Those who have read the British news magazine The Economist (affectionately called “This Newspaper” by the editors), know that it is one of the best-written and informative journals for both international and American news. This blogger has been a subscriber for almost 37 years now. So, kudos to The Economist for publishing the most insightful piece yet on the American healthcare dilemma: “The expanding universal: The fix for American health care can be found in Europe.” The full article, which appeared in the August 12 edition, is currently available at this link (we just don’t know how long it will stay up).
The article offers many recommendations and observations similar to those shared through this blog over the past months and years. Principally, the article calls out Senate Majority Leader Mitch McConnell’s (R-KY) inaccurate assessment of healthcare in Europe. McConnell represented all of Europe as having “socialized medicine… a government takeover of everything.” But, as the magazine notes, Europe is less an example of government takeover of everything and more a beacon that offers a plethora of healthcare system options.
Key facts in the article:
- There are three working healthcare system paradigms according to The Economist, although some governments mix schemes:
- Government-run healthcare: The government takes over the costs of all coverage and provision of healthcare.
- Single-payer health insurance: The government provides universal health insurance and pays for it, but the vast majority of provision of care is left in private hands.
- Universal coverage approaches: Government leaves insurance coverage and delivery of care in the private sector, but it provides regulatory oversight and subsidies as well as mandates coverage for all.
- A truly government-run healthcare system is not the model for all of Europe; even in the countries with so-called “socialized medicine,” private insurance co-exists with the system.
- European countries that do not have socialized medicine include Switzerland, the Netherlands, and economic powerhouse Germany. These countries ensure universal coverage of individuals through government subsidies but their systems are centered on private insurers and providers.
- Germany has been using its non-socialized medicine model since Otto Von Bismarck was Chancellor under Kaiser Wilhelm I. Opening up our history books, we find that Bismarck was a brilliant foreign and domestic affairs tactician with broad control of German affairs for decades. He introduced the first welfare programs in Germany, including health and pension coverage.
- The article also speaks of the tremendous complexity of the American system compared with others in the developed world. The Economist rightly calls U.S. healthcare a “bewildering hodgepodge.” This blogger thought it ironic that the article referenced Bismarck who also taught us: “Laws are like sausages; it is better not to see them being made.” Indeed, our dysfunctional system arose over many decades of political sausage-making.
- The article notes that we have numerous social safety net subsidy healthcare programs for the elderly, poor and lower income citizens, as embodied in Medicare, Medicaid and Obamacare – all forms of universal coverage subsidies and two of them more than 50 years old (say what!). In addition, we have numerous other overlapping public programs and private coverage. The inefficient and expensive delivery of healthcare means that America spends far more on administration than in other countries (e.g., 8% in America vs. 2.5% in Britain).
- With all the complexity and effort, America still has over 28 million people uninsured, according to a just-released Center for Disease Control and Prevention report. We cover about 90% of the population compared with 99% in other developed countries (they do have more generous coverage subsidies and coverage mandates). And, as we have noted, the mismatch in how much of the gross domestic product (GDP) is spent on healthcare is stunning: 17% in America (and soon to hit one-fifth) vs. no more than 12% in other developed countries.
- Health outcomes also are starkly different and America is not doing well on most measures, the exception being expensive cancer treatment due to our great technology and innovation. American healthcare is great for the rich. Health indicators for the not-so rich will almost always lag behind citizens in other developed countries.
- The Economist concludes by challenging American politicians to look to European models for potential ideological breakthroughs, noting that there are only so many models to consider if one is committed to covering populations.
But therein lies the rub. Thus far, Republican ideological firebrands may not be sold on the idea that ensuring access to healthcare coverage for everyone is what mature and responsible democracies do.
These individuals must understand that somewhere between one half and two thirds of all healthcare expenditures in America are already paid by Uncle Sam. So, what is the aversion to a responsible and simple way of ensuring everyone has access to quality healthcare coverage? (Note that since the Veterans’ Administration debacle, only the most leftist sorts are endorsing the first option of fully government-run health care).
Think of the trillions of dollars that could be saved if the system is rationalized and consistent access finally brings quality to the fore. Federal spending and health care’s proportion of GDP might actually be reduced over time. Interested yet? If, as we suspect, the firebrands are still not convinced, other GOP lawmakers must reach across the aisle to get reform done.