Americans’ Self-Contradictory Views Of Socialized Healthcare – OpEd

On December 3rd, Gallup bannered “Government Favored to Ensure Healthcare, but Not Deliver It” and reported that 57% of Americans say “It is government’s responsibility to see that all have healthcare” but only 40% of Americans want a “government-run” healthcare system to be available to everyone who wants it. In other words: many Americans want other Americans to be forced into corporate and non-profit — privately run — healthcare. Lots of Americans are irrationally rabid against any sort of socialism, even the democratic types of socialism that exist in many European countries such as Sweden, where the quality of healthcare has been proven in international studies to be superior to America’s, and where the per-person cost of healthcare is around half as high as in America. The healthcare industry and its executives and its lobbies and its paid-off politicians have plenty of libertarian fools in America who, by their political participation, make life worse for all other Americans by effectively blocking socialization of the healthcare function. Gallup’s December 3rd poll also found this mental illness, libertarianism, to be especially common among Republicans: Whereas 65% of Democrats endorse universal availability of a government-run healthcare system, just 13% of Republicans do. So, Republican voters are terrific for the drug companies and the rest of the ‘health’care (actually sickness) industries.

Gallup has polled Americans on many questions about healthcare policy. One poll they published 16 May 2016, titled “Majority in U.S. Support Idea of Fed-Funded Healthcare System”, reported that 58% of Americans wanted “Replacing the ACA [Obamacare] with a federally funded healthcare program providing insurance for all Americans.” Only 37% opposed it. A tiny 5% had no opinion. Perhaps that was a high-water mark for the American public’s support of socialization of the healthcare function in America.

On 20 November 2014, Gallup headlined “Majority Say Not Gov’t Duty to Provide Healthcare for All” and reported that, “For the third consecutive year, a majority of Americans (52%) agree with the position that it is not the federal government’s responsibility to ensure that all Americans have healthcare coverage. Prior to the start of Barack Obama’s presidency in 2009, a majority of Americans consistently took the opposite view” (that it’s not government’s responsibility to see that all have healthcare). But if it’s “not the federal government’s responsibility to ensure that all Americans have healthcare coverage” (presumably meaning for all basic healthcare, but not for vanity medical services such as “tucks” and other non-health-related medical services), then even life-saving medical care, and also essential preventive care (which lowers overall medical costs), will be available only to people who can pay for it; other people will just have to die, unless they can find someone (perhaps a relative) who is willing to pay. Of course, this type of system — the “Greed is good” system — will also mean that people die young and that disability-rates, and associated incapacity at work, will be high, and all of this will lower economic productivity. Welcome to the United States! (Of course, it’s lots better than places such as Honduras.)

Is it likely that majorities really do want single-payer, but not from the government? Hardly: a gratuitous addition of stockholders’ profits into the costs for providing essential and economic-productivity-enhancing healthcare services that everyone should have access to if it’s really needed (lawfully prescribed etc.) won’t just distort the incentives to medical-services providers (and so reduce both health and economic productivity), but it will also waste the money of medical consumers (government or otherwise). But what about having ‘non-profit’ firms provide the single-payer services, instead of the democratically accountable government doing that? Non-profits cut out profits, and so eliminate the distortions that stockholders’ wants introduce into the providing of any services (wants such as stockbrokers have, who pump the investments that pay them the highest commissions, which necessarily harms their investors). However, the top executives even of ‘non-profit’ firms can pay themselves whatever their friends who sit on their board of trustees will approve; and so a ‘non-profit’ provider, too, can be, at least to that extent, a scam. (And, of course, in an entirely free market, there is no regulation, and therefore scams will be routine; so, only crooks would want that, anyway. But all the propaganda in the U.S. praises “a free market.”)

These are reasons why the countries that have the highest life-expectancies, and therefore the best health-outcomes, are the same as the countries that have socialized basic healthcare services, paid for normally entirely through taxes and provided to all citizens as a basic human right instead of as a privilege that’s available only to individuals who can afford it. (Of course, “tucks” and such get charged extra to the patient.) The United States has by far the costliest health care in terms of not only what Americans pay for it but in terms of healthcare costs as a percentage of GDP, and yet the U.S. has the lowest life-expectancy of all OECD countries; the U.S. has the most-free-market healthcare, and also the worst healthcare, among all of the economically developed countries — all (except the U.S.) of which provide guaranteed basic healthcare services to all citizens: essential services free as a right, not charged as a privilege. America’s combination of the worst healthcare plus the by-far-costliest healthcare is no coincidence; and healthcare profits in America are the world’s highest; so, the present American system is terrific for those stockholders (whose firms hire the lobbyists and their politicians who write America’s healthcare-laws). Because basic healthcare in the United States is a privilege instead of a right, the U.S. is the only economically developed nation that does not have universal coverage, health insurance for 100% of its citizenry, healthcare as a guaranteed right instead of dependent upon the patient’s ability-to-pay. When Barack Obama entered the White House, the uninsured rate was 14.6%; when he left office it was 10.9%; the insured rate when he started was 85.4%, and it was 89.1% when he left office. His repeated promises of “universal coverage” were blatant lies. His plan was in no way designed for “universal coverage”; that promise was a lie from the very outset.

In the OECD’s “Health at a Glance 2015” (which covers 44 nations), the United States scored at or near the bottom for almost all indicators of healthcare-quality, including: Life expectancy, Access to care, Quality of care, Doctors per capita, and Hospital beds per capita. We were by far the highest on Pharmaceutical expenditure per capita. Oddly, three nations, Czech Republic, Slovakia, and Hungary, were exceptionally high in both their heart-disease death-rates and their cancer death-rates; plus their life-expectancies were even lower than America’s, and their most carefully medically calculated measured “Quality of care” rankings were also generally as bad as the United States. However, in the latest calculated year, which is shown there, which was 2013, “Health expenditure per capita” (p. 165) was U.S. $8,713; Switzerland $6,325; UK $3,235; Czech Republic $2,040, Slovak Republic $2,010; and Hungary $1,719. So, America’s was over four times as high as the healthcare costs of some of the other countries in its class — i.e. in the overall worst class. Generally the top-performing nations were: Japan, Finland, Norway, Sweden, Italy, and Switzerland. Switzerland was the second-highest in cost-of-care ($6,325), right below the United States. Norway was third-costliest, $5,862. Sweden was fifth-costliest, $4,904. Japan was 14th-costliest, $3,713. Finland was 17th-costliest, $3,442. Italy was twentieth-costliest, $3,077. The average OECD cost for all the 44 nations was $3,453, which was less than half of America’s obscene $8,713. Whether Obamacare changes any of those U.S. rankings is too early to tell. However, the U.S. is such an extreme “outlier” so that our healthcare system would need to be replaced root-and-branch in order to be competitive with any other nation’s in terms of delivering value-for-the-money, instead of rip-off (which is its existing outlier status — unparalleled by any other country’s, for delivering lousy value). It is so bottom-of-the-barrel, that it is below the barrel. This is by far the world’s most-free-market healthcare system, but our government spends more per-capita on it than do other nations’ governments that pay almost all of their citizens’ healthcare costs. Wow! In fact, as shown in the chart “9.3. Health expenditure as a share of GDP, 2013 (or nearest year)” on page 167 of that OECD report, the U.S. is the only country where the private sector pays more of the nation’s healthcare costs than does the public sector, the government. America is a libertarian’s paradise. No other nation comes anywhere close to that degree of non-governmental providing of the healthcare function. Every other nation has socialized the healthcare-function to a vastly higher extent than the U.S. has. That’s how corrupt America is.

Lots of other countries are more corrupt in the pettier forms of corruption such as bribery, but perhaps few match America’s higher-level, and far more complex, systemic corruption. It benefits only the super-rich, and their lobbyists and other agents.

*Investigative historian Eric Zuesse is the author, most recently, of They’re Not Even Close: The Democratic vs. Republican Economic Records, 1910-2010