Sunday, July 26, 2009

The Best 'Health Care System?' - Not a Chance

A persistent claim by many politicians opposed to major health care reform - most of whom are Republicans - is that we here in the United States already have the best health care system in the world. Their hope is that if they can sell the American people on this feeble myth, they will be able to preserve a system they amazingly see little wrong with.

Senator Chuck Grassley (R-Iowa) said something very stupid. Like telling Americans they can have good health care coverage too if they just "went to work for the federal government." Senator Mitch McConnell (R-Kentucky) also said that people without insurance are not really denied health care because all they have to do is "go to the emergency room." Not only do these idiotic remarks need no elucidation, they are indefensible.

What are these detractors referring to when they make this claim about Americans having the best health care system in the world? What is clear is that the United States can deliver the best emergency care of any country. "Highly trained American doctors can summon Star Wars-type technology in saving patients who have become seriously injured or critically ill." (Myth: The U.S. Has the Best Health Care System In the World)

What this means is that from a strictly medical perspective, i.e., economic considerations aside, we have the best doctors and the best system for providing high-end, complicated care and procedures to people in critical situations. As remarkable as this ability is, it has little effect on the issue of providing coverage and delivering services to the every day masses who are in need of more routine - but nonetheless important - medical care including preventive medicine. Being able to safely perform quadruple-bypass surgery or highly complicated neurosurgery is great, but what about the uninsured individual who simply can't find a primary care physician?

A sustainable, profit-driven model has yet to emerge as a viable option for providing comprehensive health care to an entire society because covering everyone for all conditions would eviscerate the bottom line of any profit-driven scheme. In other words, to realize a profit in the business of health care delivery, coverage must exclude certain conditions as well as a certain segment of society.

If the goal of making any public option a self-sustaining one is to be realized, there may be no alternative other than to tax high income earners enough to achieve this. As the United States has the world's worst income disparity between rich and poor, such a tax would serve to mitigate this cruel inequity. Further, young and healthy people should be legally obliged to participate in a health insurance program because their contributions are necessary to provide for the poor, sick, elderly and indigent among whom they will one day be counted.

The American health care industry may well be profitable, but its health care system is loathsomely deficient.

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