Friday 29 June 2012

Obamacare: Congratulations on doing the right thing, America!

I work hard. I make my own living. I can pay for my own health insurance. If you can't, it's your fault. You should go get a job. This isn't a charity.

You have a pre-existing medical condition? You've already had a lump removed? This is your second tumor? The insurance company has the right to make a profit. It if can't make a profit, it has the right to refuse you coverage or it has the right to charge you a higher premium. This isn't a charity.

Can't afford health insurance? Then go without. The country can't go bankrupt supporting people who can't support themselves. This isn't a charity.

As I stand off to one side and listen to the debate rage on over the question of health care, I am surprised at the amount of misinformation being passed around as fact in order to justify a point of view. Yes, I work hard and I deserve to keep my slice of the pie but who's looking at the bigger picture? I am but one person looking out for myself and my family. Who's looking out for the entire country, for the collective us?

A report from the Institute of Medicine of the National Academies states: "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." (Wikipedia: Uninsured in the United States: Consequences)

What? 18,000 people die each year because they have no health insurance? Holy Hannah.

The U.S. Census Bureau reported that 49.9 million residents, 16.3% of the population, were uninsured in 2010 (up from 49.0 million residents, 16.1% of the population, in 2009). (Wikipedia: Health care in the United States)

What? 50 million people do not have health insurance? How the heck do they take care of themselves?

According to the World Health Organization (WHO), the United States spent more on health care per capita ($7,146), and more on health care as percentage of its GDP (15.2%), than any other nation in 2008. (Wikipedia: Health care in the United States)

What? When I joke along with Stephen Colbert yelling, "We're number one! We're number one!" referring to the United States as being the number one country in the world, I didn't mean number one in spending on health care.

The U. S. [spends 15.2% of its GDP on health services, more] than any other country but ranks 37 out of 191 countries... The United Kingdom, which spends just [6% of its GDP] on health services, ranks 18th. (World Health Organization Assesses the World's Health Systems)

In 1997, WHO ranked the U.S. 72nd out of 191 countries for its Health Performance rank. (Health system attainment and performance in all Member States, ranked by eight measures, estimates for 1997)

You have the right to be treated
The Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. (Wikipedia) This means anybody can seek treatment even those who are uninsured.

This is also called uncompensated care or charity care. What it means is that instead of going to a family doctor, somebody without health insurance can go to emergency. They do go to emergency because they have the right to and they can't afford to go elsewhere.

Instead of somebody visiting a family doctor they go to hospital emergency. Which costs more the family doctor or emergency?

The American Hospital Association estimated that the uncompensated hospital care costs for the year 2007 to be $34 billion.

In a March 9, 2010 article from The Urban Institute, the authors John Holahan and Bowen Garrett estimated the future costs of uncompensated care for the period 2014 - 2019 to be $330 billion if the system is reformed. If the system is not reformed, the cost of uncompensated care would be between $560 and $700 billion.

Insuring people is going to cost. But not insuring people does not mean there is no cost to the health system or to the country. Anybody has the right to go to emergency and if they don't have health insurance that is the only place they can go and going to emergency is not free. Okay, it may be free for the individual but there is a cost to the system, the uncompensated charity care.

Final Word
Thank God I have a job. Thank God I can afford health insurance. Thank God I'm lucky enough to be part of the top twenty percent, never mind the 1%. I have a job. Thank God.

Thank God I pay taxes. Paying taxes means I have a job. Paying taxes means I make enough money to be even eligible to pay taxes. Paying taxes means I have money in my pocket.

But what about the people who don't have a job? What about the people who have a job but who earn so little, they still need help? What about the people who have to pay for food first then don't have enough for health insurance?

Is health a privilege or is health a right?

Obamacare is not perfect. But it is a step is the right direction. Socialism? Is helping your neighbour socialism? Is helping your country socialism? Is spending more on uncompensated charity care than on insuring people not very astute? Is spending more than any other country on health care but only ranking 72nd in the WHO's health assessment ranking something anybody would not want to turn around? Would you let 18,000 people die unnecessarily each year because they have no health insurance? You have a right to be free. You have the right to work, succeed, and travel. Shouldn't you have the right to be healthy?

From the official web site of Mitt Romney:

On his first day in office, Mitt Romney will issue an executive order that paves the way for the federal government to issue Obamacare waivers to all fifty states. He will then work with Congress to repeal the full legislation as quickly as possible.

A vote for Mitt Romney is a vote to let 18,000 people die.


Wikipedia: Health care in the United States
The U.S. Census Bureau reported that 49.9 million residents, 16.3% of the population, were uninsured in 2010 (up from 49.0 million residents, 16.1% of the population, in 2009).

According to the World Health Organization (WHO), the United States spent more on health care per capita ($7,146), and more on health care as percentage of its GDP (15.2%), than any other nation in 2008.

The United States had the fourth highest level of government health care spending per capita ($3,426), behind three countries with higher levels of GDP per capita: Monaco, Luxembourg, and Norway.

A 2001 study in five states found that medical debt contributed to 46.2% of all personal bankruptcies and in 2007, 62.1% of filers for bankruptcies claimed high medical expenses. Since then, health costs and the numbers of uninsured and underinsured have increased.

Wikipedia: Uninsured in the United States: Consequences
(Health insurance coverage in the United States)
A report from the Institute of Medicine of the National Academies states: "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States."

A 2009 Harvard study published in the American Journal of Public Health found more than 44,800 excess deaths annually in the United States associated with uninsurance.

Johns Hopkins University professor Vicente Navarro stated, more broadly, in 2003, "the problem does not end here, with the uninsured. An even larger problem is the underinsured" and "The most credible estimate of the number of people in the United States who have died because of lack of medical care was provided by a study carried out by Harvard Medical School Professors David Himmelstein and Steffie Woolhandler (New England Journal of Medicine 336, no. 11 [1997]). They concluded that almost 100,000 people died in the United States each year because of lack of needed care—three times the number of people who died of AIDS."

Wikipedia: Charity care
In the United States, charity care (also known as uncompensated care) is health care provided for free or at reduced prices to low income patients.
One estimate put the cost of uncompensated care for 2004 at $41 billion, of which $34.6 billion was funded through a patchwork of government programs.

International Herald Tribune - Jun 28/2012
U.S. Health Care Costs More Than ‘Socialized’ European Medicine by Harvey Morris
A sobering statistic emerged on Thursday as the United States Supreme Court prepared to deliver its judgment on Obamacare. It confirmed that the U.S. spends more per capita on publicly funded health care than almost every other country in the developed world. And that includes countries that provide free health care to all their citizens.

Organisation for Economic Co-operation and Development (OECD)
OECD Health Data 2012: How Does the United States Compare
Health spending accounted for 17.6% of GDP in the United States in 2010... by far the highest share in the OECD, and a full eight percentage points higher than the OECD average of 9.5%.

The United States spent 8233 USD on health per capita in 2010, two-and-a-half times more than the OECD average of 3268 USD (adjusted for purchasing power parity).

Despite the relatively high level of health expenditure in the United States, there are fewer physicians per capita than in most other OECD countries.

The number of curative care hospital beds in the United States was 2.6 per 1000 population in 2009 (latest year available), lower than the OECD average of 3.4 beds.

In the United States, life expectancy at birth increased by almost 9 years between 1960 and 2010, but this is less than the increase of 11 years on average in OECD countries.

In the United States, the obesity rate among adults was 35.9% in 2010, up from 15% in 1978. This is the highest rate among OECD countries. The average for the 15 OECD countries with measured data was 22.2% in 2010.

American Hospital Association
Uncompensated Hospital Care Costs: November 2008
Cost of uncompensated care (2007): $34 billion

The Urban Institute
The Cost of Uncompensated Care with and without Health Reform
by John Holahan, Bowen Garrett
We estimate that from 2014 to 2019, uncompensated care costs would be $330 billion with the Senate bill and about $240 billion under the House bill. In contrast, the cost of uncompensated care over the same period without reform would be between $560 and $700 billion.

Daily Finance - Jun 28/2012
Obamacare Upheld: How Health Care Reform Will Affect Your Wallet and Your Life
By Bruce Watson
The big transition, the creeping socialism that Obamacare detractors are really worried about, will arrive in 2014. That's when everyone will either have to get insurance or pay a tax.

The funny thing is, creeping socialism probably won't feel much different than the current system. Imagine, if you will, an ordinary, middle class family. For mom and dad, who work full time, insurance will still be provided through work. They'll still go to the same doctor, pay the same copay, and head to the same hospital when things get dire. Their kids will still get the same care, too, although they'll be able to take advantage of their parents' health insurance until they're 26, if they need to.

The Examiner - Aug 3/2009
The United States does not have the best health care system in the world by Karen Harper
In fact, it's not even close to being the best health care system in the world. Republicans have fought President Obama on every bill he has worked on and health care reform is no exception. Senator Richard Shelby (R), Alabama, said that President Obama's health care plan is the "first step in destroying the best health care system the world has ever known." Senator Chuck Grassley (R), Iowa, told a constituent in a town hall meeting that if he wanted health insurance to get a job with the government.  Perhaps Grassley would like the government to provide 47 million jobs to solve the problem of the uninsured in America.

There are several important aspects about the United States health care system that make it one of the worst of all the industrialized nations.

1. Cost
The truth is that Americans pay more for health care than any other country in the world

2. Quality of Health
The United States ranks only 27th in life expectancy of 189 countries. Of the 30 OECD (Organization for Economic Co-operation and Development) nations, the United States ranks only 22nd in life expectancy.

3. Not covering the uninsured makes things worse
The uninsured, approximately 47 million, go to emergency rooms. The "health system" does provide free emergency services however providing services in an emergency room, especially for more minor ailments is expensive, much more expensive than the normal treatments associated with a family doctor. As a consequence, by not providing health insurance to the uninsured, the system bears a greater financial burden.

The New Physician magazine September 2000 issue
Case Study: The Uninsured
True Stories of Unnecessary Sickness, Death and Humiliation by Howard Bell
One in six Americans does not have health insurance, and many live sicker and die younger because of it.


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1 comment:

Pauline Gaines said...

Wow. Excellent piece. And yes, the thought of Romney winning the Presidency makes me want to crawl under the covers and hide.