Health Care In America:
Why It is So Unfair and Unaffordable,
And How Americans Can Fix It
Introduction
In 1948 The United Nations adopted The Universal Declaration of Human Rights, and Article 25 states the following:
"Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."
Many countries in Europe have come a long way in ensuring those human rights, but even though the United States was a key influence in writing and adopting that declaration in 1948, in the last 30 years the United States has been going backward in that regard.
In fact, the U.S. is one of the biggest failures in the world in securing those rights and ensuring that everyone can enjoy a standard of living adequate for their health and well being, in spite of the fact that it has the knowledge, the technology and the means to be one of the most successful. And not only is the U.S. a failure in terms of providing affordable universal health care and instead has the most costly for profit system of health care in the world, the care it does provide ranks relatively low in the world.
Why is that?
It's in large part because of the same reason that America has such a huge income gap and income disparity between the wealthiest few and the working poor. The government and its political economic system is rigged to ensure maximum profits to the wealthiest few investors and industrialists, even though it is at the expense of the vast majority of the people and their country.
That has produced the horribly unfair and inequitable situation in America in which the wealthiest few are multi-millionaires and multi-billionaires while about 20 percent of Americans live in poverty and about 40 percent of the people work full time for a living but are paid meager wages and salaries that are insufficient for them to afford all the basic necessities of life in America.
By the way, if you want fact and figures about that, the article on Poverty: America's Greatest Shame explains how and why such inequity, unfairness and injustice exists, and also explains the results and consequences. It explains how and why the minimum wage laws in America are grossly outdated and inadequate; how and why child poverty rates in America are the highest of any other industrialized country, as are rates of hunger and homelessness. And it explains how and why the U.S. is rapidly going backward in terms of protecting the rights of workers and providing help to those who really need it.
That is the basic situation. But, the basic reason the health care situation is so horribly expensive and bad is because the U.S. is the only industrialized nation in the world that does not have non-profit, publicly funded universal health care for all its citizens. Instead, it has a system driven by profit-making and getting the highest profits and the greatest return on investments --- a system in which prices and costs steadily escalate and rise as demand increases --- a system that richly rewards the rich at the expense of everyone else.
By contrast, publicly funded Universal Health Care is a sane publicly owned system in which the actual costs of staff, medicine, equipment, research and development and overhead are not raised by a profit margin. They are provided at cost. Patients pay nothing out of pocket, and the system is funded through tax revenue, the amount of which is, and in America would be, a much smaller amount than Americans now pay through insurance premiums, co-pays, costs for medicine, etc.
In other words, Universal Health Care would be far less costly than what America has now.
America does not have that because Americans have been sold the idea that what they have is a fair and natural system born out of free enterprise and free market entrepreneurship. And those who sold that idea have not only fought against non-profit universal health care. They have even fought against reasonable reforms of the for profit corporate health care system, and they have made it even more profitable for the wealthiest few who control it.
But their system is not “natural.” It is calculated for profitability at our expense. And the claim that it is fair is merely rationalization by the profiteers and their propagandists and lobbyists and politicians they've bribed to try to justify it.
But they cannot justify it if they face the truth and tell the truth. For the truth is that the American health care system has been set up so that the very wealthy few top executives and majority share holders of health insurance companies and hospitals and other medical facilities are enabled to gain unjust profits from people who need medical help and medicine, even though most of them cannot afford it.
Consequently, tens of millions of Americans suffer financial hardship because of the ever-rising high costs of health insurance, copays, medicines, and costs not covered by insurance.
But why should anyone be able to profit from other people's misfortune and suffering?
Granted, well educated professional health care providers and administrators of a health care funding system should be paid well in accordance with their education, skills, and the services they provide. However, that is the case in non-profit, universal health care systems.
Therefore, why should we have a profit-making system? Why can't we have a non-profit universal health care system that operates at cost, rather than allow profiteers to constantly raise prices arbitrarily to gain higher profits so they can get richer while we grow worse off?
Why do we allow this?
There is no valid excuse for charging patients far and above what’s needed to operate the system just so that rich investors can profit and top executives of health care facilities and health insurance companies can be paid hundreds of millions of dollars per year. What makes them think they are entitled to that?
Well, there's an explanation of why they think they are entitled. The article on Ronald Reagan’s Real Legacy points out that much of this corruption and inequity and economic crises is the consequence of Reaganite propaganda and rhetoric that combines corporate propaganda along with a “Gospel of Prosperity” which was conveniently provided by the leaders of the “religious right."
While they masquerade as Christians, they actually turn Christianity up-side-down to serve the interests of the wealthy who are driven by greed and self-interest. And they do that by claiming that great wealth is a reward from God, and that the poor deserve to be poor because they are merely lazy, not "self-reliant," and don't have enough faith in God.
In other words, it was a cunning scheme that appeals to arrogant, self-righteous and "holier than thou" people, but is actually deceptive, misleading, and heartless.
You see, part of the “Conservative” Reaganite agenda is to destroy the legacy of the great American President Franklin D. Roosevelt and his New Deal, which included proper and needed regulation of banks, financial institutions, corporations and companies, and safeguards and safety nets for the people, like Social Security (and Medicare, which was established in 1965 in amendments to existing Social Security legislation).
The Reaganite hidden agenda is not only to fool the American people with misleading corporate propaganda, but also to indoctrinate the American people with a shameful and ironic distortion of a Christian principle, because while Jesus of Nazareth did say we reap what we sow, he also rebuked the rich who reap unjust profits at our expense. Moreover, Jesus said that we should treat the poor and the least of our brethren as we would treat the Lord.
Now, because right-wing extremists are fighting so hard to maintain the status quo which favors and benefits the wealthiest few and their private banks, lending institutions, corporations and insurance companies, and have extended their fight not only against universal health care but even against reform and regulation of the profit-making private health care insurance industry, we need to examine the reality of the situation, realize the real problems, and solve them.
The U.S. Health Care "Reform"
The overwhelming majority of Americans are thankful for the 2010 Health Care Reform Act, also called the Patient Protection and Affordable Care Act, because at least it did provide some needed reforms and improvements.
However, it was merely a token effort at health care reform, and it actually offers the vast majority of people crumbs while it enables the wealthiest few to feast even higher on the hog.
Perhaps even more absurd is the fact that private insurance companies take in 31 percent of every dollar spent on health care.
Some say the Act was originally concocted by the right-wing Heritage Foundation, and was first enacted in 2006 in Massachusetts by then-Gov. Mitt Romney. Then it was enacted as federal law after being written into legislation mainly by corporate attorneys and lobbyists.
It has enough provisions in it so it can be made to sound good, but it provides about $447 Billion in subsidies for the pharmaceutical and insurance industries. It penalizes the working poor who are unable to afford the high costs of medical insurance, rather than provide them with the help they need. Furthermore, it failed to provided the most needed reforms, and it enabled the private profit-making health insurance industries to charge even higher and continually escalating premiums, copays, etc.
Physicians for a National Health Plan (PNHP) have reported that the Act leaves at least 23 million people without insurance, costs will continue to escalate because the Act does not set any limits on premiums or copays, including for patients with pre-existing conditions, and senior citizens can be charged much more than young people.
The Act enables the profiteering corporate health care system to be so unfair and costly that about 62 percent of personal bankruptcies are caused by high medical bills, and nearly 80 percent of the people who were forced to declare bankruptcy did so to because of the high medical costs and insurance costs that they simply could not afford.
And it’s no wonder, because twice as much is spent per capita (for each individual) on health care in America than is spent in other industrialized nations. The average is $8,160. And some elderly couples have to pay about $1,400.00 per month on insurance alone, beside escalating high costs for medicines and copays.
Why Does It Stay So Unfair?
Unfortunately, very wealthy right-wing extremists have fought against reform, even stooping to the absurd and extremely deceptive tactic of labeling those who advocated reform as “Socialists” who wanted a “Government Takeover” of the health care system. And they even tried to get the U.S. Supreme Court to strike down the reform act.
Why would right-wing extremists do that sort of thing? Because they are fighting to maintain Reaganism, which enabled the wealthiest few to rule completely. And they feel "righteous" because they have been influenced and misled by right-wing ideologues and demagogues who have misconstrued, distorted and twisted not only the U.S. Constitution and the intent of the Founding Fathers, but also misconstrued, distorted and twisted the core universal teachings of Jesus of Nazareth that are based on the Golden Rule.
Ironically, many of them claim to be Christians, but they listen to the wrong people -- to demagogues who appealed to the ego, pride, prejudices, greed and self-interest of the American people, causing them to forget that the Founding Fathers intended for government to promote the general welfare and ensure domestic tranquility and justice for all.
More recently, though, right-wing extremists have been claiming one of the Founding Fathers, James Madison, as their champion. But, they misinterpret Madison and the Constitution, and they attempt to rewrite history.
They ignore the fact that Madison was a leading advocate of the Commerce Clause, which gave the federal government broad powers to regulate interstate commerce. And they ignore or deny that such programs as diverse as Franklin Roosevelt's New Deal, Dwight Eisenhower's federal highway system and Barack Obama's health-care reform are in line with Madison’s thinking.
President Franklin D. Roosevelt was definitely in tune with the thinking behind Thomas Jefferson’s and James Madison’s Democratic Republican Party, with which they tried to establish a Democratic Republic. But, in spite of that, for the last 30 years right-wing partisan politicians have been trying to destroy or repeal Roosevelt’s New Deal programs and regulations, and they’ve had some significant success in doing that.
Now they are after the Health Care Reform Act or Affordable Care Act, labeling it pejoratively as “Obama Care” and calling Obama a “Socialist.” Therefore, as so many conscientious people have been saying, it is time for reason, sanity, and truth to prevail.
The truth is that the health care system in America is still terribly unfair and insufficient. Even with the health care reform enacted by the Democrats and the Obama Administration, health insurance premiums keep going up higher and higher, with higher copays and higher costs for procedures and medications. Many Americans are paying close to half their total household income on medical costs and the costs of medicine, and for some the problem is even more dire than that.
Of course, the Affordable Care Act will improve somewhat in 2014 by law, because it will expand Medicare coverage. And since three states already did that voluntarily, a Harvard study reported in the New England Journal of Medicine that there was a greater than six percent decline in death rate in those three states that expanded Medicaid coverage. The study looked at those three states (Arizona, New York and Maine) that in 2001, 2002 chose to voluntarily expand Medicaid eligibility to low income adults who did not have any children at home and didn't have disability, and who wouldn’t have health care coverage available to them in most states in the U.S.
The researchers felt the study was important because this is somewhat similar to what the Affordable Care Act will do in 2014; expanding Medicaid to all adults up to 138 percent of the federal poverty level. And basically they looked at those three states and compared to them to four neighboring states that did not expand their Medicaid programs and looked at the impact on several different outcomes – insurance coverage, access to care, health, and life expectancy or survival. And one of the most significant findings was that in the states that expanded their Medicaid program there were nearly 2800 deaths prevented by expanded Medicaid.
However, the study raises a big question. How many people died in the three states in the study that did not expand Medicaid? That’s a question being considered in many other states. For example, the difference in mortality rates, if applied to Florida, would yield about 5,680 fewer deaths per year among under-65 adults, Health News Florida calculated last week in an article titled Medicaid: Life and Death Politics.
We CAN Fix It
The good news is that we, the people, can fix it. We can, though proper and needed reforms and regulations established in new amendments to the U.S. Constitution (utilizing the tools the Founding Fathers provided in Article 5 of the Constitution), ensure that America has universal health care like most of the civilized and industrial nations in the world.
We can not only ensure that the most wealthy people pay their fair share of taxes according to their ability to pay, we can also ensure that they cannot collect Social Security and Medicare benefits if their net financial worth and/or income is high enough that they clearly don’t need the safety net that Social Security and Medicare should provide to those who actually need it.
Such benefits should be provided only to those who actually need them. It should be based on an assets and means test, such as the U.S. Veteran's Administration (VA) requires of veterans who apply for health care benefits. If and when Veterans have good incomes and have private health insurance they are required to pay certain amounts or copays to the VA for services and medicines. And such an assets and means test should also determine Social Security and Medicare insurance benefits.
Only those who really need Social Security and Medicare benefits should receive them. If that were the case, and if we with required the wealthy to pay their fair share of taxes, it would make the whole human services and health care system solvent and strong.
Regarding non-government health care programs and facilities, we can ensure that we have a new non-profit universal health care system, in which all citizens receive health care and prescription drugs without paying out-of-pocket costs. After all, as it is now, Americans pay more overall, and especially out of pocket costs, than any other people on earth for health care
According to those knowledgeable about it, including the Common Wealth Fund, despite having the most costly health system in the world, the U.S. consistently underperforms on most dimensions of performance, relative to other countries. Data that incorporates patients' and physicians' survey results on care experiences and ratings on dimensions of care show that compared with six other nations — Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom — the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives.
The U.S. is the only industrialized country in the world that lacks universal public health care. This has left about forty-two million Americans seriously at risk. Most of them have either lost or cannot afford private for-profit health insurance, or were denied it by their cost-cutting employers in order to increase their profit margin. Others are forced to pay for very expensive health insurance from private profit-making insurance companies, and, even though Americans over age 65 have Medicare, it is still lacking in very significant ways, and seniors need supplemental private insurance to get adequate coverage for adequate health care and medications.
Besides that, many privatized, for-profit hospitals and other medical facilities have been down-sized and they've reduced their nursing staffs to less than a bare minimum to cut expenses and increase profits. Health insurance premiums keep skyrocketing to absurdly unaffordable rates, and it's the same with copays and other out-of-pocket costs that are in addition to costly premiums.
The consequence is that the U.S. health care system is absurdly and unnecessarily expensive, and it leaves many people uninsured or under-insured. Due to cost-cutting it has become increasingly understaffed and plagued with accidents made by overworked hospital staff. It has many serious faults and shortcomings, all of which would be remedied by a far less expensive, universal, public non-profit health care system.
Why Total Health Care Reform Is Needed
Americans need to realize that the profit-making American health care system is simply corrupt. Back in June 2009, the House Commerce Subcommittee held a hearing regarding “Termination of Individual Health Insurance Policies,” and while its findings were alarming, the commercial news media refused to tell the American people about it.
It was found that the total compensation for one insurance company CEO was $1.2 Billion yearly; that nullifications and cancellations of health insurance policies had netted insurance companies savings (unfair profits) of $300 Million; that the performance of insurance investigators is rated according to the amount of money they saved the company by nullifying and cancelling policies.
Furthermore, it was found that insurance company investigative policies focus on the claimant’s medical history for the sole purpose of finding any justification for denying claims and canceling the entire policy, even back to the original date of issue. That left the patient with no health insurance coverage, and to add salt to the wound, the patients were required to reimburse the company for any and all claims the company may have paid under the policy.
In July 2010 the Consumers Union revealed even more facts about how the premiums of many insured people were being raised between 20 and 25 percent in 2009 and by close to that much again in 2010 (even after the Health Care Reform Act was enacted in March 2010). Some copays were raised 150 percent. Deductible amounts were still being raised, and coverage decreased. And all that happened while the income of the CEOs of the insurance companies were in the millions per year. Of course, the companies claim they raise premiums simply for a “safety net,” even though regulators say that not a valid excuse.
All those facts are clear indicators of how corrupt the insurance company culture has become, right along with the cultures of many other industries, corporations, and government agencies.
Unfortunately, misguided and corrupt people, and those who benefit from the system as it is, just don’t get it. They fought hard against health care reform initiated by the Obama Administration, and since a weak version of it became law they have been fighting to repeal it. But their rhetoric is deceptive and misleading, all concocted by the health insurance companies.
A good book on the subject is Wendell Potter’s “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.” It reveals exactly how and why the forces of greed and self-interest are deceiving Americans, with the help of Reaganite Republicans, Libertarians, Federalists, and “Tea Party” members.
Granted, the health insurance industry is not completely to blame for skyrocketing costs. The medical health care industry itself is almost as culpable, charging as much as they can get away with for tests, procedures, hospitalization, staff services, etc. They probably rationalize their high costs, thinking that patients are not actually paying for it if they are insured, but we all pay for it, and patients pay far more than they should.
It is a self-defeating system, inevitably and continually raising health care costs. That’s why the top executives of both the insurance and health care industries are profiting immensely, while the rest of us are paying way too much and some of us are facing catastrophic financial disaster.
In spite of all the facts, right-wing “conservatives” don’t want universal health care, and they still want the status quo which is very rewarding to the wealthy few, exorbitantly costly to the majority, and often disastrous and sometimes even lethal for the working poor and others who are victimized by the system.
Now, the American people should just say no to the accusers and deceivers who want things to stay the way they are.
The American people need to stand up for what is truly right, and demand universal health care for all the people according to The United Nations Universal Declaration of Human Rights.