Health Care Everywhere

This week, the Washington Post reports that, even in some countries with lesser standards of living than the US, access to medical care surpasses ours.  In Thailand, only 1% of the population lacks health insurance.  The Mexican government created a safety net to insure 50 million people who are not covered by existing plans.

And in former communist countries, the urge to capitalize medical treatment that followed the fall of the Soviet system has been replaced by a social-service sensibility:

Two decades ago, many former communist countries in Eastern Europe and elsewhere dismantled their universal health-care systems amid a drive to set up free-market economies. But popular demand for insurance protection has fueled an effort in nearly all of these countries to rebuild their systems. Similar pressure is coming from the citizens of fast-growing nations in Asia and Latin America, where rising living standards have raised expectations for better services.

In the US, about 50 million people have no health insurance, roughly 16% of the population.  This percentage rises for the poor:  a 2009 study by the Kaiser Family Foundation reported that 45% of low-income Americans under the age of 65 have no health insurance.   The Affordable Care Act of 2010 will reduce these numbers — but we won’t know until next month whether the Supreme Court will find some or all of it unconstitutional.

Even if the ACA stands, it doesn’t abolish for-profit insurance companies (or constrain their power much), and its direct effects on the costs of medical diagnosis and treatment remain to be seen — so while more Americans will have insurance, some will continue to be unable to pay for some of their care.

Big question: why is the US different from Thailand, Mexico, or China?  What makes the idea of universal access to medical treatment so complicated for us when it seems to be increasingly simple for countries that have lesser GDPs?

  1. aakselrod said:

    I can see several reasons for why people may not want to have universal health care in the US. Personally, I think taxes play a big role here, as total health coverage will most likely lead to a tax increase. However, another discrepancy may be the fear of an over-involvement of the government in the lives of the citizens: many physicians with private practices fear losing their jobs, and others are afraid of a plummet in healthcare quality. Unfortunately, I think it comes down to the “Haves” vs. the “Have-nots”. Why would people who are currently fully covered, and who are getting excellent treatment by doctors in private practices, or the physicians themselves, want to sacrifice their comfort to better the quality of life for others without getting anything in return?

  2. philipalcabes said:

    That all makes sense, Alla. Especially the chronic willingness of the “haves” to allow the “have-nots” to continue to have not. But on those grounds we can’t really explain why countries that tolerate wealth inequality as much as the US does, or even more so (like China!), are seeking to give everybody access to medical care while the US continues to be okay with wide disparities in access and with the consequent burden of mortality from untreated illness.

    Does it mean that Americans believe in human rights for other countries but not for ourselves? Or simply that in the American conversation about America, medical treatment isn’t considered a right? If not, what makes our thinking so different from the Mexicans’ thinking, the Germans’, the Chinese’s, and so forth?

  3. Marina Erlikh said:

    The plummet in healthcare quality that Alla mentions is a very real concern. Under a universal healthcare policy, unemployed individuals who previously were uninsured as well as employed individuals who will be mandated to buy insurance, will all be contributing to longer lines at doctors’ offices and emergency rooms. Subsequently, many fear, the quality of care will diminish because doctors will be forced to spend even less face-time with their patients.

    And the bottom line, as always, is who will be paying for this? Universal health care, under the ACA, isn’t free for all. It’s also not a simple division between “haves” and “have-nots”– the policy affects middle-income individuals.

    The idea of universal healthcare– everyone having the right to be healthy– is one that’s easy to get behind; it’s the policies in place and in the works towards realizing this ideal, that are not so ideal.

  4. evelynatiemo said:

    I think that a large reason why universal healthcare seems to be such a complicated concept for the U.S. to grasp is because we are a very capitalistic society. Pharmaceutical and insurance companies seem to be driven entirely by the goal of making lots and lots of money; and one of the ways in which these companies do so is by either harming or killing people subliminally. Insurance companies have a number of sneaky ways of making sure that Americans have an incredibly difficult time obtaining the health insurance that they need. One common way in which they do so is by pricing insurance packages at skyrocketing prices; forcing people to either pay out of pocket for the healthcare that they need, or just leave their health conditions unaddressed—which often times leads to death. Sometimes pharmaceutical companies will form agreements with doctors (in the form of compensation) so that these doctors can promote new drugs that the pharmaceutical companies are currently marketing. Doctors will then overprescribe these new drugs to their patients—regardless if their patients need it or not. The unbeknownst patients to this devious, moneymaking cycle then go out and purchase these drugs—at of course high prices. It’s horrible. Michael Moore actually directed a 2007 documentary entitled, “Sicko,” which touches upon all the issues mentioned above.

    Below is a link to a scene in the movie where Moore speaks to a doctor in the U.K. that treats patients under the National Health Service. NHS has yet to come to the U.S.

  5. evelynatiemo said:

    By the way, the National Health Service (or NHS) is a state-funded healthcare system in England that provides its members access to a full range of healthcare services, without them having to pay out of pocket. Although the NHS does have services that do cost a fee (i.e. eye tests and some areas of long-term care), those “fee-for-service” services are at a much lower price than what they would have been if they were provided through a private healthcare provider.

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