The Health Care Crisis
and what to do about it

by Fred Sage and Peter Sciaky

People in the United States enjoy the best health care in the world if they live in a large metropolitan area and if they are wealthy enough to afford it. In this, the richest country in the world, there are 42 million people who are uninsured. Having Medicare is not a guarantee of financial security when it comes to health care costs. Between 50 and 70 million Americans have inadequate health insurance. A serious health problem would send most of them into financial ruin.

We spend far more per capita on our health care than any other country - over $4000 per person. In 1997 health care costs comprised over 13.5% of the Gross National Product (GNP). The growth has been phenomenal. At the present rate of increase, by the year 2000 we will be spending $1.74 trillion on health care, 18.1% of the GNP. By comparison, most other developed countries (with universal coverage) have stabilized their health care costs at 8 or 9% of GNP.

For all this, the quality of the American system pales in comparison to other industrialized nations when we look at the accepted measures of health care. The Organization for Economic Cooperation and Development (OECD) is a group of twenty four industrialized nations. Among the nations of the OECD, the U.S. ranked 17th in male life expectancy, 16th for female life expectancy, and 21st in infant mortality. We pay too much and get too little, because our health care system is profit driven.

The only reasonable alternative that has been proposed is a publicly funded universal coverage under medical supervision, paid through a single payer plan. By removing the profit factor and the red-tape bureaucracy it would be a more efficient and less costly system. The proposed program would be driven by quality and appropriateness rather than profit. Universal coverage is not new in this country. It exists now for those in the military and for those over sixty-five. At one time, in many states, Blue Cross/Blue Shield came close to providing low cost coverage for its members. Universal coverage has been a huge success in Canada, where, despite what you hear, over 85% of Canadians support it enthusiastically. In fact, the Congressional Budget Office (CBO) estimated that by adopting a Single-Payer national health care system, we would reduce medical spending by more than $114 billion a year by 2003.