The approval rating of the US Congress hovers persistently between 5 and 15 %. It has been stuck there for as long as most anyone can remember. Yet the voters keep returning many of the same scoundrels to office term after term.
The new term begins on January 3rd, 2017. After falling just a few votes short after the narrow victory of George W. Bush's second term in the 2004, Republican attempts to privatize Social Security were thwarted by Democrats. Now that the blocking pattern provided by the two terms of Barack Obama has ended and Republicans have seized control of two branches of government with a third in reach, their best hope for overturning parts of the safety net is greatest since the passage of the New Deal in the 1930s.
Understanding The Current State Of US Healthcare
About 2/3 of US health spending is paid for by the government through Medicare, Medicaid, Children's Health Insurance Program, the VA and the Affordable Care Act. The remainder is paid for by employers, unions, other groups, and individuals.
Medicare has been one of the most successful health insurance programs, yet it's the most detested by Republican leaders. They have made many attempts to drill holes in Medicare since its inception in 1965. The most successful of these being the private Medicare Advantage plans, a Republican gift to the healthcare insurance market. These plans cost substantially more to administer than the pure government-administered medicare plan.
One of the other successful giant Republican straws into the US Treasury was created by Bush The Younger in the form of the Medicare part D prescription drug plan. The key poison pill here was that Medicare was not allowed to negotiate drug prices like the government-run VA system. The end result is that drug prices and drug advertising has soared mainly for Americans. Other countries are more likely to have the citizens in mind, whereas the US congress favors their political donors for campaign funds and end of career payouts, an ingenious form of bribery.
All this trickery and congressional slight-of-hand is an example that has caused the US to have the most expensive healthcare in the world. The United States spent more on health care per capita ($8,608) or as a percentage of GDP (17.2%) than any other nation in 2011. No one is really even close with Norway and Switzerland a distant 2nd and 3rd at a bit over $5,600. Imagine what good could be accomplished if that $3,000 extra per person was spent at our colleges and universities for health research and development.
But, Republicans would argue, we have the best healthcare in the world. Sorry! That's a nope and not even close to being accurate. While that may have been true after World War II, the US has continued to slide as the rest of the world rebuilt and expanded Roosevelt's New Deal vision for themselves. The best examples of this are of course Germany and Japan whose healthcare results now exceeds the US. However, the greatest success is in the smaller Nordic countries. While we spent our money on bombs, bullets, and shock and awe they spent theirs on the health, welfare and education of their citizenry.
While we hear stories of the wealthy traveling to the US for care or we hear of Canadians lined up at the border to get care in the US, these are just more false implantations intended to deceive, like "cigarettes are not addictive or cause cancer", "too much sugar doesn't cause obesity", or the "earth isn't warming".
In recent comparison with the other 221 nations, the US only ranks 50th in life expectancy. Pick almost any other category and the US also ranks poorly. A 2014 survey of the healthcare systems of 11 developed countries found the US healthcare system to be the most expensive and the worst-performing in terms of health access, efficiency, and equity.
Where The US Healthcare Excels
American healthcare is decent in providing healthcare to the wealthy. Note that I said decent and not excellent like you would think. We are not highly-rated even for the wealthy. However, the American healthcare system is excellent at delivering giant profits to insurance CEOs, specialty doctors, and especially drug companies. For the average citizen? Not so much.
We can do much better. It is not even hard to fix. The problem is that our Congress and Presidents just don't want to fix it. They want us to have a complicated, loop-holed, corrupt system so some can become wealthy at the expense of others.
In an attempt to solve the uninsured problem Obama proposed, and the Democratic Congress adopted, The Affordable Care Act in 2010. No Republican voted for it even though it was originally a Republican-concocted plan. While it does accomplish some good things, it mostly adds more confusion and waste to the already burdened healthcare mess.
One such ACA expensive plan I am personally familiar with costs nearly $10,000 a year. It provides about $500 worth of overpriced preventive services and nothing else until $7500 out of pocket expenses have been paid by the insured. For the healthy it is not much help, but for the already or soon to be very sick or those with preexisting conditions it is a godsend. This simply is not a prescription for efficiency.
Can the American healthcare system do better? It already does. The Veterans Administration medical system is the least expensive and most beloved health delivery system in the US. And the ones who love the VA are mostly a bunch of old cranky white men who are mostly Trump voters. Not bad for socialism, eh? (eh is Canadian for "are you listening?") Many veterans will be truly burdened if Republicans push through privatization and dissolution of the VA healthcare.
How Did We Get In Such A Mess?
Republicans couldn't stop the New Deal in the 1930s and the FDR programs and other similar government programs have been very popular with the public since then. One FDR failure was in healthcare. Some of this was rectified by LBJ by the creation of Medicare as a government single payer system for the elderly. It was envisioned as an eventual single-payer system for the entire population.
To combat these successful government programs, Republicans created a brilliant insurgency strategy that has been methodically implemented at every opportunity. This strategy can best be summed up in one word, privatization. Republican prescription for wealth: If it is government, De-fund it, Break it, Declare it broken, Privatize it, then Plunder it.
This privatization effort has been enabled by a propaganda war that convinced many voters that private business could provide better services cheaper, a result most often not achieved in practice. When in power, Republicans have implemented this breakage strategy. Convince the public that government is bad and private is better, and then divert attention from the end results with divisive social arguments like abortion, gay rights or gun control.
One Giant Scheme To Make Some Healthcare Providers Wealthy
With the money currently being spent in the US on healthcare, it is easy to see that the US could have the "greatest according to Trump" healthcare system in the world if it converted to a government-provided and single-payer system like nearly the rest of the world. There is no reason to believe our health outcome would be dissimilar to other nations.
This Republican break and privatize strategy is about to hit full stride with the Trump administration and the 115th Congress. Either buckle up buckaroos and ride the healthcare bronc down or join the opposition.
About the Author
Robert Jennings is co-publisher of InnerSelf.com with his wife Marie T Russell. InnerSelf is dedicated to sharing information that allows people to make educated and insightful choices in their personal life, for the good of the commons, and for the well-being of the planet. InnerSelf Magazine is in its 30+year of publication in either print (1984-1995) or online as InnerSelf.com. Please support our work.
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