We Have the Best Healthcare in the World, if You are Rich

We Have the Best Healthcare in the World, if You are Rich

But if you aren’t a one-percenter, it is the worst in the developed world

With the exception of one country, the goal of every developed nation on earth is to provide each of their residents (even when they travel) with access to first rate health care without reference to the cost of that care. This extends to prescriptions, dental and vision care and sometimes even the transportation to and from the medical facilities. The focus prioritizes the patients and usually bends over backwards to provide even treatments and prescriptions that are exceptionally expensive, and often even new evolving treatments that are routinely rejected in the US. The costs are supported by a graded tax structure, assessed against employers (or businesses) and employees (covering everyone regardless of employment status). There is no separate system for retirees… everyone, often even tourists just visiting, is under the same coverage. Europe, for example, did not have to pass any special legislation to deal with the recent pandemic.

It's obvious which developed country has the worst healthcare system. It has to be the only nation where the profit-makers are the priority (certainly not patients), where insurance companies, hospitals, pharmas and highly-paid physicians are prioritized above all, where the proclivity to deny or limit coverage (or require huge premiums with big deductibles and/or copays) is rampant, where arguing with your insurance company (if you have one) over coverage has phalanxes of experts at denying coverage write rejection letters, deny claims over the phone or simply refuse to pay for the treatment even after the fact, is normal. That country is the United States of America.

Funny, while they usually know better, legislators (state and federal) who are bought and paid for by the profit-makers in healthcare sector, generally cry “creeping socialism” when the notion of universal healthcare, available in every other developed nation (and many developing countries as well), is mentioned for us. Universal healthcare is no more socialism than providing public schools. Social programs ARE NOT socialism! Germany – which is the home to Bayer AG (pharmaceuticals), Porsche and Mercedes super-cars and owners of some of those absurd castles looking down on their vast estates – is NOT a socialist country. Yet their universal healthcare system is the best in the world, followed closely by Switzerland. Socialism is about government ownership of the land, factories and housing, not providing programs for their people.

Under Germany’s universal healthcare, the most a patient pays for all prescriptions per month is about $13. They did not replace the body of health insurance carriers when the instituted their healthcare system; instead of exploding the governmental bureaucracy to replace them… the government hired such insurance companies to run the program for a flat percentage. Patients never see those costs… surgical patients check out of any medical care facility without seeing a bill. So, what makes me say that our rich country, at the cutting edge of medical technology, has the worst healthcare system in the developed world? A survey by the Commonwealth Fund comparing the top ten developed countries, those with standards of living comparable to each other… including the United States (ranked deal last!!!), as reported by Jessica Glenza in the September 19th Guardian UK: “In spite of Americans paying nearly double that of other countries, the system performed poorly on health equity, access to care and outcomes.

“‘I see the human toll of these shortcomings on a daily basis,’ said Dr Joseph Betancourt, the president of the Commonwealth Fund, a foundation with a focus on healthcare research and policy… ‘I see patients who cannot afford their medications … I see older patients arrive sicker than they should because they spent the majority of their lives uninsured,’ said Betancourt. ‘It’s time we finally build a health system that delivers quality affordable healthcare for all Americans.’

“However, even as high healthcare prices bite into workers’ paychecks, the economy and inflation dominate voters’ concerns. Neither Kamala Harris nor Donald Trump has proposed major healthcare reforms… The Democratic presidential nominee has largely reframed healthcare as an economic issue, promising medical debt relief while highlighting the Biden administration’s successes, such as Medicare drug price negotiations… The Republican presidential nominee said he has ‘concepts of a plan’ to improve healthcare, but has made no proposals. The conservative policy agenda Project 2025 has largely proposed gutting scientific and public health infrastructure.

“However, when asked about healthcare issues, voters overwhelmingly ranked cost at the top. The cost of drugs, doctors and insurance is the top issue for Democrats (42%) and Republicans (45%), according to Kaiser Family Foundation health system polling. Americans spend $4.5tn per year on healthcare, or more than $13,000 per person per year on healthcare, according to federal government data.

“The Commonwealth Fund’s report is the 20th in their ‘Mirror, Mirror’ series, an international comparison of the US health system to nine wealthy democracies including Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK, Sweden and Switzerland. The foundation calls this year’s report a ‘portrait of a failing US health system’.

“The report uses 70 indicators from across five main sectors, including access to care, health equity, care process, administrative efficiency and outcomes. The measures are derived from a survey conducted by Commonwealth as well as publicly available measures from the World Health Organization, OECD and Our World in Data… In all but ‘care process’ – the domain that covers issues such as reconciling medications – the US ranked as the last or penultimate nation. Presenters for Commonwealth noted the US is often ‘in a class of its own’ far below the nearest peer nation.” While we have made some strides in covering more Americans under Affordable Care Act, the system is being pushed to the limit (God help you if you do not live in or near a US city with a good hospital system at its core). Obviously we can do better, if Republicans would simply stop using false descriptions of global standard healthcare… and get out of the way!

I’m Peter Dekom, and I still wince when I hear some rightwinger, insisting to the end that America has “the best healthcare in the world,” notwithstanding a tsunami of data that conclusively provides we have worst in the developed world.