Deadly cost of for-profit health care

October 23, 2008

IF ANY more evidence is needed that the U.S. health care system is failing, consider this: The U.S. recently placed 29th in infant mortality, out of 37 industrial nations surveyed in a study released by the U.S. Centers for Disease Control and Prevention (CDC). The U.S. is behind Singapore (number one), Canada (number 24), Cuba (number 27), and tied with Poland and Slovakia.

Although absolute infant mortality rates have been declining, the U.S. has been falling behind relative to other countries for over 40 years. In 1960, it ranked 12th in the world, and in 1990, it ranked 23rd, according to the CDC report.

The CDC also notes that infant mortality among non-Hispanic Black women is 2.4 times higher than it is among non-Hispanic white women. If non-Hispanic Black women were ranked as a nation of their own, they would come out next-to-last on the international list, only somewhat better than Romania.

Don't look for good news at the other end of the life cycle either. The U.S. is 38th (out of 195) in overall life expectancy according to the UN, in a virtual tie with Cuba, and behind the leader, Japan, by 4.4 years overall.

In order to attain these rather mediocre outcomes, the profit-based U.S. health care system requires an estimated 16 percent of the gross domestic product, (or about 20 percent of each household's budget), twice as much as countries like France, Germany or Canada, where overall health outcomes are superior to those in the U.S. Fifteen percent of the U.S. population, or about 45 million people, are without any medical coverage, and that figure is growing.

Much of the U.S. health care budget is wasted on non-productive advertising and administrative costs. According to a 2003 article in the New England Journal of Medicine, administration was estimated to consume 31 percent of U.S. health care expenditures. This amounts to almost $295 billion each year, or about $1,000 per capita, about twice the per capita administrative costs in Canada.

The sorry state of the U.S. health care system is hardly a secret, of course. In the current election cycle, both of the major party presidential candidates have proposed changes.

The McCain proposal, effectively a neoliberal tax swindle, has been described in a recent article in the New England Journal of Medicine as '"the McCain plan for health insecurity," whose "central purpose is to reduce the role of insurance and make Americans pay a larger part of their health care bills out of pocket."

The Obama plan at least promises to extend coverage to most uninsured Americans. But without addressing the profit-based inefficiencies in the system, the Obama campaign estimates that an additional $65 billion will be required to fully implement his plan. After spending over $1 trillion (and counting) to bail out the bankers, will this money be left to improve heath care (and subsidize the insurance and drug companies)?

Decent health care should be a human right, not a source of profit. The solution is obvious--a single-payer system that cuts out the insurance parasites. What we need is a movement strong enough to fight for, and win, this elementary right.
Rick Greenblatt, San Diego

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