The Envy of All

The US has the finest health care system in the world. That’s the mantra we hear from the president, from our elected officials, and from the media. It’s certainly the most expensive health care system in the world – and perhaps expensive has come to be our definition of “best.” Or, perhaps, this is really a case of a lie being repeated often enough to become the truth.

A joint team of researchers from University College London, the University of London, and the US Rand Corporation studied two groups of comparable white people from both countries. The groups were divided into sub-groups based on education and income, and the researchers compared the rates of disease. They found that Americans aged 55-64 are twice as likely to suffer from diabetes, lung cancer, and high blood pressure as English people in the same age group. The healthiest Americans had similar disease rates to the least healthy Brits. Rates of diabetes were twice as high among the US group.

Americans spend almost double per head on health care than the English do. US healthcare is funded through insurance companies, while the British National Health System is funded by taxation.

The researchers found that health inequalities were more pronounced in the US, and that this may be partly attributed to the lack of health care and social programs to help those who are sick (like they have in the UK.) Those factors, however, were not enough to explain why the wealthiest Americans still had rates of health comparable to the poorest in England.

When this sort of study comes out, it’s immediately dismissed in the US as being junk, and the British system as a bunch of commie-pinko-socialist claptrap that can’t compare to the finest health care system in the world. It’s a shame that we don’t stop mouthing jingoistic slogans and bother to try to learn something from this sort of study. The US has a higher infant mortality rate than Cuba. If we weren’t so arrogant, we might actually learn something from the other countries that are healthier than we are.

Hot on the heels of the release of this study is a new federal bill that would change US health insurance laws. It’s basically SB110 for the whole country! SB110 was the law enacted in NH a few years back that allowed insurance companies to rate clients on the basis of age, sex, occupation, and location. It proved to be devastating to folks in the north country, who saw their rates increase by as much as 200 percent. Governor Lynch made repealing SB110 a cornerstone of his gubernatorial campaign in 2004.

The federal bill is called the Health Insurance Marketplace Modernization and Affordability Act (S.1955) is intended to allow small business owners to organize across state lines and purchase health insurance through trade groups like Chambers of Commerce. NH Senators Judd Gregg and John Sununu are both in favor of the bill. Governor Lynch and 41 attorneys general around the country say the bill will block states from being able to regulate insurance companies. It may also end state specific benefits, like Michelle’s Law – the recently passed law that requires coverage for acutely ill college students. The bill would also let insurers drop coverage for mammograms and diabetes – both required now by state law. Deputy Commissioner of Insurance, Alex Feldvebel predicts that groups with between 1 and 10 members would see rates double at renewal time. Feldvebel found that the federal law would allow premiums to differ by a ratio of up to 25-to-1. NH state law allows for a difference of only 3.5-to-1. In other words, for every $100 spent in premiums by one individual, another could spend up to $2,500. The state limit is $350.

So – insurance companies can charge way, way more, and cover much, much less. Business groups are in favor of this; the NH Restaurant and Lodging Association, the Home Builders and Remodelers Association, and the NH Realtors Association are some of the groups supporting the bill. Opponents include the American Cancer Society, AARP, the American Diabetes Association, and the American Academy of Pediatrics.
Perhaps I’m being too cynical. Perhaps this isn’t a valentine to insurance companies, perhaps it’s merely increasing our rates to show us that we do indeed have the finest health care system in the world – look at how much it costs!!

This is being touted by Senator Gregg as “putting consumers first.” It’s hard to imagine that he can say that with a straight face. Once again, our elected officials are putting business ahead of our health. As long as we continue on the dunderheaded path of an expensive, insurance based system, we will experience increasing costs, disappearing coverage, and deteriorating health. It’s a great deal for insurance companies and Chambers of Commerce. As for the rest of us – well, we can take comfort in knowing we’ve got the best – even though we can’t afford to use it.

“The US healthcare system is the envy of the world.” George W. Bush