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An Aussie looks over the US health-care system

Whichever way you look at it the US health-care system is appalling - and to think that they are almost manning the barricades to stop the introduction of Obamacare, whatever its deficiencies.     In a piece on truthout, An Aussie looks over the US "system" and, rightly, ponders how such a wealthy country like America can have such a dysfunctional health-care system.

"These days, most people would say that an adequate standard of living includes readily available health care of a proper standard, that "health care delayed is health care denied." Most people would also expect that citizens of a wealthy country should be able to expect better health care than the benighted citizenry of a poor country. So it comes as something of a shock to learn that the United States, which spends almost 50 percent of the world's total health expenditure, ranks way down on most health statistics. Let's start with the World Bank Health Indicators, which show that, in 2009 (latest available figures), Germany, for example, spent $4,724 per capita, some 11.7 percent of GDP, for which citizens received 8 hospital beds per thousand people and a princely four doctors per thousand. Germans are generally pretty healthy, but they pay for it. My tightwad country, Australia, spent $4,118  per capita, 9.0 percent of GDP, to get four beds and one doctor per thousand patients for slightly better standards of health than the Germans. Since then, our government has committed to spending 8.0 percent of GDP on health, and we are on course to get that (now down to 8.4%).

However, when we look across the Atlantic, we find that the United States spends $7,990 per person, an astounding 17.7 percent of GDP, to get only three beds and two physicians per thousand population. To make things worse, US figures are rising rapidly, now thought to be over 18.0 percent of GDP, but where are the standards of health? In a word, they're nowhere. In fact, they're worse than that, as the statistics conceal a grossly inequitable distribution of health expenditure. A Hollywood starlet's boob job, at $65,000, crowds out any number of poor people from even a look at a clinic, as Joe Bageant's biting reportage shows. Health costs are the biggest single cause of bankruptcy in the United States, while disabled veterans can be seen on street corners in any city, begging for money, not to mention all the mentally ill people crammed in prisons, the new asylums.


But the most bizarre fact is, alone among the world's hundred or so wealthiest countries, the United States does not provide health care for its most vulnerable citizens. Oh sure, the wealthy can book into some very fancy, ultra-high-tech institutes to have a total body rebuild, but that's the sort of stunt that got Prince Grigory Potemkin a bad name: Behind the facades, the poor are warehoused in the charity wards, if at all. Anybody with an interest in the health game (and that's all of us) knows perfectly well that the true measure of a nation's health is not the tiny heads of rich old people getting heart transplants, whose expenditure drags the national average up, but the very large tail of poor children who drag the health statistics down, because their untreated throat infections end up as rheumatic heart disease, perforated eardrums, chronic bronchitis etc. What counts is not expenditure, but what that money achieves. Now the interesting thing is that, if we look at the very large, naturalistic experiment going on around the world, the one called "health care delivery and funding," it would seem that providing treatment for all those poor people does two things: it actually lowers the total cost  to the country and  it yields improved health standards.'

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