Charlene Smith 27 January 2012 Charlene Smith says it’s is expensive, inadequate and drug dependent
Cambridge, Massachusetts – “The U.S. spends 50 percent more on healthcare than Europe, yet a black child born in Washington D.C. has less of a chance of reaching his 1st birthday, than a child born in Barbados,” Jonathan Gruber, Massachusetts Institute of Technology economist and adviser to President Barack Obama on the Affordable Health Care Act said this week.
And yet mention healthcare in any setting in the United States and bitter arguing and polarisation ensues. Ironically the law that Obama piloted – the Affordable Health Care Act (AHCA) is based on a law that 2012 Republican presidential hopeful, Mitt Romney put into place when he was governor of Massachusetts.
In Massachusetts the law has been successful in cutting costs and improving care, it has a 70 percent approval rating from citizens. Here, 90 percent of citizens are covered by health insurance compared to an average of only 60 percent nationwide, according to Gruber. some states like Minnesota are already going ahead and implementing the AHCA on their own, but most remain aloof.
Gruber, who worked with Romney to create the law in Massachusetts and then with President Barack Obama, says, “When it was signed it was a Republican plan. On the platform that day was a rightwing guy from the Heritage Foundation who extolled it as an example of the best of Republican government – until Obama showed an interest in it and suddenly it became the devil’s work.”
Better and more affordable healthcare is absolutely necessary as Americans become poorer; according to the Social Security Report (2009) more than half of Americans earn $26,000 a year – barely above the poverty level of $22,000 a year.
The latest U.S. Census Bureau report on earnings (September, 2011) noted that “in 2010, median household income declined [and] the poverty rate increased…Real median household income in the United States in 2010 was $49,445, a 2.3 percent decline from the 2009 median. The nation’s official poverty rate in 2010 was 15.1 percent, up from 14.3 percent in 2009 ─ the third consecutive annual increase in the poverty rate. There were 46.2 million people in poverty in 2010, up from 43.6 million in 2009 ─ the fourth consecutive annual increase and the largest number in the 52 years for which poverty estimates have been published. ”The number of people without health insurance coverage rose from 49.0 million in 2009 to 49.9 million in 2010.”
Gruber, speaking at an event organized by the independent Harvard book store to publicize his new book Health Care Reform: what It is, why It’s Necessary, and How It Works pointed out that the U.S.A. has been trying to reform health care legislation for one hundred years – on average the issue comes up every 17 years.
The number of Americans without health insurance is worrying when you consider how much more expensive health care is here than elsewhere. Pharmaceutical drugs, as an example, are 40 percent costlier here than anywhere else in the world, and law prevents Medicare and Medicaid from negotiating lower prices – an extraordinary situation. no surprise then that the $800 billion healthcare sector is the most prosperous in the country and recession proof.
This is also the only country in the world, but for New Zealand, that allows prescription drug advertising to consumers.
And so we have a situation summed up well by Professor Allan V. Horwitz of Rutgers University who wrote in the New England Journal of Medicine on February 11, 2009 ”Americans have long craved chemical solutions to their problems of living.” and buoyed by few controls over the pharmaceutical industry’s rapacious marketing and a system that as Gruber notes: “Pays doctors according to how much they give you – the so-called fee per pay system instead of paying physicians according to the health outcomes of patients,” the healthcare system contributes to increasing, instead of discouraging, ill-health.
As another example, American children consume two-thirds of the global production of Ritalin, according to the most recent annual report from its manufacturer Novartis. The drug is to counter a disorder that many say doesn’t even exist – attention deficit disorder – for active children. The drug, which is a schedule II drug with cocaine, is cardio-toxic and has been implicated in a rise in cardiac deaths among children.
The fee per pay system has resulted in overtreatment – Los Angeles, as an example, has more MRIs than Canada. This has also become the country with the highest load of prescription drug addicts. At present prescription drug overdoses are the highest cause of accidental death – 37,000 in 2010 according to the Centers for Disease Control – outranking traffic accidents and death by overdose for all illegal narcotics combined.
Gruber says, “a third of what is done [in terms of treatment] is unnecessary.” and yet preventative screenings like pap smears or mammograms are not universally free. In 2010 Amnesty International lambasted the United States for a doubling of deaths from pregnancy and childbirth in the past 20 years. In addition, the rights group said, about 1.7 million women a year, one-third of pregnant women in the United States, suffers from pregnancy-related complications, which could be avoided by free prenatal care.
Gruber points out that, “a rich person pays a quarter of his or her healthcare costs [because their workplace covers them] but the person who works at McDonalds has to buy his own health insurance – he is paying for 100 percent of his healthcare costs.”
The new law is already funded by tax increases and spending cuts – most of the cuts were in areas where existing benefits were being misapplied, for example, Gruber notes, the elderly (a rapidly growing demographic) were being overpaid by thirty percent, but adjusting that saw funding go toward the Act without fewer benefits to the aged. Gruber estimates that the Affordable Care Act once implemented in all states will see savings of at least $100 billion within a decade.
But it may never survive that long: in June the Supreme Court will decide whether Obama’s mandate to pilot the law was constitutional. “If the Supreme Court eviscerates the mandate it will gut the law,” Gruber says. If the Supreme Court rules the law constitutional, the Republicans will not be able to repeal it if they come to power, “but they can stow it so implementation collapses and then they repeal it.” and implementation will collapse if states don’t adopt it.
Charlene Smith is a South African born journalist who lives and works in the United States; she is presently researching a book on prescription drug overmedication and addiction.
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