When it comes to health care, it’s easy to complain. All you have to do is find something you don’t like and complain about it. Bitch about it. Moan. Tell the world “There ought to be a better way”. Now, what that better way should be requires more thought and analysis.
The health care system we have today is a hodge-podge of band-aids grafted on to a model centered around the concept of health insurance. But it wasn’t always this way. In fact, over 70 years ago President Harry Truman had a proposal for Universal Health Care. In the aftermath of World War II, Truman saw under-served populations counting in the millions and wanted to do something about it. At roughly the same time, the United Kingdom started it’s National Health Service with it’s single-payer system. So let’s take a look at where we are, 70 years later..
First, a comparison for a sense of proportion:
- U.K. population: 65 million.
- U.S. population: 321 million (just under 5x as many)
So let’s use a factor of 5 when we have to compare numbers between our two countries.
What is the UK spending on their National Health Service? For Fiscal Year (FY) 2015/16 the budget was £116.4 Billion. At today’s exchange rate (£1 = $1.27), that’s $147B. Now, multiply that by 5 and you get a little under $740B for a theoretical cost for an “NHS-like” plan scaled up to the size of the United States. Let’s keep that number in mind.
What are WE spending on health care? Let’s look at our government expenditures first.
- Medicare (The “Over 65 & Disabled” universal health care program): $699 Billion (Gross, $595B net)
- Medicaid (The “extremely low income” health care program): $574.2 Billion
- Veteran’s Administration (Health Care & Disability): $163 Billion
That’s a total of $1,436,200,000,000 or $1.4 TRILLION. …and that’s just to cover the elderly, the extremely poor and our veterans. Somehow, the UK manages to cover EVERYONE for just over HALF the cost, adjusted for population.
But that’s not the end of our spending… In 2016, total US health expenditures were going to top $10,000 for every man woman and child in the country. …to a total of $3.35 TRILLION. This would be after you add in what insurers are paying out in benefits and what people are paying out in co-pays, deductibles, fee-for-service, etc.
But what about all the horror stories that we hear from Republicans about Obamacare? That’s their wallet talking. Specifically, the wallets filled with insurance company cash. Insurance companies are trying to have it both ways. In public, they’re claiming that the ACA causing them losses, but when they have to report to the SEC, by law, they have to admit that they are figuratively swimming in cash. When you press them they even admit to making money on Obamacare.
But let’s go back to that extrapolated UK number.. $740B. That covers EVERYONE. What does our $1,436.2B cover? The elderly, poorest of the poor and veterans. What about everyone else? We’re paying 94% MORE to cover a FRACTION of our people! Maybe there’s some quality of care issues – like our health care is better than theirs and that is why it’s so expensive! Let’s look at some numbers:
- Life expectancy: US – 79.3 years, UK – 81.2
- ER waiting times: US – 95% seen by a doctor in 3 hours. UK – 94.3% seen AND TREATED by a doctor in 4 hours. (Note the difference between just being seen and being treated)
- Getting an appointment on the same or next day? UK – 52%, US – 48%
- Medical bankruptcies? US – Over 600,000.
- Medical tourism top destination? Malaysia. Closer to home (US)? Costa Rica. On a personal anecdotal level, the woman who had my job before me was flying to Mexico for dental work. Even after all the traveling expenses, it was still cheaper.
So.. We pay more, get less, wait longer, die sooner, go broke more often and have to find our passports to get better-priced care.. Why do we put up with this? (My personal theory is that we’ve been a very parochial country since at least the end of World War Two – anything not invented here isn’t ‘Murican enough for people)
But take a look at those numbers above. For just over HALF of what our taxes are now paying – we could have an NHS-like system in this country. FOR OVER $700 BILLION LESS THAN WE PAY NOW TO COVER A MINORITY OF OUR PEOPLE – THAT’S MORE THAN THE ENTIRE FEDERAL BUDGET DEFICIT. Though, I have to confess, the Medicaid spending numbers DO include spending at the STATE level.
Oh – and after that – we’d have a couple TRILLION dollars in private spending left over – to help make up for the predictable crash in the stock values of the private insurers. But that’s not so bad. We could adopt a plan like France or Germany and allow for private, supplemental insurance for people who can’t wait until later in the day or tomorrow to see their GP. Believe me, the insurance companies will find a market and try to sell to it.
I’m not even including the savings we could get by being able to negotiate drug prices. How about the savings if we banned drug advertising over the air like we used to? No more “purple pill” ads telling you to “call your doctor”. Guess what – your doctor already knows about the drug – and you calling their office only makes them stop what they’re doing for patients they’re seeing.
We can learn from other countries and improve upon their experiences.