The Ongoing Struggle for Better Healthcare

The Republicans in the bicameral U.S. Congress are still moving forward with their disastrous “healthcare” bill, one that’s really intended as a tax cut mostly for the richest people. The approximately $600 billion in tax cuts for the top few percent that the legislation entails affirms how those Republicans are — once again — putting the interests of wealthy corporate donors over the general public.

A way to measure how democratic a country actually is could be by seeing how public opinion polls relate to actual policy. In the United States, the bottom 70% of the wealthiest generally do not have their views represented well by elected officials. Moving up to the top 20% and beyond, views by the wealthier Americans are generally given more priority. When approaching the top 1%, that’s where much of the main policy is basically written and/or influenced from. That’s a corrupt system, but economic power and political power have an obvious correlation — the unjust concentration of one follows the other.

Universal single-payer healthcare polls at about 53% support now, which makes it a majority position among the American public. It’s possibly been polling like that for decades, depending on how the criteria is considered, but even if the majority support was a recent phenomenon, it’s still significant when compared to what’s happening with current federal policy. The Republicans aren’t even holding Congressional hearings on single-payer and the Democrats are quite inadequate in their support for it. This is despite how single-payer would function well, especially compared to the currently dysfunctional healthcare system.

The U.S. is spending about $3.2 trillion a year on healthcare, an amount approaching 18% of annual GDP. Just north of its border, Canada spends about half per capita on healthcare compared to the U.S., and that’s with Canada having universal healthcare and lower infant mortality rates, among other advantages. Many other wealthy industrialized countries are similar to Canada in that respect too. Since about $10,000 per person in the U.S. is spent on healthcare per year there annually, the savings from spending thousands of dollars less per person instead would be immense. It’s entirely possible for that kind of savings, but for it, there must be clear and persistent political focus on what has to be done.

First of all, there should be a switch to a single-payer system. Single-payer simply is public funding while private delivery is maintained. Instead of that being fully implemented though, there are currently thousands of different health insurance plans with different networks and different reimbursement rates, leading to ridiculously high administrative costs. This is seen with how a single-payer system itself would save $500 billion every year — while still covering all American citizens. A strikingly related statistic is how the overhead for private insurers averages a conservative estimate of 12% (and often 15-20%), as contrasted with the 2-3% overhead of Medicare. Medicare is a single-payer system already, and the calls for Medicare-for-All reflect the proposal for lowering its eligibility age to 0. Instead of the disaster known as the Vietnam War, Medicare should have been extended to all American citizens decades ago, so that a lot of unfortunate death and suffering would have been avoided.

A single-payer system that functions relatively well existing concurrently with the bigger, more malignant and dysfunctional system is another absurdity about America. All other OECD countries besides the U.S. and Mexico have universal healthcare, and that’s with the U.S. being the wealthiest country by far. The main reason there are about 30 million Americans without healthcare coverage is because the incessant greed of the for-profit health insurance industry is a powerful force that hasn’t been opposed enough. The consequences are real — from over 20,000 people that die every year due to a lack of medical insurance, to the various other problems that have been infected and been allowed to spread over time.

Most people are unaware that 100,000 Americans die every year due to hospital malpractice, and that’s been consistent for years. The opioid epidemic is also now the leading cause of death for Americans under 50, bringing its death to 60,000 Americans in 2016. For comparison, street killings are about 15,000 deaths a year, and those receive more mass media coverage. The resources for dealing with these and other problems is continuously being drained due to the gross misuse of taxpayer funds.

Also mostly unknown to people is that at least $320 billion of that $3.2 trillion in spending (and perhaps higher) is from computerized billing fraud and abuse. Malcolm Sparrow, an applied mathematician at Harvard, has confirmed this over the years. Sparrow has said that instead of 10% of annual expenditures going to fraud and abuse, it may be upwards of 20%, which wouldn’t be much of a surprise to experts in these types of criminal areas. The government hasn’t measured the actual numbers, Sparrow has said, “because the news would be too bad.” The actual amount of this needs to be measured and revealed, and investigating it is common sense. A study noted by the AARP found that for every $1 spent investigating this type of fraud, $17 was returned. Yet this gets almost no coverage anywhere, even as how much the healthcare debate is discussed.

Prescription drugs are another truly serious problem worth revisiting. This year, the U.S. will spend $440 billion on prescription drugs, which is around 2.4% of GDP. The costs of prescription drugs would be $80 billion or less instead if the unjust intellectual property protections for pharmaceutical companies were removed, a difference of $360 billion annually. Drugs are usually cheap to produce, but patent monopolies and unnecessary restrictions have made them expensive in the U.S. A reliable cure for Hepatitis C known as Sovaldi has a list price in the U.S. at $84,000 for a three month course of treatment. In India, a high quality generic version sells at $200-$300 for the same twelve week period. Unfortunately, drug importations to pharmacies from Canada and elsewhere are limited under U.S. law, showing again how Big Pharma has rarely lost legislative battles.

The lack of price controls in the U.S. also means that it spends roughly double what some other wealthy countries do on prescription drugs. There’s notably how Medicare is forbidden from negotiating drug prices with the drug companies, which itself amounts to costs of hundreds of billions of dollars per decade. When millions of Americans are going without their prescriptions due to costs, this type of policy is about as inhumane as it gets. Depriving millions of disabled and elderly people healthcare and medications that reduce their plight is a depraved, grand immorality.

Evidently, it’s a dark time when tax cuts for the richest people are being pushed by Congress and big business — even when those cuts will lead to many thousands of people dying. The latest CBO score for the Republican healthcare travesty is 22 million people losing health insurance, a major setback to the time before the Affordable Care Act. Again, today over 20,000 people are dying per year in the U.S. due to lack of health insurance, but before Obamacare, that number was in the 40,000 range.

The recurring theme though is policy and the healthcare system placing profits over public health. It hasn’t been working for the general population, and it’s overall been becoming worse. There needs to be a breaking point where organizations with majority public support finally reform the healthcare system for the better, with all the added benefits that encompasses.