On Health Care

The United States spends 15% of its GDP (gross domestic product) on health care. This percentage is culled from both public and private expenditures on insurance coverage and direct payment of medical bills by uninsured Americans. America spends more than any other nation on health care, even those with socialized or nationalized medicine. Yet, in spite of the astounding amount of actual dollars spent, we have at least 16% of our nation living without any health coverage at all. With fewer employers providing insurance, these numbers are sure to skyrocket as insurance rates climb even higher.

The GDP is defined as the total value of final goods and services produced within a territory during a specified period. The GDP for the United States is currently around $11,750,000,000,000, give or take a few million here and there. We multiply that amount by 15% and we get $1,762,500,000,000, which is a whole lot of money. Now, we divide that amount by the estimated number of Americans (approx. 300 million) and we get $5870.50.

Let’s compare these numbers with the closest nation percentage-wise to the United States. Switzerland’s GDP is $251,900,000,000 and they spend 11.5 % of this amount on health care which comes to $28,968,500,000. Switzerland’s health care system is fully nationalized and, last I checked, the Swiss were not in any hurry to ‘privatize’ their health care. With a population of 7,489,370 citizens, the expenditure per person is $3,880.00. That is about $2000.00 less than Americans spend, and everyone is fully covered. Noone is Switzerland goes without health coverage.

To be fair, the administrative costs are necessary, and a nation of 300,000,000 will take a little more managing power than a nation of 8 million. Remember, however, we are speaking of percentages and dollars per citizen, and not the overall amount spent. It is interesting that nations like Switzerland, with a GDP less than 3% of our own can find a way to insure each and every person within their borders. (They manage to educate them as well, which is another subject.)

Now whether you think this is too much or too little is irrelevant. It does show that we are already spending an astronomical amount for our health care, not just in percentage over other industrialized nations, but in terms of sheer dollars. Switzerland is doing something right, and perhaps, if our leaders in Washington really cared about the health of the nation they would be taking notes and planning a strategy to make sure we all have health care. If the Swiss can do it, and do it cheaper, then why can’t we? Aren’t we the great innovators of the world? The ‘can-do’ people of the world?

There are ways to cut our costs and use those cuts to spread those health care dollars around more evenly. To reduce the current rate of our expenditure would require cutting out the fat that goes to insurance vendors, negotiating with pharmaceutical companies for better prices, stamping out the fraud and graft within the system, and take the profit motive out of the health care industry. Millions and millions of dollars are spent each year to maintain a status quo that ensures them the power to dictate price and availability. Those are millions of dollars already in the system, paid by you and I as consumers, that could also be going to lower the overall health care costs well below the projected $6000.00 per year. The money from our premiums and payments is being used against us by the insurance lobbyists to maintain their already obscene profits margins.

In the not so distant past, insurance companies didn’t use premiums to make money. Premiums paid for the services and what was left over was invested in the market. With receding profit margins and greedier CEOs and shareholders, the health insurance companies could no longer rely on the risks that everyone else takes when investing, and decided to raise premiums in order to keep up their profit margins. They have done so by an average rate of 15% per year across the board, in spite of saddling consumers with higher co-pays, higher deductibles, and fewer services covered. It is estimated that 30-40% of your health care dollar goes directly to the middleman and has nothing to do with your actual health or well-being. Doctors, nurses, researchers, physical therapists, and psychologists heal people. Insurance companies don’t.

The single-payer plan sounds like a good compromise between the fully nationalized system and the mess we have now. Please check out this well-done presentation.

I was recently quoted a health policy for myself, a healthy non-smoking 40-something white guy, at around $3,300 per year. There were, of course, the usual co-pays, deductibles, etc., that would have to also be paid out of pocket, but to keep it simple we’ll stick with an even and easy to work with number. Remember this is $3,300 that I am paying directly to the insurance company for the promise that under certain conditions, they will make sure that my medical bills are paid. I’m sure there are people paying much higher premiums, especially if they have children or preexisting conditions. In any case, even before I get sick or injured, I have already paid $3,300 into health care. That plan comes with an overall $1,500 deductible, which is really another word for an additional premium by another name, so now I am forking over $4,800 dollars for my health insurance.

I know that lots of Americans don’t want socialized medicine because they don’t want to pay for someone else’s health care. Aside from being selfish assholes, they are also trying to live in a health care vacuum that doesn’t exist. The fact is, that when people without health insurance receive care and cannot pay for it, those of us who do carry insurance end up paying a little bit more to the insurance companies so those companies can meet their obligations to the providers. The doctors, nurses, therapists, billing specialists, and whoever else might be working at the hospital still has to be paid. We are already paying that cost in higher premiums, deductibles, or co-pays and, as the number of uninsured grows, so will our premiums.

I support fully nationalized health care. That’s no secret. I’m not blind to its problems either. It’s possible that the single-payer system is the best compromise, given our current situation. Something has to be done in that direction. We are Americans. There is no good reason we can’t do it, do it right, and do it now.

Kol Tuv