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America's health-care outcomes are the worst in the world: no one spends more to get less than Americans, and that situation grows worse by the day - and covid makes it all the worse.
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It's not as if we don't know how to fix it. Every other wealthy country just provides universal health care, free at the point of delivery, either by owning and operating the entire system or by setting prices that the industry can charge. They spend less and get more.
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All of the exceptionalist stories about why America can't do what everyone else has done have been completely hollowed out.
Take the story about "rationing" under universal health care.
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Take the story about "rationing" under universal health care.
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People who spend thousands of dollars a year with companies like Cigna, Kaiser or Blue Shield are routinely told they simply can't have therapies or drugs their doctors have recommended. Life-extending cancer therapies are routinely refused by insurers as "experimental."
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America has death panels, and they issue stock and quarterly reports. Killing the people you love best in the world is good business.
It creates fortunes so vast a tiny sliver can distort our public policy so that we continue to murder people rather than treating them.
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It creates fortunes so vast a tiny sliver can distort our public policy so that we continue to murder people rather than treating them.
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This can be quantified. @JAMAInternalMed's May issue contained an important observational study: "Lobbying Expenditures and Campaign Contributions by the Pharmaceutical and Health Product Industry in the United States, 1999-2018" by @ojwouters.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054854/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054854/
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In 2018, the US spent $3.7T on health care - 17.6% of national GDP. In the preceding 20 years, the industry spent $4.7B on lobbying - a giant number, but also a stellar ROI. That's a $233M/year spend to generate a $3.7T return.
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The recipients of this spending represent a rare example of bipartisan cooperation, with Dems and Repubs alike staggering away from the trough, showing the telltale hectic flush of chronic overconsumption.
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It explains a lot about how the Democratic establishment destroyed any candidate who breathed the words " #MedicareForAll" despite the incredible, bipartisan popularity of taking Wall Street out of our health-care.
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And it explains why the current Democratic Congressional Congress, cabinet and party bigwigs are making ready to destroy the "public option" - an anemic alternative to universal health care that will still murder Americans by neglect.
https://jacobinmag.com/2020/12/health-care-policy-joe-biden-xavier-becerra-m4a-pahcf
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https://jacobinmag.com/2020/12/health-care-policy-joe-biden-xavier-becerra-m4a-pahcf
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Health care is an essential, not a discretionary item. It's literally a matter of life or death. People must procure health care or they will sicken and die. That means that whatever system exists for health-care is the system we will use.
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That makes the money Americans spend on their health-care a form of tax, and in the case of the US, it's a tax we pay to giant, highly profitable corporations who divert part of their winnings to bribe politicians so we are forced to continue paying the tax.
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It's a regressive tax. The richer you are, the less of your income is raked off: "Factoring in private insurance the average tax rate rises from 30% at the bottom to 40% for the middle class, before collapsing to 23% for billionaires."
https://www.theguardian.com/commentisfree/2019/oct/25/medicare-for-all-taxes-saez-zucman
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https://www.theguardian.com/commentisfree/2019/oct/25/medicare-for-all-taxes-saez-zucman
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"Take a secretary earning $50k/year, who has employer-sponsored health insurance at $15K. Her compensation is $65k (what her employer pays in exchange of her work), but she gets $50k. The executive earning $1m also pays the same $15k for healthcare."
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"Funding universal health insurance would lead to a large tax cut for the vast majority of workers, and the data show that for most workers, it would lead to the biggest take-home pay raise in a generation." - @gabriel_zucman and Emmanuel Saez.
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