With development, health outcomes generally improve, but the U.S. is an anomaly. The U.S. and the U.K. are both high-income, highly developed countries. The U.K. spends less per person ($3,749) on health care than the U.S. ($9,237). Despite its high spending, the U.S. does not have the best health outcomes. Life expectancy, for example, is 79.1 years in the U.S. and 80.9 years in the U.K. And while the U.S. spends more on health care than any country in the world, it ranks 12th in life expectancy among the 12 wealthiest industrialized countries, according to the Kaiser Family Foundation, a non-profit organization focusing on health issues.(NPR website, April 21, 2017)
The British are constantly complaining about the National Health Service, and I have no doubt that, starved of funds and investment, it is creaking. Nonetheless, if you are really ill (not just waiting for a new hip) the NHS is brilliant and looks after you well. Americans po-poo it: socialised medicine they call it. But then the NHS runs on the smell of an oily rag in comparison to the American system, which sucks up about double the GNP compared with the British and other health systems. Why? Because at every turn someone has to make, not just an income, but a profit.
At its best American healthcare is excellent, but with one proviso – you have to be well-off or work for a generous company. Even so, this must be the only country where the patient has to spend hours on the phone trying to get insurance companies to do their job. Case in point : I have waited for weeks now to get pre-authorisation for a dental procedure. Wait, wait wait. I said to the person on the other end of the phone:”As it happens, I am not at death’s door, but nonetheless, here I am spending ages trying to satisfy your requirements as to the necessity and nature of the procedure. Were I on my deathbed how could I do this? The patient shouldn’t have to be constantly on the phone to find out what further information the insurance company needs”. The truth behind all this is that the insurance company doesn’t want to fork out and hopes you give up.
A fine mess the country has got itself into; and I haven’t even started on Obamacare and its successor, or the dire healthcare given to the poor and returning sick soldiers, or those with medical pre-conditions who are sick, and get dumped by insurance companies. Meanwhile, the Republicans cannot agree amonst themselves, but are quite likely to make matters worse. Unless you are rich.
The problem with health insurance in America, and in many parts of Europe, is an over-reliance on insurance. In most insurance industries, the chances of you making a claim are only slight: the likelihood of your car being stolen or your house burning down isn’t particularly high. But with healthcare, its virtually inevitable that at some point, you will get sick and need to make a claim. If you have a pre-existing condition, you will need to claim all the time. As a result, some people are uninsurable, requiring clumsy and expensive government intervention (Obamacare) to compensate the private insurance market for otherwise unprofitable customers.
The other problem with insurance is that particularly with employer-sponsered plans with low deductibles, there is no incentive to shop around for the cheapest deal. Why search for the cheapest surgeon for instance, if your insurance company is going to pay for everything anyway? Equally, having a plethora of insurance companies increases the cost of healthcare compared to a single-payer system, because in single-payer, the government can use its sheer size to negotiate down costs. The point is that America has the worst of both the private and public sector worlds: the private system drives up costs by providing tax incentives for employers to provide generous healthcare plans, and the public system inefficiently spends money subsidising private insurance and overpaid doctors, rather than subsidising the costs of treatment.
My personal solution would be something along the lines of the Singaporean system. Nationalise most of the hospitals to lower the costs of treatment. Then get rid of private insurance entirely, and force every American to save about 10% of their income in a health savings account, which would alleviate employers from having to cover healthcare costs and make the cost of healthcare more transparent. Then people would have to pay most of their healthcare costs out of pocket from their health savings account, which would utilise the price competition that occurs in a genuinely free market. If people ran out of money once their savings account had been depleted, the government would pay the remainder of their costs. Overall, the country would save a lot of money, but many people within the healthcare industry would lose their jobs or have their salaries considerably reduced.
The other problem with the American healthcare system is the American people and their unhealthy ways. An overconsumption of fatty and sugary food, combined with a lack of exercise and an increasing use of drugs, is driving up healthcare costs considerably. Part of the reason why countries like Italy or Japan spend less on healthcare is that their populations are healthier and so don’t require as much treatment in the first place. Now there’s an awful lot the government can do to make Americans healthier- Michelle Obama’s campaign against obesity was a good start. But Republicans and some libertarian-leaning Democrats would probably regard many government health initiatives as authoritarian. The government could clamp down on drugs, ban doctors from ever prescribing opioids, impose heavy taxes on fat and sugar, discourage car usage through taxes and densification of cities, and impose limits on the number of fast food restaurants that can open in a given area. None of those things are likely to happen, continuing America’s health woes.