Why should you care about health care reform?
It’s your money. The United States spends more per person on health care than any country in the world — by far. We spend almost $7300 per person per year on health care. The next closest, Switzerland, spends about $4400. Most modern democracies insure all their citizens for less than $4000 per person per year. That extra money might be worthwhile if we were healthier for it — we’re not. Portugal, Greece and the Czech Republic, among others, have better infant mortality rates than the U.S. In short, we’re wasting a huge amount of money on extraordinarily inefficient health care.
Wages have stagnated for decades despite productivity gains. Why? All that extra money is going into health care. When your employer has to pay more in premiums to cover you, that’s money you are not seeing in income. Unless we do something to change the system and control costs your future earnings are only going to be further eroded by health care costs. Don’t forget, you are getting ripped off — we are not any healthier for all this extra expense.
We don’t have the best health care in the world. If you need the latest cutting-edge care for a rare kidney cancer or a heart-lung transplant, America is clearly the place to be. The truth is, though, you are much more likely to suffer from heart disease, diabetes, a car accident or a bad back.
The World Health Organization ranks America only37th for overall health care quality; that’s behind Chile, Costa Rica and Saudi Arabia among others. Surely we can do better.
Successful reform means more government involvement. Markets are great, when they work, but the evidence is overwhelming that market mechanisms lead to less care and more inefficiency in U.S. health care. Every one of the countries that outperforms us and covers all its citizens does so through: a greater proportion of spending on health care coming from the government; greater government regulation of health insurance and care.
We do ration health care. Rather than ration through waiting times, we ration through whether your employer provides coverage and your ability to pay. The result is that millions of Americans forego needed care. That’s rationing. More government involvement simply means we ration care more efficiently than we do now. Best estimates suggest that more than 20,000 Americans die needlessly every year due to inadequate access to care. Furthermore, smart reforms don’t mean long waiting times and poor customer service. There’s a reason opponents of reform pick on Canada — it needs work. The truth is that most countries with universal coverage have waiting times equal to and often better than we encounter in America. You can see a specialist in Japan the next day. Try that here.
Our system of rationing is horribly inefficient. One of my favorite former students, a recent grad, just took a job at a bakery (definitely not his chosen field) because it was the only job he could get with health care coverage. He, and our economy would be better off and more productive if he could choose employment based on his actual interests. How many entrepreneurs are stifled because they cannot afford to leave employer-sponsored health care?
Change will come. The only question is will it be good or bad change. If we do nothing, the evidence is overwhelming that our medical costs will go up, your wages will stagnate, fewer people (maybe you or your family) will have insurance and we won’t be any healthier! Or, we can undertake meaningful and comprehensive health care reform — your choice.
