Are We Prepared to Provide Real Healthcare… or Not?

 

Are We Prepared to Provide Real Healthcare… or Not?

As the Senate once again stares at the ugly cost of the government’s “guarantee of profits to insurers vs meaningful healthcare for all Americans,” and in the battlefield of affordability, these two positions remain mutually incompatible; for all of us, it is an either/or conundrum that defies logic as rests on clever labeling and catering to special interests. Mislabeling a “social program” as “creeping socialism” remains the go-to explanation why raw capitalism is the solution, according to the mega-rich. They clearly don’t want to pay taxes to support the healthcare of others, and they tolerate gobs and gobs of expensive waste as long as the owners of the mega-billion-dollar healthcare insurers are making gobs and gobs of money. In a rich country like the United States, you’d think we’d prioritize a system that elevates a nation of healthy citizens over investors seeking wealth. I hope my explanation below clarifies the nefarious motives involved.

First, as a standard for comparison, according to demographics analytics from WorldoStats, “Globally, the average Healthcare Expenditure (% of GDP) stands at 10.35%, underscoring the significant role of healthcare systems in sustaining economic and social stability.” Of the 38 “high income nations,” OECD members in 2023 considered for inclusion, the OECD (2023) concludes that six countries—Chile, Colombia, Costa Rica, Mexico, Poland, and the United States—do not have universal (or near-universal) coverage for core medical services.

So, let’s drill down into economies from the expensive Western World and see how our cost efficiency profile compare. Simply, how wasteful is our healthcare system? Since every other developed country in the world has universal healthcare, paid for by an overall tax levy that mirrors our social security system, it would seem an easy comparison. So instead of looking at “average” healthcare cost as a percentage of GDP in developed nations, let me take the percentage of what is universally considered the most efficient and effective universal healthcare country: “Germany stands out among developed countries for its efficient, publicly funded healthcare system, contributing 12.65% of its GDP to healthcare.” Worldostats. Nobody is going to accuse super-educated, tech superpower Germany of limping along with inferior doctors, hospitals or below-state of the art equipment and facilities.

Excepting the COVID years, the US has been consistently generating healthcare costs north of 17% of GDP of late, although that percentage is has begun to creep upwards, projecting 18.5% now and rising to 20% by the end of the decade… unless we wake up. Using 17.5% as our assumed US number (lower than it is by a small amount), the GDP percentage difference between the efficient German system – which actually pays local insurance companies to administer the system for a reduced flat rate – and the US, produces a difference of 4.85%, which when calculated against our current GDP of $3.8 trillion, comes out to about $184 billion. That’s $184 billion dollars we pay for: a system that does not cover everybody, the mark-up/profits of the entire healthcare system, without factoring the productivity losses from workers who are impaired by sickness and accidents. That’s $184 billion of waste and self-indulgence, where profits trump healthcare.

We have now entered a post-Affordable Care Act (passed in 2010) era, where the Republican Party believes they can finally repeal or reduce he ACA (which they have been trying to do since the day it was passed) – which provides subsidies for Americans meeting certain lower-income criteria – to opt into an ACA healthcare coverage exchange. The overwhelming number of Americans receiving subsidy support are employed. Well over 90% of the 24 million Americans on ACA receive subsidy support, and for those, the expiration of those subsidies unless renewed by Congress immediately, will double (or more) their monthly premium next year. It is the battle reflected in the recent government shutdown.

The Dems want a straight-up extension of those subsidies. The GOP plan kills the subsidies and pays the savings directly to the participants (with a few concessions to their base) so they can go into the private insurance market, with carriers able to sell across state lines, and shop for cheaper rates. Wonder where carriers will offer those cheaper rates? Really? Cheaper? I suspect they would only favor healthier consumers. Scotch tape and hastily drafted language. Neither bill will pass the Senate (and then go to the House) no matter how many times they vote on this choice, with Republicans hoping that explosion of rate increases less than a month away, will force Democrats to vote “the GOP bill is better than nothing.”

Meanwhile, our Department of Health & Human Services has purged medical experts with advanced degrees and decades of experience, replacing them with a clown car of antivaxxers and science skeptics, folks who have substituted empirical facts with conspiracy theories. Diseases that we thought were erased from our shores, like measles, are now roaring back. Even COVID cases are rising fast. A direct result of HHS policy changes.

And there is this little epidemic in China which will find its way to the US next year. “According to a report in [China’s] Daily Star, a countrywide outbreak of the H3N2 flu strain has debilitated many throughout the country of China, overwhelming hospital staff throughout China ‘from major cities like Beijing and Tianjin to provinces including Hebei, Henan, Guangdong, Fujian, Shandong, Shanxi and beyond.’… Social media posts have detailed countless patients helplessly waiting for attention as hospitals have become overrun with patients seeking medical attention.” Bloomberg, December 10th. And no, that’s not just another strain of COVID.

Further, in the tariff war, what the administration isn’t telling you is that manufacturing companies in developed countries (where universal healthcare is generally a rule) do not have to factor healthcare costs in their union agreements or anywhere in their employment or subcontracting engagements. The imputed number is always less than the US. Hence the same quality that our workers can manufacture is always going to be cheaper because of our wasteful “profits come first” system. Add to that the massive tax cut for the rich in that “Big Beautiful Bill” is resulting in massive cuts in Medicaid, Medicare, SNAP… and Social Security is in their headlights. That legislation represents the greatest transfer of wealth from middle- and lower-income Americans to the rich in our nation’s history. As the deficit soars!

I’m Peter Dekom, and there is, and for a long time has been, only one viable solution to America’s healthcare crisis: universal healthcare, perhaps linked with tuition-fee medical and nursing school education (with some required government service).