How About That Best Health Care In The World?

Ham & Cheese

During this election cycle we’ve often heard politicians argue that the United States has the best health care system in the world. Unfortunately, there are problems with how this assertion should be measured and a new report suggests that U.S. politicians have ignored one very important factor. Specifically, for the 47 million people who lack health insurance, the results can be deadly despite the following inane comment from George Bush at a recent speech in Cleveland:

I mean, people have access to health care in America. After all, you just go to an emergency room.

In the report released by “Researchers Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine”, the evidence suggests that the United States ranks dead last in terms of preventable deaths…a statistic that fully refutes the wisdom of the president’s observation. Basic logic should tells us that treating conditions in an emergency setting is inferior to routine care and monitoring…which rarely happens for those individuals who lack health insurance.

France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.

If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.

Nolte said the large number of Americans who lack any type of health insurance — about 47 million people in a country of about 300 million, according to U.S. government estimates — probably was a key factor in the poor showing of the United States compared to other industrialized nations in the study.

“I wouldn’t say it (the last-place ranking) is a condemnation, because I think health care in the U.S. is pretty good if you have access. But if you don’t, I think that’s the main problem, isn’t it?” Nolte said in a telephone interview.

All the countries made progress in reducing preventable deaths from these earlier rankings, the researchers said. These types of deaths dropped by an average of 16 percent for the nations in the study, but the U.S. decline was only 4 percent.

“It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance,” Commonwealth Fund Senior Vice President Cathy Schoen said.

“The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals and efforts to improve health systems make a difference,” Schoen added in a statement.

As one can see, this report clearly points out just how absurd it is for the President to make the above statement. Yes, everyone knows that the uninsured can go to the emergency room…if they’re having an urgent medical event such as a heart attack, kidney failure, diabetic coma, and so on…but they’re not going to be provided with long term care in the form of heart medication, blood pressure medication, or insulin The care that is needed to treat long term medical conditions and chronic diseases and to avert or reduce these emergency room events as well as the increased risk of death is not available to many of the uninsured.

The bottom line is that the prevailing problem being ignored by the President and the 2008 GOP presidential candidates is the cost of health insurance and the inability of many, if not most of the 47 million uninsured, to afford it.

The topic was discussed in the recent ABC New Hampshire Republican debate. The following are a few relevant excerpts that clearly demonstrate the insufficiency of the GOP’s proposals to correct this urgent and expanding problem.

MR. ROMNEY: Charlie, it — that doesn’t mean it shouldn’t be improved. And I think — I think that the notion of people buying their own private health insurance is a very good one, so long as a lot of them do it. Only 17 million Americans right now buy their own health insurance. If 50 million Americans were buying their own health insurance — because it would be just as tax-advantageous to do it that way — and we had a health savings account, people — economists believe there’d be a 30 (percent) to 50 percent reduction in the cost of health insurance, and quality would come up.

MR. GIBSON: You all have proposed free market, consumer- purchased insurance, and you all talk about giving tax deductions for buying insurance. Let me do a little math. The average family employer-provided insurance, when the companies buy it, its $13,000 a family.

Now, you’ve talked about a 15 (thousand) to 20,000-dollar deduction, right, for people buying their own insurance? If you take a median-income family of $62,000 in this country, you’ve just saved them $3,000 on their taxes. That doesn’t come close to buying an insurance policy.

MR. GIULIANI: Charlie, a health savings account actually helps to accomplish what the governor is talking about. If somebody can put aside — and the plans that we’ve been talking about include a health savings account — you’d have a — you’d have an exemption up to 15,000 (dollars). If you could find a policy for 11,000 (dollars), you could have a $4,000 health savings account. You would be able to buy some of your health care and your prevention yourself. It gives you an incentive over a lifetime to deal with wellness.

None of these comments address the fundamental problem. The fact is that the vast majority of the uninsured don’t have the income to buy health insurance even if they wanted to do so.

Let’s look at some of the GOP candidate’s specific statements. Mitt Romney seems to suggest that the problem will resolve if we can simply get more individuals to buy private health insurance. Excuse me, but there are millions of Americans who can’t even afford to pay their portion of an employer sponsored insurance plan. Just how are those individuals going to be able to afford even more expensive individual policies?

Rudy Giuliani’s plan isn’t any better. Note Charlie Gibson’s explanation whereby the government offers a tax incentive for individuals or families to purchase private insurance. However, to do so, a family needs to be able to afford at a minimum of $13,000.00 (the amount they currently pay for employer sponsored insurance) in order to receive a $,3000.00 tax break. If you haven’t the ability to pay for the insurance, the tax break is meaningless. Therefore the Giuliani plan only works for those who can already afford health insurance. It sounds nice to talk about a 15 to 20 thousand dollar exemption, but it isn’t going to help those with low incomes who already pay minimal taxes.

When Giuliani goes on to laud the benefits of an HSA, he is once again insulting our intelligence. If most of the people who lack health care had the ability to set aside $4,000.00 in an HSA…or under their mattress…wouldn’t they already be doing so? Further, the assumption that people aren’t mindful of their own wellness is laughable. If you can’t put food on the table for your family, you sure as hell don’t put $4,000.00 in an HSA account for wellness care.

Frankly, the bulk of the GOP rhetoric on health care is little more than smoke and mirrors intended to feign concern without ever having to fund care. I would relate it to one of my favorite expressions told to me by an old friend, “I’d have a ham and cheese sandwich…if I had any ham or cheese.” By and large, the same logic holds for the plight of the uninsured.

In fairness, both John McCain and Mike Huckabee argued that the lack of wellness and preventative care are largely responsible for the skyrocketing costs of health care. Their statements are a sensible equivalent to the oft heard expression, “you can pay me now or pay me later”…except for one critical omission. The “pay me now” portion of the equation is the lion’s share of unfunded health care costs…costs which are only currently covered by health insurance…the health insurance that millions can’t afford…and that the GOP has little desire to fund.

Since the health care industry isn’t absorbing these costs (and doesn’t want to), they have absolutely no motivation to offer to subsidize this type of care. At the same time, it’s abundantly evident that the GOP opposes the government stepping in to cover these costs. The truth of the matter is that the health care industry and the GOP both accept that it’s cheaper (and more profitable) to continue only requiring the health care industry to provide indigent emergency care. In the end, that essentially leaves few people advocating for the needs of the uninsured…and more people in the morgue.

It’s been more than seven year since George Bush sold the American public on the notion of “compassionate conservatism”. Let’s hope that the election of a Democrat in 2008 will be the first step towards seeing it demonstrated.

Cross-posted at Thought Theater

29 Responses to “How About That Best Health Care In The World?”

  1. rube cretin Says:

    excellent overview of the health care situation among the GOP. while i have not followed this issue much, i on Medicare, i wish you had included an analysis of the Obama plan. based on what i’ve heard he supports more of the same. we need universal, single payer and i don’t think his plan goes far enough either.

  2. christopher Radulich Says:

    They clamor over our films. They rave over our jeans. They emulate our management techniques. Yet nowhere in the world do they clamor for our health care. Certainly is strange if we have the best health care in the world.

  3. Jersey McJones Says:

    Oh, and don’t forget - we pay 50% more for it! Yeah, for us!


  4. Lisa Says:

    Oh yeah they didn’t bring a Peruvian boy here to operate on a tumor in his head or a little girl from Haiti who would have died had she not come here for lung surgery or Egyptian Siamese twins to get separated .
    Why didn’t they go to Canada? I guess they couldn’t wait the 8 weeks.

    Okay now what country is it that has the best health care in the world? I keep forgetting

  5. Daniel DiRito Says:


    It isn’t the United States if you’re one of the 47 million uninsured, now is it?

  6. Jersey McJones Says:

    Lisa, please God tell me that you are not comparing America to fuckin’ God damned Peru!!!!! Are you INSANE??? Oh, and please stop the SLEAZY CON LYING about Canada. There is no waiting time in Canada for emergency treatment, you idiot!!!!


  7. Lisa Says:

    Can you give me actual facts of how many people that are uninsured are legal citizens? I think it’s about 1/ 2 of those 47 million. Yes I am one of those insured but if you are willing to pay for my medical by all means go ahead.
    I wish we could go back to the 90’s when everyone was covered and jobs were plentiful.
    You think healhcare is expensive now,wait until it’s free.

    And Jersey Peru is just an example. But Egypt is a little different don’t you think
    “There is no waiting time in Canada for emergency treatment, you idiot!!!!”

    No shit a-hole. I never thought they would leave you to bleed to death just slow enough for a tumor to spread.Just ask the woman from Canada with breast cancer that were suing the government there because of the long waiting periods and with all the people here I can say our waitng lists will be alot longer than theirs.
    I hope you make well over 100 grand Jersey otherwise you will be looking for a 2nd job because food and electric is important when you are sick too.

  8. Jersey McJones Says:

    Egypt??? Hell no!!! Egypt is not a First World country, Lisa! What the hell planet are you living on???

    “I hope you make well over 100 grand Jersey otherwise you will be looking for a 2nd job because food and electric is important when you are sick too.”

    THAT’S THE WHOLE PROBLEM, YOU IDIOT!!! The waiting in America is just as bad as anywhere else, so I don;t know where you get that stupid, stupid, stupid shtick from. Are medical care is no better than the rest of the First World - and in many ways it’s worse - and we pay 50% more for it! What kind of stupid moron idiot sees the upside of that??? You use the example of one lady waiting??? How about the girl that just died HERE because her insurance wouldn’t cover her??? She was a friggin kid, Lisa!!! Are you really THAT heartless and stupid???


  9. Selene Says:

    “Can you give me actual facts of how many people that are uninsured are legal citizens? I think it’s about 1/ 2 of those 47 million.”

    If this claim is correct, this still leaves 23.5 million Americans without health insurance. What would you propose as a solution for this group? Surely you wouldn’t suggest that they should continue living without coverage… Since you are one of these individuals, you can appreciate how expensive (and often unaffordable) adequate medical care is. Think about those with chronic illnesses who cannot afford to pay for the medications and doctor’s visits they need. What would you suggest for them?

    “You think healhcare is expensive now,wait until it’s free. http://www.q rticles/2007 /11/26/opin ion/letters/ doc4746660ac b5a606648550 5.txt?showCo mments=true”

    As many of the responders pointed out, Canada’s system doesn’t reflect the current proposals for health care. None of the major candidates is suggesting a truly universal healthcare plan, so why is Canada the focal point here?

  10. Lisa Says:

    I agree we need reform but I don’t believe Universal Healthcare is the “cure all” from what I have read and heard. Sure if you have the Flu or a something not that major . And yes I am mad about that girl dying and I am more upset with the doctors for not just going ahead with the operation as they would have had it been someone from another country.
    I say we help to insure the ones without but have to prove citizenship to qualify instead of having to cover 300 million.
    And if we do go to Universal Healthcare I say all politicians and rich people have to use the same system.

  11. Lisa Says:

    Okay Selene the focal point isn’t Canada it’s also this:

    The only proposal I heard for reform was from Mitt Romney all the rest are Universal Helathcare unless I missed something by all means clue me in.

  12. William Weber Says:

    Something like 80% of the people in this country are satisfied with their health care (except perhaps for the cost). Virtually everyone I know is satisfied, but then most everyone I know is middle class or above. My wife has just had a 2 year bout with thyroid cancer. The initial treatment did not work and we saw 3 different sets of doctors before getting it under control. I shudder to think what it would have been like if we were unable to shop around for a better treatment. I am just concerned that the effort to satisfy the 20% will screw things up for the 80%

    I understand there are people in this country who have a problem getting health care due to a lack of money. They also have a problem getting enough food, gasoline, decent housing, clothing, etc for the same reason. There are public and private entities set up to help these people.

    Scarcity is pervasive and applies to virtually all goods and services. Money and the market determine who gets what. The system is not perfect (whatever that means), but is way ahead of all the other systems that have been tried.

    I don’t think I want some government board determining that I don’t get a knee transplant (maybe because I am to old). Of course, if I was young and couldn’t afford it on my own, I might feel differently - that I should get one before some 80 year old geezer. But then, if that 80 year old were my mother …

    I understand that in Great Britain, the cost of univeral health care program is so out of control they are beginning to deny care to the elderly and people who do not follow good health life styles (smoking, overeating, etc). They are even encouraging self diagnosis and treatment - boy is that a can we don’t want to open.

    Anyway, it is a complicated problem and throwing rocks at those who have different ideas is all we seem to be doing.

  13. Emma Allen Says:

    Not everyone qualifies for the aforementioned public and private aid. And even if one meets the requirements, these systems are not all they’re cracked up to be. They often limit access to quality care and completely restrict access to many treatments and services. They in no way compare to private coverage. Even if we do not opt for universal healthcare in this country we obviously need to address the healthcare issue.

    I myself work and attend school part time. I’m not eligible for school or employer insurance, yet I don’t qualify for Medicaid either. On top of that I have a chronic medical condition that requires frequent doctors’ visits and expensive medication. For the cost of private health insurance I may as well pay the medical bills out of my own pocket - but I can’t do that. All in all, I’ve been forced to ignore the condition because I simply cannot afford to pay for medical treatment.

    It’s quite easy to dismiss that 20% until you’re a part of it.

  14. Lisa Says:

    I understand that in Great Britain, the cost of univeral health care program is so out of control they are beginning to deny care to the elderly and people who do not follow good health life styles (smoking, overeating, etc). They are even encouraging self diagnosis and treatment - boy is that a can we don’t want to open.

    Interesting point William. It is quite unnerving to think that if the governement denies you care based on rationalization there would be nowhere else for people to turn and I believe that percentage would be higher than 20%.
    I heard that in th UK if you need a treatment that they don’t consider a matter of life or death you go on a list and if they only do say 40 of that procedure a year and you are # 43 you have to wait till your number comes up and you are correct that they don’t take good care of the elderly because they feel…..well you know.

  15. Emma Allen Says:

    Lisa, do you have any resources you can post to show us that the figures and stories you mentioned might be accurate?

  16. Lisa Says:

    Oh they are acurate but I would have to research them again as I didn’t save them. Actually my 77 year old mother told me about the elderly .
    Although I am sure you would be able to find them just as easily . Don’t use Google as they tend to be left of center.

  17. christopher Radulich Says:

    So Lisa

    Please explain to me why health care is a big political issue here and not in the rest of the western countries. If 80% of us are satisfied why is heath care a major political issue? Why is the major reason for bankruptcy medical payments?

  18. Selene Says:


    You seem to have conveniently left out the fact that Americans are medical tourists just as often as Britons.

    There’s even an American owned medical tourist agency:

    And if you notice, the US isn’t on the list of popular medical travel destinations. So, perhaps you’ve proved your point in that the UK and Canada don’t necessarily have the most desirable healthcare system, but I think you can admit that we don’t either.

  19. Lisa Says:

    What you all don’t seem to notice is that I do agree we need to do something but I don’t think Universal Healthcare will work for us unless you don’t mind forking over more than half your paycheck to pay for it and the costs trickle down to other things as well.
    So if you want “free” healthcare you will need it because if you make 80,000 per year you may bring home 40,000 or less.
    And yes healthare is cheaper in 3rd world countries but to it’s citizens it’s probably unfordable.
    It’s all relevant.

  20. Lisa Says:

    I meant “unaffordable” Damn spellcheck

  21. Lisa Says:

    Another point of people traveling abroad fro procedures. The reason Brits do t is because the waiting period is so long that they can’t wait so don’t you think eventually, especially with the amount of citizens we have that the waiting period will be any less.
    Just for a root canal someone I know her father in law lives in England and he has to wait 6 monts for that procedure and suffers in pain in the meantime.Sweet air forget about it.
    Welcome to your future.

  22. Jersey McJones Says:

    Lisa, I don;t believe you. I’ve known plenty of Brits and I’ve never heard such nonsense in all my life.


  23. Lisa Says:

    You probably know the ones who have supplemental insurance. I also hear the public hospitals there are filthy and so are the bathrooms in them and there are lines of people liming all the hallways. Yep can’t wait to naked there.

  24. Christopher Radulich Says:

    Yet there is no clamor for changing it there. They must be very strange people. I have played golf with a few brits vactioning in florida. They though our system was insane and would not trade theirs for ours.

  25. Selene Says:

    What exactly do dirty bathrooms have to do with the NHS? Are we to believe that hospital staff neglect to properly do their jobs when a country relies on a universal plan? Such a claim seems a bit extreme to me…

    Furthermore, have you actually seen these filthy hospitals for yourself or obtained this information from a credible source? Or are you just perpetuating gross rumors and stereotypes about other countries? These statements sound like nothing more than discrimination and desperate attempts to prove that universal health care doesn’t work.

    Lisa, I think we’d all be more than happy to debate the health care issue with you, but please, don’t rely on hearsay to confirm your points.

  26. Lisa Says:

    That’s not heresay that’s from someone that was there.
    I’ve done alot of my own research as well and the ones who are happy with the NHS are more than likely people who can afford the extra insurance who don’t have to rely on NHS for all their medical needs.
    Take a number because that’s what you will just figured into the budgeted,rationed healthcare system.
    Oh and don’t forget to get a 2nd job so you can afford the 55% tax deduction.

  27. Selene Says:

    hearsay [-sei] noun

    that which one has been told about by others but for which one has otherwise no evidence.

    I don’t even believe you anymore, Lisa. Now you all of a sudden you happen know someone from the UK? Earlier you said your 77 year old mother was your source of “proven” information about the NHS, but now you directly know someone from that area. Sorry, but I’m done arguing about this unless you have some real facts you’d like to contribute.

  28. Bring It On! National News » More On That Alleged Best Health Care In The World Says:

    […] Selene: hearsay [-sei] noun that which one has been told about by others but for which one has otherwise no evidence…. […]

  29. Deborah Says:

    Uh… I’m married to a British guy. He didn’t come here for the medical system, trust me. His family members won’t even think about setting foot in this country for a VISIT without purchasing “travel health insurance” and they also wouldn’t trade their system for ours, any day of the week. We are ALREADY rationing health care in this country. Wake up and get a clue. The Brits would be the first ones to tell you the NHS isn’t perfect, but if they tried to abolish it, there would be rioting in the streets.

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