred health savings accounts to finance the difference between employee costs and employer coverage.
Sen. John Kerry blames high costs on the bloated health care bureaucracy and insurance companies’ reluctance to cover high-cost procedures. He suggests getting government involved a little by covering catastrophic costs for companies that offer comprehensive coverage. That would make coverage more affordable to small business and lower individual premiums by about $1,000 annually.
Neither plan addresses the real culprit – the extra 20 percent to 24 percent it costs to maintain a multi-payer system, which gives each insurance company its own redundant claims department. More than 30 percent of U.S. health workers perform nothing but paperwork – at a cost of $118 billion annually. Neither plan calls for the government to negotiate lower prescription drug prices, although Kerry would legalize importing drugs from Canada.
When writing a business column, it’s most important to get to the bottom line. Despite spending almost 140 percent more for health care, the mostly private U.S. health care establishment delivers mediocre results compared to other advanced countries that rely primarily on public financing.
Considering instances of breast cancer, deaths attributed to cancer, heart disease or circulatory problems, number of physicians or infant mortality, the U.S. ranks in the middle or below the world’s most developed countries. We are close to or dead last in life expectancy, the number of hospital beds and numbers of those who survive stomach cancer.
Yet when Americans use their insurance, Medicaid or Medicare, the care and treatment they receive is arguably the best the world. If the 45 million people now disenfranchised from health care coverage were brought into the system, our health care delivery success rates most certainly would rise.
The only way to achieve such 100 percent access to health care, which virtually the rest of the world has done, is to adopt a universal health care access system here, similar to our neighbors to the north.
Although under-funding in the 1990s created some shortages and longer waits for certain care, Canada’s single-payer system is improving and continues to get support from the country’s business establishment, as well as the U.S. auto industry that continues to operate plants there.
“Canada’s health care system is a source of national pride; it distinguishes us from the United States and, in the minds of many, makes us a better country in which to live,” concluded the nation’s premier business organization, the Conference Board of Canada in a 2002 report.
Apparently, Canadian business leaders are comfortable not having the responsibility of providing health care to more than half the population, knowing that it thus increases their country’s economic competitiveness.
Write Eric Zoeckler at The Herald, P.O. Box 930, Everett, WA 98206 or e-mail mrscribe@aol.com.
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