Why Do We Not Have Universal Healthcare in America?

This seems to be the best answer I have seen, yet: How American Cultural Assumptions Keep Us From Having Universal Health Care by Nick Licat:

 The first belief is that America is the greatest nation in the world, and hence our health care is better than anywhere else. Second, collecting taxes makes for a big government to interfere in people’s private lives.

Those beliefs are not evil but are stopping our healthcare system from being universally accessible to all Americans.  Consequently, let’s examine how each assumption is challenged by how our healthcare compares to other nations’ healthcare plans.

We BS ourselves. I have a friend who moved to Canada who raves bout their healthcare system. I think if I had had better healthcare, I would have a much different life.

Pay attention to the facts put forth by the article:

Cost of medical drugs – A study on Retail Rx spending per capita (1980–2015) showed that the US spent more than nine other high-income nations of similar population sizes. For example, Americans spent $1,011 annually, while Australia, Canada, France, Germany, and the United Kingdom spent considerably less. Germany came the closest to the US, spending $686 a year.

Findings concluded that Americans consume similar amounts of drugs as people in other countries, so the high US cost was not due to our greater demand.

Health expenditure per capita – The data is expressed in Purchasing power parities (PPPs) which equalize the purchasing power of different currencies. In 2021, the US had the highest expenditure at $12.3 thousand. This amount includes both public and private expenditures.

Of the nine other comparable developed democracies, seven in Europe and two in Asia, Germany, at $7.4 thousand, had the next highest per capita ranking. All the other countries had per capita amounts that ranged from six to four thousand dollars per capita.

Life expectancy – In the US, the average life expectancy is 79.11 years, which ranks at #46 out of 149 countries based on the latest United Nations Population Division estimates. We rank last among economically developed democracies. On average, citizens in the three nations with our closest cultural heritage, Canada, England, and Australia, live five years longer than Americans.

Although the public may need to become more familiar with these metrics, a 2019 survey by Statista revealed that only 33% of Americans were satisfied with our national health system. Compared to other economically developeddemocracies, the UK ranked highest with 53% satisfied, followed by Australia, France, Canada, Spain, Germany, South Korea, Japan, Italy, and the US. The Statista survey also showed that 43% of Americans were dissatisfied with our health system.

 We have the power to change this, but we have to change our thinking, and to stop voting Republican:

Since 1980, Republicans have opposed tax increases for expanding Medicare and Medicaid and enacting ACA. Providing more health care is a precursor to producing a big government with more bureaucracy and poorer service. Most countries with effective and affordable UHC heavily fund it through taxes. Tax-financed expenditures as a percentage of US national health expenditures were 65.7 % in 2020. That is in the high range for comparable nations but not unusual.

However, our private per capita health expenditure is the highest of all of them. It is 17% higher than what citizens spend in Australia, Canada, and South Korea, which spend the following highest amounts per capita. US tax dollars do not offset out-of-pocket costs that individuals must pay for health coverage, while citizens in nations providing UHC pay less out-of-pocket expenses. This discrepancy is not a problem of a big government; it is a problem of how our tax dollars are spent.

I thought 14 years ago, the federal government had a perfect format to copy, its legal services program, which is decentralized but funded by Washington. Turns out, I may have had a good idea:

Surprisingly nations adopting UHC have not created large central bureaucracies. As a result, the decision-making and delivery of services are more decentralized than expected.

In the UK, which has one of the most extensive UHCs, responsibility is divided among geographical areas through strategic health authorities. And within each of the UK’s states (England, Scotland, Wales, and Northern Ireland), their legislatures make changes that address their citizens’ concerns.

Italy permits considerable variation in the quality and outcomes of care by region. For example, when measured at their Local Health Authority level, the results varied between 5% and more than 60%. And Australia’s state and territory governments regulate and administer the significant elements of healthcare, such as doctors, public hospitals, and ambulance services.

Germany has a unique arrangement where the Federal Joint Committee executes its healthcare system, making binding regulations and routine decisions. The Committee consists of representatives of public health insurance, hospitals, doctors, and dentists and three impartial members. In addition, on a local level, regional groups of sickness funds negotiate with regional doctors’ and dentists’ associations for payment for ambulatory and dental care.

Canada has a single payer system operated by a third-party payer responsible for paying health care providers for medical services. The government generally doesn’t own hospitals or employ doctors directly, and health services are delivered through provincial and territorial systems.

Each nation has a different way of planning and delivering health services. But they all manage to provide health coverage more cost-effectively and equitably than what the US is accomplishing.

sch 3/30