Republicans Demand the Impossible in a Healthcare Bill

Eric Zuesse

Republicans demand a healthcare bill (or medical system) that will simultaneously (and without sacrificing quality of healthcare) reduce their total expenses on medical care — including their insurance premiums and their out-of-pocket costs — and that will also be more free-market (with less government involvement and regulations) than in existing U.S. healthcare policy (both before and after Obamacare began); they want more free-market, and less cost, and also no sacrifice on quality.

The economic data show that (by far) the most cost-effective medical care is in countries that have socialized healthcare; the least cost-effective (meaning the least efficient) medical care is in countries that have not socialized healthcare, and the middle that’s between those two extremes is countries (there is only one: Switzerland) that are between those two categories: countries that legally require everyone to have health insurance but that remove the profit-motive from health insurance by having (as Switzerland puts it) “60 government-approved non-profit insurance providers offer basic mandatory insurance and optional loss-of-earnings [disability] insurance in accordance with legal requirements and the supervisory authority’s directives.” America’s propagandists for Obamacare had been saying such things as “Switzerland Has Its Own Kind of Obamacare — and Loves It”, and mentioned that “For many Americans, the Patient Protection and Affordable Care Act, which makes health insurance mandatory, is a bitter pill to swallow” but that it’s really “a victory for common sense,” but they were misrepresenting the extent to which the Swiss system is similar to Obamacare, and also misrepresenting (over-praising) the Swiss system’s track-record of performance.

Besides the Swiss system’s using only approved non-profit insurers, it importantly has nothing like Obamacare’s “insurance mandate.” One might wonder: how, then, could coverage be “mandatory” in Switzerland? The answer is that, “If you fail to insure yourself within three months, the canton will chose a provider for you and you will be sent a premium bill by the provider.” Consequently, whereas Switzerland really does have “universal coverage” (meaning 100% of citizens are insured), Obamacare leaves 10.9% of Americans uninsured. Prior to Obama’s coming into office, 14.6% of Americans had no health insurance; so, Obamacare increased the pre-Obama 85.4% of Americans who had health insurance, to 89.1%. He increased the insured percentage by 3.7%. That’s all — nothing like increasing it to “universal insurance” (100% insured) which is what every other OECD nation has (besides their having better health care, at far lower prices, as will be documented in the paragraph immediately below). Democrats propagandize about their achievement, by comparing the current 10.9% figure versus the 18.0% peak figure that was the all-time high percentage of Americans who had no insurance, which was right before the Obamacare exchanges opened for business, on the first day of October in 2013. Millions of Americans had simply dropped their existing insurance as Obama’s promised health insurance system came closer to reality, and especially after the U.S. Supreme Court gave it the go-ahead; but for propagandists to compare the 10.9% figure versus the 18% figure is fraudulent, which is par for the course in U.S. politics and government — thoroughly untrustworthy, like in a dictatorship. (Jimmy Carter calls the U.S. an “oligarchy” instead of a democracy; he’s correct, and an oligarchy is a dictatorship by the super-rich. Democracy is impossible with a misinformed public, such as here. “Oligarchs” need it to be that way.) The Democrats’ touting that 18% pre-Obamacare uninsured figure includes the additional 3.4% of Americans who, after Obama became elected in 2008, abandoned insurance, because they were hoping for the Democrats to provide a much better health insurance system; but the Democrats, immediately after Obama’s win in 2008, yanked much that was best in their promised plan — for example, the promised “public option” was immediately abandoned by Obama; he never really intended it, except as an attractive campaign line. He knew that the insurance companies didn’t want to be competing against that, and he had a top executive, Elizabeth Fowler from WellPoint, America’s largest health insurance company, actually draft his Obamacare plan, in the Senate office of his buddy U.S. Senator Max Baucus.

The U.S. has the most-free-market healthcare system, and by far the most inefficient, with super-high costs, and the worst performance, among all the OECD countries. Here are the facts: the detailed data are right here. Look at it. Life-expectancy is used there as the measure of healthcare-quality, because the reliable data for calculating it in a trustworthy way are available for almost every nation on Earth. So, look there at the graph, “Life expectancy vs. health expenditure over time, 1970-2014” and what you’ll see is shocking: The U.S. is alone in one category, of astounding inefficiency — high cost combined with low quality — and all other OECD nations are clumped close together in a very different category, where they all are remarkably similar, all of them having vastly higher efficiency: far higher life-expectancy, and far lower cost, than the United States. It looks like the U.S. is rip-off-ville — Reagan’s City on a Hell, to reverse his exaggerated claim, toward the extremity that it’s actually getting far closer to: his greed-is-good libertarian ideal (the Republican predilection) — the place where defrauding the public reigns without any effective challenge at all. Then look further down that page, at the “Appendix: Latest available data on life expectancy and spending on health per capita in OECD countries.” The exact figures are given there, “Life expectancy” and “Health spending per capita.”

Okay: so, Democrats are deluded when they say that Obamacare is anything close to the best that we can do, but Republicans are blithering fools who demand that we do even worse than we already are.

To make healthcare more free-market, with lower prices and without cheapening the quality, is proven by all the data to be a ridiculous ideal, which, the more that it is pursued, will suck up an ever-bigger percentage of the total national economy, while it makes the public sicker, shortens the public’s lifespan, makes the public more disabled, lowers workers’ productivity, and drives down the entire nation’s economic international rank. Such a nation is in decline, as compared to its economic competitors. Anyone who would want to buy that package, I would want to sell a bridge in Brooklyn to; and, to such a person: Good luck charging tolls on it, while motorists sue you for its potholes and the damages it has done to their cars and trucks (if not also to themselves).

Free-market-extremism can be very costly to a country, because anything that builds a country’s physical infrastructure (such as roads) or human capital (such as healthcare) is far more efficiently provided by the government than by the private sector; and this fact is recognized practically everywhere on Earth except in the suckered-by-oligarchs United States. And what results from that — the failing, and the falling — is now clear in the data.

—————

Investigative historian Eric Zuesse is the author, most recently, of  They’re Not Even Close: The Democratic vs. Republican Economic Records, 1910-2010, and of  CHRIST’S VENTRILOQUISTS: The Event that Created Christianity.

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  • diogenes

    Bernie Sanders is putting forward a single payer health care bill in the Senate and the same bill is also being advanced in the House. Please devote maximum reporting to this extremely important initiative. In 2008 67% of Ameicans wanted single payer. Despite 8 years of lies and deliberate confusion, the backing today for single payer is similar.

    It needs constant emphasis that ALL “developed” countries on earth manage to deliver universal health care, and all of them cost their citizens drastically less than America pays for public health levels that fall below those of Turkey and Cuba — in, for instance, infant mortality and life expectancy. If Canada can do it, if Italy can do it, if Germany and France and Spain can do it, so can America. But not as long as American health policy is enslaved by Wall Street oligarchs. THIS NEEDS CONSTANT EXPOSURE AND EMPHASIS.

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  • Adreng

    I agree completely with the statements about the Swiss healthcare system. It depends on how you look at it. On one hand, you could say that it is less socialized than healthcare in the US because in Switzerland, there is nothing like Medicare and Medicaid, private companies are always involved (except in the case of accident insurance – in that area, there is a kind of single-payer system and, not too astonishingly, that area is particularly efficient, but of course, accident insurance involves much less money than general health insurance). This may have to do with the fact that Switzerland is also one of the countries where a kind of anti-state ideology is relatively strong and because lobbyists for health insurances are well represented in the Swiss parliament.

    However, there is a number of reasons why the Swiss health insurance system is very different from Obamacare and – although private companies are always involved – on the whole more socialized:
    – There is universal coverage, health insurance is compulsory and people have no option not to be insured (there are possibilities for people who don’t need medical services and pay everything themselves up to a certain amount to get lower premia, but that is limited).
    – There is a clear definition of “basic insurance” (Grundversicherung), and most people would probably agree that it covers everything that is important (there can be some corner cases, but there are more complaints that it is too broad than too narrow). Health insurances are not allowed to make any profit with this basic insurance. So, although private companies are involved, they are only allowed to operate in non-profit mode, as far as basic insurance is concerned. They are allowed to offer additional insurances for profit – this is mostly things like better rooms at hospitals, not coverage for treatments that are really needed for health.

    Furthermore, the Swiss healthcare system is the second-most expensive one (after the US). Single-payer systems tend to be more efficient. Switzerland is relatively rich and most people can afford the high premia (and there are subsidies for a large part of the population with a lower income), but the Swiss system is certainly not an example for a particularly efficient health care system. Are people really so satisfied with it? Indeed, they repeatedly voted in referendums against the introduction of single-payer systems, but many people are also dissatisfied about rising premia. The compromise with compulsory non-profit basic health insurances – something between a private for-profit system and a socialized single-payer system -, which fits general tendencies in Switzerland that favor compromise. A system that does not cover everyone and means that people don’t get necessary treatments for financial reasons or are financially ruined because of health problems would be totally unacceptable in Switzerland, as in most of Europe.