What's Wrong with our Health Care System?
By Peter Sciaky
In a January, 1996 Harris Poll
only 16% of Americans agreed with the statement, "on the whole, the health
care system works pretty well and only minor changes are needed;" 59% said
that "fundamental changes" were needed; over 70% felt that the situation
will worsen over the next three years. The American people are savvier
than their elected representatives. They are right; there is plenty
wrong with the American system:
The American people were right again when they said our system needed
"fundamental changes." What is needed is a Universal Health Care system
similar to the Canadian system. Basically, a government run insurance
- The Uninsured: In this, the richest country in the world,
there are 42 million uninsured people. That is almost 17% of our
population and the number is growing at an annual rate of 1.1 million.
- The Under-insured: Having health insurance, or being covered
by Medicare or Medicaid, is not a guarantee of financial security when it
comes to health costs. Between 50 and 70 million Americans have inadequate
insurance. Any major health problem would send most of them into financial ruin.
- The Quality: The quality of the American system is such that
we pale in comparison to other industrialized nations when we look at the
standard measures of health care. The Organization for Economic
Cooperation and Development (OECD) is a group of twenty four
industrialized nations. Among them, the U.S. ranked 17th in male life
expectancy, 16th in female life expectancy, and 21st in infant mortality.
- Health Care Costs: We spend far more per capita on our health
care than any other country, over $4000 per person. Health care costs now
comprise almost 14% 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. So, despite all our
sophistication, our expertise and advanced research, our high-tech medical
devices, we are clearly not the best (as some of our politicians have
assured us). We spend more for less and are being short-changed!
For those who quake at the thought of yet another governmental
bureaucracy, consider these facts:
- We already have a government-run health care model, Medicare.
Medicare is more efficient than any private insurance program, spending
only 3% for overhead and administrative costs.
- Those in the Medicare program (over 65 or disabled) are the
only universally insured portion of our population. In 1987 24% of
America's health care dollars went to pay administrative costs, it is
still more today. In the same year, only 11% of Canada^Òs total health
care bill went to administration. Remember, we are not talking about the
actual cost of health care itself, only that of its management.
Apparently the American health care industry is not very efficient. In
1990 it took Blue Cross / Blue Shield of Massachusetts 6,600 people to
administer insurance to its 2.5 million clients in New England. In the
same year, 435 people in British Columbia managed the provincial health
program for that province^Òs 3.1 million people. In fact, Blue Cross /
Blue Shield of Massachusetts employs more administrators than does
Canada's entire health care system, which serves over 26 million
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.