Commentary: The "Bright Side" of America's Health Insurance System
By Jay Brock
GUEST WRITER
Not that long ago I happened to run into someone who was running as a candidate in a primary election for Congress. The conversation soon turned to the American health insurance system, including a number of points regarding the gaping insufficiencies of our current system.
We ended up discussing the most startling example of how our current health insurance system has failed the American people—each year, 70,000 Americans die prematurely because they cannot afford to pay for timely medical care.
The candidate’s response? In a nation of 350 million, having only 70,000 die each year as a direct result of a failed health insurance system seemed to be quite a low number.
I guess that’s one way to look at it.
(The candidate happened to be a veteran, and I still wonder what his reaction would have been if I stated that having only 70,000 American troops die in battle every year due to gross mismanagement—and indifference about their welfare—was also quite a low number. In any case, he didn’t get the nomination.)
But maybe he had a point. Let’s look at the bright side of our health insurance system.
We’re #1 in the world in healthcare spending per person. We may get worse results than all other advanced nations, and unaffordable healthcare may be the #1 kitchen table issue for most Americans for multiple election cycles, but no other nation can say they spend as much as we do. We’re still #1!
Only 25 million Americans don’t have health insurance—but 325 million do!
And of the 325 million with health insurance, if 60 million are by definition considered “underinsured” (they cannot afford to use their insurance due to onerous out-of-pocket costs) then 265 million Americans aren’t considered underinsured.
On the other hand, 3/4 Americans still worry that they won’t be able to afford to pay their medical bills if they get sick. The bright side, of course, means that one in four Americans don’t worry. Imagine: nearly 90 million Americans DON’T worry about being able to afford to pay their medical bills if they get sick! A remarkable success!
Only a half-million Americans endure a medical bankruptcy each year. That means 349,500,000 Americans don’t endure a medical bankruptcy in any given year. Of course, medical bankruptcy is not a usual occurrence in other advanced nations, but when it comes to medical bankruptcy we’re #1! And likely to stay there unless and until we get a different health insurance system. (Don’t hold your breath.)
That means that since 2000, some 12 million Americans (most with health insurance) have endured a medical bankruptcy. But who’s counting! (Certainly not Congress.)
Is the Big, Beautiful budget Bill recently passed by Republicans in Congress (not a single Democrat voted for it) another “bright side” of our health insurance system? Let’s see: the bill will cut about one trillion dollars from healthcare —especially Medicaid—over the next decade in order to provide huge tax breaks for the wealthiest Americans.
Though spending cuts will be directly affecting mostly the poor and disabled—the people on Medicaid—eventually even rich folk will be harmed by this bill when hundreds of local hospitals (that don’t serve just poor and disabled people on Medicaid) start closing their doors as a result of these dramatic cuts to healthcare spending.
But the bright side is that the wealthiest Americans will keep getting huge tax breaks!
Maybe they should have called this the “Big Beautiful Bright Side of Health Insurance Bill!”
Republicans are defending this trillion dollar cut to healthcare funding by claiming that they will save Medicaid for those who really need it. Their prime example: if you can work but aren’t, this program isn’t for you…unless you jump through numerous government-mandated hoops to prove that you really are deserving of health insurance.
It’s as if there are two groups of folks: those who deserve healthcare, and those who don’t. (In case you haven’t already noticed, this is remarkably representative of our current entire system, where rich Americans can afford great healthcare but non-rich Americans struggle.)
Republicans saying these huge funding cuts are actually saving Medicaid for those who really need it is reminiscent of American military spokesmen during the Vietnam War claiming that they needed to destroy a village in order to save it.
What Republicans aren’t saying is that mandating work requirements to be eligible for Medicaid doesn’t work. The overwhelming majority of those on Medicaid are in fact eligible, but the new bureaucratic paperwork requirements are so burdensome that many deserving enrollees will be thrown off the program, saving money to pay for those tax cuts for the wealthiest Americans.
Even worse, some states spend more on enforcing their eligibility requirements than they do on healthcare for these enrollees.
But who’s counting!
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Thanks for your insights, Jay. I fear the cynicism of the guy running for congress is representative of all too many in our congress today.
An Angus Reid Institute study found that over the previous year almost a quarter of Canadians decided against filling a prescription or having one renewed due to medication unaffordability. As a result, many low-income outpatients who could not afford to fill their prescriptions ended up back in the publicly-funded hospital system, therefore costing far more for provincial and federal government health ministries than if the medication had been covered.
The study also found that about 90 percent of Canadians — including three quarters of Conservative Party supporters specifically [who definitely are not known for supporting publicly-funded social programs] — support a national 'pharmacare' plan. Another 77 percent believed this should be a high-priority matter for the federal government. …
It's very expensive and morally wrong when our elected governments promise the populace much-needed universal (albeit generic brand) medication coverage, as Canadians have been more than once by ours, only to cancel it after the pharmaceutical industry successfully threatens to abandon its Canada-based R&D, etcetera, if the government goes ahead with the ‘pharmacare’ plan. While such universal medication coverage would negatively affect the industry’s superfluously plentiful profits, the profits would nonetheless remain great, just not as great.
Clearly, a truly universal healthcare system needs to be supported by a pharmacare plan. Instead, we continue to be the world’s sole nation that has universal healthcare (theoretically, anyway) but no similar blanket coverage of prescribed medication, however necessary. Ergo, in order for the industry to continue raking in huge profits, Canadians and their health, as both individual consumers and a taxpaying collective, must lose out big time.
The extremely profitable American healthcare insurance industry, as an insatiable corporate greed thus grave example, always needs to become all the more profitable, even if lives are lost as a result. It really does seem there's little or no accountability when huge profit is involved; nor can there be a sufficiently guilty conscience if the malpractice is continued, business as usual. ‘We are a capitalist nation, after all,’ the morally lame self-justification typically goes.
Canadians can only dread the day our “universal” health-care system includes crucial health treatments that, at least in a timely thus beneficial manner, are universally inaccessible, except for those with the money to access privately at for-big-profit prices. Abroad, we are often envied for our supposedly universal healthcare; yet, in a sufficiently significant way, it already comes second to the big-profit interests of industry, thanks to big pharma's seemingly insatiable greed.