American point of view.....
It seems clear to me that, as far as the civilized world goes, America is pretty primitive when it comes to healthcare. I think Michael Walzer puts it very well in his book, Spheres of Justice: "the United States currently mantains one of the shabbier systems of communal provision in the Western world"(p. 84). Both in terms of the availability of healthcare to those who need it, and in terms of the quality of healthcare for the amount of money we pay. So today I'm going to try to back up the claim that American healthcare sucks.
(As an aside, I should point out that there is a strong force that will respond to all this with "so what?" From the Libertarian stand point, it might just be a case of "no big deal." The people who deserve healthcare get it just fine, whereas the people who don't pull their share (i.e., the poor) sometimes don't end up as well off. All as it should be. Well, I think that's monstrous. I think Walzer puts it well again: "Needed goods are not commodities"(p. 90).)
It's always nice to start out with some good anecdotal evidence to get things warmed up. Consider this story by Belle Warring about her experience with medical care in Singapore. Now, by all accounts, Singapore has its flaws. It is both a fairly authoritarian country and not exactly the wealthiest per capita in the world. And yet their healthcare is both of higher quality and is cheaper, at least anecdotally. Sounds like we're doing something seriously wrong!
Now consider this more careful statistical information that I found through Matthew Yglesias. Of the countries shown in that data, we both spend the most money and get the worst care. Clearly we're not getting so much for our money. Matthew also pointed the way to this interesting chart that shows that while we're pretty healthy overall, we're certainly not getting very much for our money. On the other hand, look at Cuba!
In fact, why don't we talk about Cuba for a moment. Cuba is communist, they are racked by the negative economic effects of our ongoing embargo. By all American accounts, they should be doing pretty shabby. But to the contrary! Cuba's healthcare is so good that Castro is sending Cuban doctors to work in impoverished areas, and challenging American and European doctors to do the same. Another article points out that despite the economic embargo, "All Cubans recieve free medical care, regardless of socioeconomic standing. All areas of Cuba have doctors, whether urban or city." Healthcare is widely available and of very high quality, though the embargo has damaged the healthcare system. Nevertheless, "the Cuban government still strives to achieve equality in access to health care among all social classes and regions."
Let's switch to another neighbor, whose healthcare system has been oft-maligned by Americans: Canada. We've already seen that Canadians get more bang for their buck. Often, you hear talk of Canada as being a bureaucratic nightmare. The propaganda reaches so far that even though Canada is the most livable country in the world, they often wish they were more like the us. As it turns out that Americans are least satisfied with their healthcare, while Canada's single payer system has greatly reduced their administration costs: "For instance, it takes more people to administer Blue Cross Blue Shield of Massachusetts that it does to administer the entire health care system of Canada." And not only that, Canadians are most satisfied with their healthcare of all industrial nations. My own conversations with Canadians bears this out.
Our problems are many. There are pervasive racial and ethnic disparities. We are in a healthcare crisis: protection is not widespread, costs are absurd, quality is poor, and spending has been consistently huge. There is a ton of research indicating the sorry state of healthcare for the uninsured and underinsured. Our system sucks. There are other systems that are much better. We ought to be able to look at what they are doing right and adapt it to our own situation.
Unfortunately, a combination of big-business pressure and poor journalism has made it difficult for many Americans to even see clearly the landscape of the problem, much less the very real possibilities for solutions. Sensible healthcare improvements suggested by Democrats are consistently voted down. Big business pushes for it. Many Americans don't care nearly as much as they should. Next time on Why America Sucks we'll be covering a major cause of this apathy and confusion: the sorry state of American journalism. |
