As have previously noted, the United States has the highest medical costs in the world, almost twice as high as the next highest developed nation, France. But conservatives tell us we get the world’s best health service for those high dollars. But do we? The World Health Organization, measuring categories such as life expectancy, infant mortality, universal access, providers’ response etc., rates our overall health-care quality 36th, just below Costa Rica. Of course the right wing attacks the WHO as a bureaucratic, incompetent propaganda tool of the U.N. Nevertheless, it is evident we have major problems and we need to address them.
Our present system is a fee-for-service arrangement dependent on free-market forces to mediate the quality and costs of our medical care. In regulating consumer goods and services the free market is fairly efficient. But health care simply does not lend itself to mediation by free-market forces. The main problem is incentives.
The primary goal of any health care system should be to keep people healthy. But in our system there are few incentives to do this. There is little profit in convincing patients to eat healthier foods (and less of them, I might add), to exercise, to give up smoking, to drink moderately, if at all, and to avoid recreational drugs entirely. Such an approach is both difficult and unpopular, but vital to good health. The alternative? More disease and the resultant higher health care costs.
Many Americans are aware that the same prescription medications manufactured by the same American companies and sold in the same boxes cost considerably less, often less than half, in foreign countries. In reaction the U.S. pharmaceutical lobby, "Big Pharma," is trying to legally block U.S. citizens from bringing back drugs purchased abroad. The U.S. companies claim they charge higher prices here to pay for the expensive research required to develop these medications. But that is an insult to our intelligence. Although everyone knows we lead the world in medical innovation, they apparently don’t know that a huge part of this research is funded ($32.2 billion last year) by our federal government through the National Institutes of Health. And much of this research was conducted in publicly-supported state university laboratories. Big Pharma is not only getting a partially-free ride, they are lying about it to boot.
The pharmaceutical industry spends almost twice as much as its nearest rival, the insurance companies, on congressional lobbying. One of their biggest victories was an attachment to the Medicare Part B. Bill that denies cheaper drug prices as a bulk purchaser benefit to the federal government, by far the largest customer. This cost break advantage is a universally-accepted business practice. The amazing thing was that this overtly corrupt act evoked hardly a whimper from the press or the electorate. Are we no longer indignant at being bamboozled or are we just getting numb to it?
Health care reform? All I hear about so far is cutting health care access to the neediest people (who are also the sickest) and cutting taxes for the wealthiest few. So what’s new?
George B. Reed Jr., who lives in Rossville, can be reached by email at firstname.lastname@example.org.