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Why is the USA the only major western economy that doesn't have universal health care?
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Why do so many quintessential middle Americans find the idea of a United States style NHS so objectionable?
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// Why is the USA the only major western economy that doesn't have universal health care? //
21:14 Tue 07th Feb 2012
Rich americans think that poor people are poor because it is their own fault. So they don't deserve health care. Not unless they can pay for it.
My cousin in California lost his job and soon developed a small cancerous area of skin on his face. Treating that cost him and his wife every penny of their savings.
I suppose rich americans would blame him for his company going out of business, for his not having made more money, for getting cancer.
Nice one.
My cousin in California lost his job and soon developed a small cancerous area of skin on his face. Treating that cost him and his wife every penny of their savings.
I suppose rich americans would blame him for his company going out of business, for his not having made more money, for getting cancer.
Nice one.
The question was kind of rhetorical – I've looked into this subject on numerous occasions but as you would expect, the debate is almost entirely carried out in America by Americans. I wanted to get a sample of views from this side of the pond - so thanks everyone for contributing.
My own views seem to concur with the majority on this thread – universal healthcare provided through taxation is considered too socialist for many Americans. It's not a view I share but as I don't live in America I can only pity the families whose lives have been effectively ruined by astronomical medical bills that they simply cannot afford. I think it's shameful that the world's largest economy does not provide universal health care.
After posting this question last night, it was rather ironic that as I was driving home from work earlier today, I heard on the radio the new single by Bruce Spingsteen which is called, “We Take Care Of Our Own”. At first I thought it was just a good-old American flag-waving delusional ditty... but it's not. It's quite the opposite in fact. I should have known better than to think that Springsteen would sing pro-American propaganda. I always think it's funny when I watch “Born In The USA” played to American audiences – they seem completely unaware of the underlying message.
My own views seem to concur with the majority on this thread – universal healthcare provided through taxation is considered too socialist for many Americans. It's not a view I share but as I don't live in America I can only pity the families whose lives have been effectively ruined by astronomical medical bills that they simply cannot afford. I think it's shameful that the world's largest economy does not provide universal health care.
After posting this question last night, it was rather ironic that as I was driving home from work earlier today, I heard on the radio the new single by Bruce Spingsteen which is called, “We Take Care Of Our Own”. At first I thought it was just a good-old American flag-waving delusional ditty... but it's not. It's quite the opposite in fact. I should have known better than to think that Springsteen would sing pro-American propaganda. I always think it's funny when I watch “Born In The USA” played to American audiences – they seem completely unaware of the underlying message.
Jake the peg
Those figures that you have produced,do not tell the whole story as Cuba has a well developed and successful state health service equal to that of the NHS and this may be reflected in the infant mortality rates being as low as the UK.
America has, as you rightly say poor infant mortality rates which have improved dramatically over the past 25years.
There is one big problem that America has and that is of uncontrolled immigration from South America into the Southern States of the U.S of A. Large numbers of pregnant women enter illegally, many pregnant and do not present themselves for ante-natal care and hence are poor obstetric risks from the outset.
I am not suggesting that this is the only reason for the poor figures but it is a major contributory factor.
Yes, as you say, the American's should be ashamed of this state of affairs just as i am ashamed of the treatment given to old folks in some of our NHS hospitals.
Those figures that you have produced,do not tell the whole story as Cuba has a well developed and successful state health service equal to that of the NHS and this may be reflected in the infant mortality rates being as low as the UK.
America has, as you rightly say poor infant mortality rates which have improved dramatically over the past 25years.
There is one big problem that America has and that is of uncontrolled immigration from South America into the Southern States of the U.S of A. Large numbers of pregnant women enter illegally, many pregnant and do not present themselves for ante-natal care and hence are poor obstetric risks from the outset.
I am not suggesting that this is the only reason for the poor figures but it is a major contributory factor.
Yes, as you say, the American's should be ashamed of this state of affairs just as i am ashamed of the treatment given to old folks in some of our NHS hospitals.
as should this, we think of America as the land of milk and honey, well many of my experiences in US were seeing people in abject poverty, which i found truly shocking,
http://www.dailymail....n-living-poverty.html
http://www.dailymail....n-living-poverty.html
In reality, our infant mortality rate is just the same as Cuba's (and many other countrys. Here's the problem (if anyone wants to get beyond USA bashing) according to the World Health Organization (WHO):
"Those who argue that the U.S. lags behind some other countries in infant mortality fail to take into account national differences in definitions of live birth. The U.S. complies with the World Health Organization standard, which requires registration of a live birth whenever an infant shows any sign of life outside the womb, regardless of birth weight, size or duration of gestation. Many countries restrict registration to cases in which these measures exceed certain limits, such as a birth weight of 500 to 1,000 grams, a crown-to-heel length of 25 to 35 centimeters, 22 to 28 weeks of gestation, or survival for a minimum amount of time. Since small and pre-term babies are more likely to die, standards that exclude these cases artificially decrease a country’s infant mortality rate, making its health-care system seem better than it really is. Yet U.S. infant mortality rates are competitive, despite a much more broad definition of live birth."
Contd.
"Those who argue that the U.S. lags behind some other countries in infant mortality fail to take into account national differences in definitions of live birth. The U.S. complies with the World Health Organization standard, which requires registration of a live birth whenever an infant shows any sign of life outside the womb, regardless of birth weight, size or duration of gestation. Many countries restrict registration to cases in which these measures exceed certain limits, such as a birth weight of 500 to 1,000 grams, a crown-to-heel length of 25 to 35 centimeters, 22 to 28 weeks of gestation, or survival for a minimum amount of time. Since small and pre-term babies are more likely to die, standards that exclude these cases artificially decrease a country’s infant mortality rate, making its health-care system seem better than it really is. Yet U.S. infant mortality rates are competitive, despite a much more broad definition of live birth."
Contd.
Contd.
"The United Kingdom defines a still birth as “a child which has issued forth from its mother after the twenty-forth week of pregnancy and which did not at any time after being completely expelled from its mother breathe or show any other signs of life.”
In Canada, Germany, Ireland and Austria, premature babies weighing under 500 grams are counted as still births. In Australia, those weighing under 400g are stillbirths. These babies have a mortality rate of 869 per 1,000.
France requires a medical certificate that confirms that a child was born “alive and viable.” This isn’t easy to obtain.
Many countries (with the exception of the United States) classify babies as “stillborn” if they survive less than 24 hours. The “stillborn” under that criteria make up 40% of all infant deaths.
In Hong Kong and Japan, children who die within 24 hours of birth are classified as “miscarriages.”
Genetics also play a role; the infant mortality rate for blacks in the United States is 2.4 higher than that of whites.
Switzerland doesn’t count the death of babies under 30 centimeters (11.8 inches) into their rate."
Other facts that get in the way... a Federally funded program called Medicaid but administered by individual States supplies doctor care, in patient and out patient care as well as prescription drugs and a zillion other health care services to any prson or famly recieving any other State assistance, such as
pregnant women, children under the age of 19, people 65 and over, people who are blind, people who are disabled and people who need nursing home care. additinally, anothe Fereally funded but State administered program is Medicare. It provides care for People 65 and over people of any age who have kidney failure or long term kidney disease and people who are permanently disabled and cannot work. Significantly, Medicare is a social insurance program that serves more than 44 million enrollees (as of 2008). The program costs about $432 billion, or 3.2% of GDP, in 2007. Medicaid is a social welfare (or social protection) program that serves about 40 million people (as of 2007) and costs about $330 billion, or 2.4% of GDP, in 2007. Together, Medicare and Medicaid represent 21% of the FY 2007 U.S. federal government.
Medicare insurance requires patient participation in the cost due to co-pays. But very inexpensive "bridge insurance" is available for those costs. Retirees at age 62 or 65 are enrolled automatically.
Social Security is a retirement program which, during the working life of the individual, the worker pays a certain amount into the program matched by the employer. Retirees are able to receive payments when they reach 62 or 65 or eralier if they become disabled.
Look, many here in the U.S. are unwilling to cede government control over any significant portions of ones life. We see what's happenng to our friends north of the border in Canada. A news reporter, David Gratzer has written a book called "Code Blue", in which he states this: If we measure a health-care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50 percent; the European rate is just 35 percent. Esophageal carcinoma: 12 percent in the United States, 6 percent in Europe. The survival rate for prostate cancer is 81.2 percent here, yet 61.7 percent in France and down to 44.3 percent in England—a striking variation."
He also details the decision making process for providing care in the Canadian system... and as always it's metered or rationed. No government administered system (single payer) can compete with the private system for efficiency and must... must ration care one way or another. Such rationing is handled by beureaucrats who have no other choice than to work within th elimits of the system. His book is well detailed and footnoted...
"The United Kingdom defines a still birth as “a child which has issued forth from its mother after the twenty-forth week of pregnancy and which did not at any time after being completely expelled from its mother breathe or show any other signs of life.”
In Canada, Germany, Ireland and Austria, premature babies weighing under 500 grams are counted as still births. In Australia, those weighing under 400g are stillbirths. These babies have a mortality rate of 869 per 1,000.
France requires a medical certificate that confirms that a child was born “alive and viable.” This isn’t easy to obtain.
Many countries (with the exception of the United States) classify babies as “stillborn” if they survive less than 24 hours. The “stillborn” under that criteria make up 40% of all infant deaths.
In Hong Kong and Japan, children who die within 24 hours of birth are classified as “miscarriages.”
Genetics also play a role; the infant mortality rate for blacks in the United States is 2.4 higher than that of whites.
Switzerland doesn’t count the death of babies under 30 centimeters (11.8 inches) into their rate."
Other facts that get in the way... a Federally funded program called Medicaid but administered by individual States supplies doctor care, in patient and out patient care as well as prescription drugs and a zillion other health care services to any prson or famly recieving any other State assistance, such as
pregnant women, children under the age of 19, people 65 and over, people who are blind, people who are disabled and people who need nursing home care. additinally, anothe Fereally funded but State administered program is Medicare. It provides care for People 65 and over people of any age who have kidney failure or long term kidney disease and people who are permanently disabled and cannot work. Significantly, Medicare is a social insurance program that serves more than 44 million enrollees (as of 2008). The program costs about $432 billion, or 3.2% of GDP, in 2007. Medicaid is a social welfare (or social protection) program that serves about 40 million people (as of 2007) and costs about $330 billion, or 2.4% of GDP, in 2007. Together, Medicare and Medicaid represent 21% of the FY 2007 U.S. federal government.
Medicare insurance requires patient participation in the cost due to co-pays. But very inexpensive "bridge insurance" is available for those costs. Retirees at age 62 or 65 are enrolled automatically.
Social Security is a retirement program which, during the working life of the individual, the worker pays a certain amount into the program matched by the employer. Retirees are able to receive payments when they reach 62 or 65 or eralier if they become disabled.
Look, many here in the U.S. are unwilling to cede government control over any significant portions of ones life. We see what's happenng to our friends north of the border in Canada. A news reporter, David Gratzer has written a book called "Code Blue", in which he states this: If we measure a health-care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50 percent; the European rate is just 35 percent. Esophageal carcinoma: 12 percent in the United States, 6 percent in Europe. The survival rate for prostate cancer is 81.2 percent here, yet 61.7 percent in France and down to 44.3 percent in England—a striking variation."
He also details the decision making process for providing care in the Canadian system... and as always it's metered or rationed. No government administered system (single payer) can compete with the private system for efficiency and must... must ration care one way or another. Such rationing is handled by beureaucrats who have no other choice than to work within th elimits of the system. His book is well detailed and footnoted...
@Clanad - “... Here's the problem (if anyone wants to get beyond USA bashing)...”
No one is bashing the USA per se. The criticism is about the system that is currently in place in the USA. This is not bashing the USA or its citizens. This is a political issue not a personal one.
Your post makes an interesting read. I'm not going to comment on the infant mortality issue as it wasn't a subject I was considering or addressing in my initial post.
The way you describe Medicaid and Medicare, anyone would think that they are amazing, all encompassing health-care providers. You meticulously list those members of society that are covered by these two schemes. However, you conveniently omit those who are not covered – which turns out to be the vast majority of the population of the USA if your descriptions are anything to go by:
Medicaid covers:
1) pregnant women;
2) children under the age of 19;
3) people 65 and over;
4) people who are disabled;
5) people who need nursing home care.
So anyone above the age of 19 and under 65 who are not disabled are not covered by this scheme. That's an awful lot of people – the vast majority, in fact.
Medicare covers:
1) people 65 and over;
2) people of any age who have kidney failure or long term kidney disease;
3) people who are permanently disabled and cannot work.
Once again, this leaves out the vast majority of tax paying Americans.
I don't claim to be an expert on the American health care system. The only glimpse of the costs of the USA's health care system I regularly receive is watching Judge Judy(!). It never ceases to amaze me just how expensive medical treatment is for the ordinary USA citizen. It's doesn't seem unusual for an emergency room visit to cost upwards of $1000 for a simple dislocated shoulder or damaged knee. That is outrageous. It also leads to the vastly expensive and cumbersome compensation culture that pervades the USA as injured parties attempt to recover the ludicrous costs incurred from hospitals from their alleged assailants.
The bottom line is that the American welfare system in its current form is monumentally unfair. It hammers the least well off and burdens them with debts that they cannot possibly absorb.
No one is bashing the USA per se. The criticism is about the system that is currently in place in the USA. This is not bashing the USA or its citizens. This is a political issue not a personal one.
Your post makes an interesting read. I'm not going to comment on the infant mortality issue as it wasn't a subject I was considering or addressing in my initial post.
The way you describe Medicaid and Medicare, anyone would think that they are amazing, all encompassing health-care providers. You meticulously list those members of society that are covered by these two schemes. However, you conveniently omit those who are not covered – which turns out to be the vast majority of the population of the USA if your descriptions are anything to go by:
Medicaid covers:
1) pregnant women;
2) children under the age of 19;
3) people 65 and over;
4) people who are disabled;
5) people who need nursing home care.
So anyone above the age of 19 and under 65 who are not disabled are not covered by this scheme. That's an awful lot of people – the vast majority, in fact.
Medicare covers:
1) people 65 and over;
2) people of any age who have kidney failure or long term kidney disease;
3) people who are permanently disabled and cannot work.
Once again, this leaves out the vast majority of tax paying Americans.
I don't claim to be an expert on the American health care system. The only glimpse of the costs of the USA's health care system I regularly receive is watching Judge Judy(!). It never ceases to amaze me just how expensive medical treatment is for the ordinary USA citizen. It's doesn't seem unusual for an emergency room visit to cost upwards of $1000 for a simple dislocated shoulder or damaged knee. That is outrageous. It also leads to the vastly expensive and cumbersome compensation culture that pervades the USA as injured parties attempt to recover the ludicrous costs incurred from hospitals from their alleged assailants.
The bottom line is that the American welfare system in its current form is monumentally unfair. It hammers the least well off and burdens them with debts that they cannot possibly absorb.
Some of what you mention may be true, bidie, but you don't address the major failing of any government sponsored, single payer system, that being the rationing of health care services. No "free" system can possibly provide care for any and every one on demand, hence the need for rationing. To the point that citizens of Canada, for example, often travel to the U.S. at their own cost to receive the life saving treatments that are unavailable in Canada for severl monthe if not years. And... all those decisions about ones life are made by the government. If that's the trade off, no thanks.
Fact is, doctors, medical clinics and hospital "write off" millions of dollars in debts each year here just to help those that cannot pay.
The other issue you do not address is that, at least with the financial crisis in Greece (so I read) a major part of the unsustainability of a semi-socialist type of government is the ever increasing cost of the health care system for union retirees. I read that even the NHS will or has reached an era of reducing costs by reducing service availability... Time will tell I suppose, but with our current system costing nearly 25% of our gross national product (GNP) (49% by 2082) such costs (plus other "socialistic" programs instituted by this President and adminstration) will bring us to the same level as Greece in the not too distant future. The results of that catastrophe will be no health care for anyone, much less everyone... and I fear you in the U.K. are closer than we to experiencing that...
Fact is, doctors, medical clinics and hospital "write off" millions of dollars in debts each year here just to help those that cannot pay.
The other issue you do not address is that, at least with the financial crisis in Greece (so I read) a major part of the unsustainability of a semi-socialist type of government is the ever increasing cost of the health care system for union retirees. I read that even the NHS will or has reached an era of reducing costs by reducing service availability... Time will tell I suppose, but with our current system costing nearly 25% of our gross national product (GNP) (49% by 2082) such costs (plus other "socialistic" programs instituted by this President and adminstration) will bring us to the same level as Greece in the not too distant future. The results of that catastrophe will be no health care for anyone, much less everyone... and I fear you in the U.K. are closer than we to experiencing that...
\\\\Fact is, doctors, medical clinics and hospital "write off" millions of dollars in debts each year here just to help those that cannot pay. \\\
\\\\The results of that catastrophe will be no health care for anyone, much less everyone... and I fear you in the U.K. are closer than we to experiencing that..\\\
Clanad.....two very true and telling paragraphs.............but the pro NHS, anti American Healthcare system, are not interested in those facts and never will be.
\\\\The results of that catastrophe will be no health care for anyone, much less everyone... and I fear you in the U.K. are closer than we to experiencing that..\\\
Clanad.....two very true and telling paragraphs.............but the pro NHS, anti American Healthcare system, are not interested in those facts and never will be.
Agreed Clanad that different ways of defining stillbirth , for example make comparisons difficult.
But taking something with a definite and irrefutable endpoint - death - the US government spends more per capita on health than anyone ...
http://en.wikipedia.o...of_healthcare_systems
..yet ranks 36th on life expectancy
http://en.wikipedia.o...of_healthcare_systems
suggesting that the US government is not getting good value for its dollar.
No system is perfect, but I have to say I would prefer to live in a country that was at the top of the healthcare rankings.
As for the NHS; not to worry - that nice Mr Cameron, under the guise of "reform" and "modernisation" is proposing the abolition of the NHS and its replacement by a system of competing businesses - "Any Qualified Provider"
As an aside - glad you are doing well Sqad. A surgeon knowing more than a cardiologist - strewth!
But taking something with a definite and irrefutable endpoint - death - the US government spends more per capita on health than anyone ...
http://en.wikipedia.o...of_healthcare_systems
..yet ranks 36th on life expectancy
http://en.wikipedia.o...of_healthcare_systems
suggesting that the US government is not getting good value for its dollar.
No system is perfect, but I have to say I would prefer to live in a country that was at the top of the healthcare rankings.
As for the NHS; not to worry - that nice Mr Cameron, under the guise of "reform" and "modernisation" is proposing the abolition of the NHS and its replacement by a system of competing businesses - "Any Qualified Provider"
As an aside - glad you are doing well Sqad. A surgeon knowing more than a cardiologist - strewth!
Oops - the second link should be..
http://en.wikipedia.o...es_by_life_expectancy
http://en.wikipedia.o...es_by_life_expectancy
slaney.........LOL
\\\No system is perfect, but I have to say I would prefer to live in a country that was at the top of the healthcare rankings. \\\
Look at survival rates for breast and other cancers....UK...well down in the league,so I would suggest that you come to mainland Europe for your treatment and management.
But you are correct ...no system is perfect and i just wish that the Brits wouldn't *** off the American system so easily and superficially.
\\\No system is perfect, but I have to say I would prefer to live in a country that was at the top of the healthcare rankings. \\\
Look at survival rates for breast and other cancers....UK...well down in the league,so I would suggest that you come to mainland Europe for your treatment and management.
But you are correct ...no system is perfect and i just wish that the Brits wouldn't *** off the American system so easily and superficially.
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