Saturday, November 30, 2013


The typical American knee-jerk condemnation of single-payer systems for the delivery of healthcare care, i.e. the socialization of healthcare is a crystal clear example of knee-jerk, i.e. non-thinking. The knee-jerk response is likely in many cases to reflect the type of "thinking" that loves to proclaim that the American healthcare system is "the best in the world." And repeating "America is s the best country in the world" ad nauseam is a mantra the origins of which I am quite curious. I don't believe that the slogan was commonplace in the 1950s although I am not sure. I suspect the origins of the braggartism may have been a collateral outgrowth of the Vietnam War and other follies in which some Americans have felt forced to justify the needless sacrifice of human life—while other Western democracies stand aside relatively unscathed. Thus, of course, the cost of American blood was worth it because, after all, "America is the greatest country in the world!"

Don't get me wrong, I love America too. But arguing that all things American are better than that had by any other country is patent nonsense and unflattering jingoism. Acknowledging that China may have a competitive advantage in their space program because they don't have to deal with democratic resistance to policy does not constitute an endorsement of the Communistic dictatorship even if we acknowledge their edge. Regardless, hardly any American would trade his liberty in return for getting back to the moon first! Dear  Americans, self-proclaiming ourselves as the best in everything is arrogant and, thereby, self-diminishing. And America is far from being best when it comes to the delivery of affordable and effective healthcare. A key ingredient to greatness is an ability to deal with hard facts, and then use them to achieve a positive outcome.

Some parameters of the healthcare problem are nicely spelled out by Todd Hixon in "Why Are U.S. Health Care Costs So High?" in a 3/01/2012 article. Hixon reports that various, highly credible analyses conclude that the cost of American healthcare is about twice that of "peer countries" such as Japan and the U.K. One of the largest disparities is the dramatically higher earnings of medical specialists in the U.S (three to six times higher). And the use of specialists in the U.S. vis–à–vis primary care doctors is also much higher than in other countries.Yet, the outcome in quality when measured in terms of longevity is about the same. I decided to do some quick web surfing to see if this claim is supported and it quickly became apparent that, indeed, it is. A University of California, Santa Cruz website shows that, based on figures for the year 2000, despite its enormous lead in per capita healthcare spending the United States ranked 27th in the world in longevity. Cuba, which ranked 28th, spent $186 per capita while the U.S. spent $4,500 (no, this is not a misprint). []  Consistent with this perspective, the online Wall Street Journal's Market Watch site reports that, "However counterintuitive, spending more on health care does not result in better health outcomes. Of [the] top 10 nations with the highest health expenditure per capita, only three are in the top 10 for life expectancy." [].

These trends indicate that the primary drive for higher prices is not the quality of healthcare but the desire for profit. Some self-examination by the American psyche reveals, fairly easily, that while many sectors of the economy operate on purely capitalistic principles of charging what the market can bear, the practice does not always hold up and is not justifiable in all areas of economic activity. This mentality is wrecking the American healthcare system and it is also wrecking its system of higher education. I would put the "justice" system in the same boat because the purchase of justice just ain't justice. There is no persuasive reason for why a single-payer system—the government, cannot efficiently administer the healthcare system. A culture that cultivates an ombudsman mentality and internal competition can succeed in areas of economic activity that have little use for profit. It is anathema to suggest that a surgeon might recommend surgery because of undue influence by the opportunity for profit. Take your head out of the sand! And Big Pharma brings to mind a caduceus with the dollar sign superimposed on it. But this is a subject for a future posting.                                                                                  

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