Tuesday, March 08, 2005

Continued Observations on Free Mark Philosophy, Part Two - Health Care

Today, I'd to take a look at health care and the free market. Health care costs in the United States are exploding. Some facts from the National Coalition on Health Care (NOCH):

  • The United States spends more on health care than other industrialized countries; as a percentage of 2001 GDP, the United States spent 13.9%, Germany spent 10.7%, Canada spent 9.7%, France spent 9.5%, and Sweden spent 8.7% on total health care spending. (David Walker, “Health Care System Crisis: Growing Challenges Point to Need for Fundamental Reform,” presentation to the General Accounting Office Health Care Forum, 13 January 2004).
  • Americans’ average annual out-of-pocket expenses for health care rose 26% between 1995 and 2001, to $2,182. (Bureau of Labor Statistics)
  • Co-payments for brand-name drugs that have generic equivalents jumped 62% to $26 last year from $16 in 2000, while generics rose to an average of $9 from $8. (The Kaiser Family Foundation)
  • Health insurance premiums will rise to an average of more than $14,500 for family coverage in 2006 (“Charting the Cost of Inaction,” National Coalition on Health Care, May 2003.)
  • In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada
  • Approximately 45 million Americans, or 15.6 percent of the population, had no health insurance coverage in 2003
I have heard arguments that these high costs are the price to pay for the innovation and quality of health care in the United States. And, yet, the United States lags behind other industrialized nations in many key health care metrics:

  • Despite its higher levels of health care spending, the United States has higher infant mortality rates, lower life expectancy, higher levels of poverty, and lower levels of health care coverage than other comparable industrialized nations, such as Canada, France, Germany, Britain, and Japan
  • About 11% of cancer patients under the age of 65 are uninsured, and as many as 20% of minority cancer patients do not have coverage. (Lucette Lagnado, “What is a Bet on Life Worth?” Wall Street Journal, 18 June 2003)
  • The uninsured are more likely to put off seeking care; to not receive care when needed; and to not fill a prescription or get a recommended treatment because of the expense. (“Access to Care for the Uninsured: An Update,” Ibid).
  • Uninsured adults who have been hospitalized for heart attacks are over 25 percent more likely to die while in the hospital than privately insured adults. While the uninsured are just as likely to improve blood flow to their hearts in the acute stages of their heart attacks, they are less likely to undergo further costly diagnostic and therapeutic interventions. (“Access to Care for the Uninsured: An Update,” Ibid)
I generally avoid resorting to the anecdotal, but will today share my experiences. I lived the first 24 years of my life in Canada, and have spent three and half years in the United States. During my time in the United States, I have had medical coverage from three separate health insurance companies, and due to the economic turmoil generated by the Bush Administration, I have also spent about six months of the past few years living in the US uninsured.

While in Canada, I generally took the Universal Health Care coverage offered by the government for granted. My experience in the United States has awoken me to the harsh reality of privatized health care. I have experienced the frustration of having valid medical claims denied time after time, after forking over thousands of dollars per year in insurance premiums to insurance companies. I have experienced firsthand the deterrent effect that being uninsured has on seeking preventive health care -- The costs of medical visits, tests, and prescriptions in the United States is unreasonable, and the state of being uninsured persuades individuals to avoid seeking treatment at all costs.

I'd like to get back to my original point, which was to equate the current state of Health Care in the United States to the trend of unwavering belief in free market fundamentalism (A term I picked up from Robert Reich's book, Reason, which I'm currently wrapping up) Unfortunately, it's getting pretty late, so you'll have to stay tuned for part three in my series on Free Market Philosophy.