by Randolph T. Holhut
American Reporter Correspondent
Sept. 19, 2003
HEALTH CARE COSTS, NOT AL-QAEDA, WORRY AMERICANS
DUMMERSTON, Vt. -- What is considered a bigger worry to the average American - another 9/11-style terrorist attack or not having health insurance?
According to a recent poll taken by the Kaiser Family Foundation, the latter is more feared by Americans.
The Kaiser poll found that 33 percent of the people they surveyed who now have health insurance are afraid their income won't keep up with the ever-increasing costs of the premiums. By comparison, only 8 percent fear that they'll be a victim of a terror attack.
Despite all the fear-mongering by the Bush administration, it's very apparent that most Americans are more afraid of health care costs than al-Qaeda.
Americans have every reason to be afraid. According to Kaiser, monthly premiums for employer-sponsored health care rose 13.9 percent between Spring 2002 and Spring 2003. That's the biggest increase since 1990 and it's certain to mean higher premiums, higher co-payments and higher deductibles. Already, workers have seen their out-of-pocket costs for doctor visits and prescription drugs double in the last three years.
Why is health care getting so expensive? Look no further than a study published last month in the New England Journal of Medicine. Investigators from Harvard University and the Canadian Institute for Health Information found that 31 cents of every dollar spent on health care in the U.S. goes to pay administrative costs. By comparison, Canada - which has a single-payer health care system administered by the government - spends about half as much, 16.7 cents.
Administration costs for the U.S. health care system amount to nearly $295 billion a year. If we had the Canadian system in the U.S., that $295 billion would be more than enough to cover the cost of coverage for the 41 million Americans who currently don't have health insurance.
It stands to reason that you could save a lot of money having one insurer - the federal government - instead of having thousands of different insurers and managed care providers. And government-run doesn't necessarily mean inefficient. Administration costs for Medicare are estimated at around 3 percent, far less than private insurers. And instead of watching their premiums go up 15-30 percent every year, some employers are starting become receptive to the idea of paying into a central fund - the way they do for Social Security - to cover health care costs for their workers.
Of course, we know the obstacles to getting some sort of single-payer health care plan enacted. Even though it has the support of most Americans, the medical-industrial complex - the drug companies, the insurance companies and the rest of the elements of the for-profit health care system in this country - is absolutely opposed and isn't afraid of spending millions of dollars to protect a system that allows them to make billions of dollars in profits. Their work in crushing President Clinton's feeble attempt at health care reform in 1993-94 is a perfect example of the kind of fight they put up when their profits are threatened.
The chattering classes won't offer support for single-payer health care either. Given the anti-government, pro-private market bias of the corporate press, they repeatedly dismiss single-payer health care as being costly and unworkable. And the politicians won't back single-payer health care, especially considering how much money they get in campaign contributions from the medical-industrial complex.
Despite the abundant evidence of the inefficiency and wasted money of the current American health care system, there are still people who are quick to scream about the evils of "socialized medicine" and how a government-administered system would mean less care and more restrictions.
That argument falls apart when you look at the HMO-dominated system we have now, which has given us less care and more restrictions. As this country has moved from a mostly fee-for-service system to a profit-driven HMO system, we've gotten more bureaucracy without better coverage and have managed to make health care an expensive commodity that millions of Americans can't afford.
We should be embarrassed by our status of being the only industrialized nation that doesn't insure all its citizens. Streamlining our health insurance system while providing universal and comprehensive health care for all is something that can be done.
It won't be done easily, given the power of the folks interested in maintaining the present profitable status quo. But the inescapable conclusion is that the present system isn't working, and that there is an alternative.
Randolph T. Holhut has been a journalist in New England for more than 20 years. He edited "The George Seldes Reader" (Barricade Books).