Health Care – Stealth Care: Can We Keep a Secret?

23 02 2010

As rhetoric heats up on the final compromise, I realized that as a citizen I haven’t heard a politician answer a simple question – Why is the US paying more and getting less for healthcare? Or, more importantly, why are international papers clearly publishing the answers when the US media is not? Why all the stealth?

As a scientist I try to seek answers. The “other” media provides some interesting data. Consider the work of Andrew Kennis, a PhD fellow, investigative journalist, an adjunct professor and researcher in International and Political Communication from the Institute of Communications Research at the University of Illinois, Urbana-Champaign. The stats from his research I found overseas but missing in US media are simple:

  1. The US continues to be the country with the highest proportion of uninsured people in the developed world.
  2. The US  has the distinction of spending a greater portion of its total economic output on healthcare than any other developed country – just over 17 per cent of its gross domestic product (GDP) last year.
  3. The US spends on average twice as much as other developed countries on healthcare.
  4. The US results show a lowly 37th place ranking among healthcare systems in the world, according to a study by the World Health Organization based on quality and fairness.
  5. The US has an infant mortality rate, a common marker for the overall state of healthcare systems, outranked by all of the following countries according to the CIA’s World Factbook: Sweden (3rd), Japan (4th), France (7th), Norway (10th), Germany (14th), Israel (17th), Denmark (21st), United Kingdom (31st), Canada (35th), Taiwan (39th), Italy (41st) and even a few underdeveloped countries, including Cuba (43rd).

Why stealthily hide that US spends the most and gets the least for its healthcare? Even when the US has the world’s largest economic output? Fair question.

Andrew’s report uncovered some clues. Claudia Schaufan, an Argentine physician and professor of comparative health policies at the University of California in Santa Cruz –  healthcare systems in the developed world have universality of coverage and the lack of for-profit entities. “Everyone has health insurance and there is no significant for-profit aspect in any part of the medical sector … nobody in these systems ‘makes a buck’ at the expense of the health of patients,” she says.

Ooops. Lack of profit? Are they saying the sacrilege of removing profit for health keeps solutions invisible to lobbyists? Even if these blasphemous systems all outperform the US in terms of infant mortality rates, administrative costs, the extent of population with coverage and the proportion of GDP spent on healthcare?

As a capitalist myself, I like profit. But when 17% of my GDP is going to producing healthcare, which I can’t export, then when do I pull the plug? When 95% of our GDP is used for healthcare of patients? So our contribution to the world goes to zero? And this will provide food for how long?

But, surely our politicians have evaluated all these other country systems to arrive at the best solution, right? Not so fast. Asked what the proposed US reforms show in terms of learning from other examples, Naoki Ikegami, a leading Japanese healthcare economics professor, says simply: “Not much, because there has to be a willingness to learn and if anything, US leaders have isolated themselves from learning about other healthcare systems.”

What? They never checked? And they’re getting ready to vote?

Unwillingness to learn and sustained isolation is a good recipe for StealthCare. What bill is the government really passing? We may never know.

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