Agreeing on healthcare … mostly

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Randy Riley has a great deal of experience and knowledge about the health care system in the United States and I agree with virtually all of it. I did spend 12 years on the Clinton County Hospital Board, but the depth of knowledge does not match Randy’s.

He says like education, health care should be a right of citizenship – I agree wholeheartedly. Basic changes, he observes, will necessitate changes in how the government, major healthcare insurance companies and the pharmaceutical industry operate – I agree.

He also ventures into politics saying health insurance companies make huge annual profits which they pass on to the politicians who perpetuate the system that underwrite the most expensive health care system in the world (the last phrase is mine!). He delves deeper into the political abyss by saying we need real campaign finance reform – absolutely.

However, I have a problem with a phrase he used without explanation, “I believe we have the best healthcare system in the world.”

My question is this – what does this mean? The measure that comes to me immediately is life expectancy, but the US ranks behind dozens of countries in the world, many of which are not in the upper tier of wealthy countries.

Then maybe what is meant is that the recipients of the healthcare are more satisfied, but that is certainly not true. In a recent international study comparing 11 wealthy nations, the US ranks #11, just ahead of Canada. The other nine are, from first to last: Britain, Switzerland, Sweden, Australia, Germany, The Netherlands, New Zealand, Norway and France.

One looks in vain to find the US ranked in the upper tier of just about any dimension of health care, but it seems to always be the most expensive.

I do not find any reference to “single-payer system” in Randy’s essay. From what I read there are very few pure single-payer systems (Canada is one) — most and possibly the best systems are a combination of private and public.

Central to the arguments concerning some variation of the single payer system is the fear of expanded government or simply succumbing to some variant of socialism – essentially, the loss of our free economy.

In a report in Forbes magazine on the 2015 Index of Economic Freedom produced by the Heritage Foundation, there is no relationship between a country’s economic freedom and having universal health coverage. The US is 12th on the Index and of the 11 countries with greater economic freedom, 10 of them have universal health coverage.

The groups researching and publishing this research are paragons of US political and economic conservatism. In the Index, there are four categories, with three sub-categories each: 1) Rule of Law; 2) Government Size; 3) Regulatory Efficiency; and 4) Open Markets. The five countries scoring highest on the Index are Hong Kong, Singapore, New Zealand, Switzerland and Australia; Canada is seventh.

The article is rich in quotes and I will include two: “The two advanced economies with the most economically free health care systems – Switzerland and Singapore – have achieved universal health insurance while spending a fraction of what the U.S. spends. Switzerland’s public spending on health care is about half of America’s and Singapore’s is about a fifth of ours. If we had either of those systems, we wouldn’t have a federal budget deficit.”

The other quote: “The reason why U.S. government health care is so big already, without achieving universal coverage, is that we heavily subsidize health coverage for Americans with high incomes, while leaving many Americans with low incomes unsubsidized.”

I agree that the topic is “complex.” I am not resting my argument since I may have overlooked some very important points, but I stick with our President of City Council in saying that health care, like education, is a right of citizenship.

I do hope that US Rep. Steve Stivers will read and consider this well-reasoned and balanced assessment of our health care system.

Neil Snarr is Professor Emeritus of Wilmington College.

Neil Snarr

Contributing columnist

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