The United States, which once took pride in delivering superior health care to its population, now ranks 47th among nations in life expectancy. We also rank 43rd in infant mortality, after Cuba and Slovenia. We are the only wealthy industrialized nation that lacks a universal health care delivery system. This is of critical importance because while nonprofit, public systems such as Medicare spend 97 percent of their budget on actual patient treatment, private, for-profit insurance companies devote as little as 74 percent to delivery of medical care. The rest goes to CEO salaries, administrative costs and profit for investors.
These figures are particularly significant when you realize that countries such as the United Kingdom, which provide national health care, spend less than half the amount per capita and slightly less than half the percentage of Gross National Product as does the United States in delivering medical and preventative services to their populations. And they get better results! If we had single-payer universal health care and could divert 23 percent of current private overhead costs to direct care, imagine how many more people could be treated and live longer, healthier lives.
Attending to one’s health, whether by having appropriate medical screenings, regulating one’s diet, getting sufficient exercise, controlling alcohol, drug and cigarette consumption, is a very private matter. Any medical decision ought properly to be made by the patient (or the patient’s legal representative), in consultation with a physician. No one should be forced to undergo treatment to which one is opposed. No one should be denied competent medical care when it is desired. The decision is private; but the ability to access medical care that is delivered safely, legally and in a dignified manner should be a basic human right.
People who work in the medical field at any level (including developing and manufacturing drugs, medical equipment or providing direct or indirect service) should be fairly compensated for time and energy, and be able to live comfortably. But it seems unconscionable that in a civilized society, anyone could or would profiteer from the illness of others. The cost of educating the providers and developing the drugs and technology could be borne by everyone and the benefits of medical education and discoveries would then be universally available. The federal government already underwrites a great deal of medical research. What if we covered the costs entirely and eliminated patents on lifesaving medications? Generic drugs would be the new normal.
As for paying for such an expanded system, we could easily solve that problem by removing the cap on Medicare payments so that the rich pay the same percentage of their income into the system as the working class. (We should remove the cap on Social Security payroll taxes as well.)
Fortunately, Obamacare (as its opponents love to label the Affordable Health Care for America Act of 2009) has already begun to provide some relief. More children and young adults are covered now than two years ago, preexisting conditions can no longer be used to justify rejection of insurance coverage, and tighter rules on health insurance company expenditures are taking effect this month. Private insurers are now required to spend 80 percent of premium income for actual care. For large group coverage that figure is now 85 percent. S
The Declaration of Independence includes “life, liberty and the pursuit of happiness” as unalienable rights. One way that our government can and should ensure these rights is to guarantee access to health care for all.
