Helath Care In America

I am posting a copy of a paper my freind Virgil Caine Wrote on the Healthcare system in America. I like it I hope you will to.


The American healthcare system has received criticism from liberals and conservatives for years. Many remain ignorant of the actual workings of the current healthcare system. It has become commonplace to chide the United States’ lack of universal healthcare as a rich industrialized nation while considerably less wealthier countries supposedly fare better. “We pay more and get less” seems to be the recurring complaint. True, Americans pay the most for healthcare at 16% of the GDP (Tanner 8), but where do these other countries get their medical technology, supplies, and expertise from? Do they enjoy the same choices and quality in healthcare that Americans do? Universal healthcare, or as some refer to it pejoratively in the United States, socialized medicine, is dismissed by many as being as “un-American” as the Taliban and endorsed by others as being as basic a right as freedom of speech. Both seem to be relatively simpleminded analysis of the item at hand, it is a nearly universal desire that all receive the healthcare they need, but universal healthcare often compromises the entire healthcare system and brings on a whole slew of new problems.

In analyzing the American healthcare system, it is important to establish a few basic facts. Our economy does not fully follow the free market model and we are in fact a mixed economy with some socialist elements. There are services that are fully socialized such as law enforcement and there are government corporations such as the Postal Service. Recently, banks have been nationalized. We do not have a purely free market economy. When talking of socialism, it is important to talk in degrees, because the term “socialism” is commonly used to rouse negative feelings in the United States and to some is synonymous with evil. When we speak of “universal healthcare” by definition this is a system where the whole of the population receives healthcare. Most often this means that elements of socialism are implemented (it is nearly always necessary). The term “universal healthcare” is often used interchangeably with “national healthcare,” which has a very similar meaning. True national healthcare, unlike universal healthcare, is always completely government owned or “nationalized.” Conservative critics refer to either of these pejoratively as “socialized medicine.” For the sake of simplification and not going overly into specifics, these terms will all carry the same meaning. There are elements of socialism in the American healthcare system through subsidies to employer-based health insurance that covers 60 percent of the national health bill (America’s Headache 2). Relative to the rest of the world though, the United States stands out as having a system with relatively low government regulation and comparatively low levels of direct funding to healthcare.

Healthcare in the United States is undoubtedly in need of reform with “82 percent of Americans believe[ing] that our system either requires fundamental change or needs to be completely rebuilt” according to a survey by the Commonwealth Fund (Tanner 35). To be fair, there is certainly not a country that is completely satisfied with their healthcare and only a moderate number where the majority is. Much of the call for reform stems from the recurring complaint that we as Americans spend more and receive less. One cannot deny the high costs of healthcare in the United States, or rather the high amounts spent. The United States places first worldwide for “total expenditures on health care as a percentage of GDP” at close to 17 percent (Tanner 2). However, is the United States not also the biggest spender on a number of other items that are typical of a rich country? Economists have classified healthcare as a “normal good”, which is to say that the amount spent on the good rises as income rises (Tanner 2). Americans spend liberally on healthcare, as they tend to spend on most other goods and services. However, can one deny the quality of American healthcare (sans any financial considerations)? Italy and Canada are two countries that have been praised by some for their advanced national healthcare systems that are supposedly far superior to the US’s. That did not seem to be the case when Italian Prime Minister Silvio Berlusconi checked into a Cleveland, Ohio clinic for heart surgery (Tanner 5). Nor did it seem the case when Canadian politician Belinda Stronach had her breast cancer treated in California (Tanner 5). These two politicians, who come from countries with “advanced national healthcare,” left their own country to receive healthcare (where they had to pay for it) because the United States offers better treatments than their respective countries.

Modern medicine is hugely indebted to American advancements. “Eighteen of the last 25 winners of the Nobel Prize in Medicine are either U.S. citizens or individuals working here. U.S. companies have developed half of all new major medicines introduced worldwide in the last 20 years. In fact, Americans played a key role in 80 percent of the most important medical advances of the past 30 years,” (Tanner 5). The rest of the world has benefited from the advancements in the United States, which effectively lower costs in their countries (America’s Headache 2). “In many ways, the rest of the world piggybacks on the US system,” (Tanner 5). There is no questioning the superiority of the American medical field. These advancements have been fostered by the American healthcare system’s loosely government regulated attitude towards the field, lacking the financial and legal barriers of other countries (Tanner 5). These advancements would not have occurred had research been hampered legal and financial barriers prevalent in other countries where healthcare is nationalized.

Despite the self-evident strengths of the American healthcare system, there are obviously problems within the system and criticisms are not without merit. Besides the high cost of healthcare, there is “the army of the uninsured” which numbers 46 million (America’s Headache 2). This figure is often cited, but the fact that any of these 46 million if they entered a hospital would receive treatment is often neglected (America’s Headache 2). The calls for reform range from the Libertarian slant of ending all government involvement, to nationalizing healthcare as proposed by Democrats in recent years. It is important to note that Obama does not support nationalizing healthcare. Liberal critics often cite the wonders of European nationalized healthcare. Liberal commentator and filmmaker Michael Moore as well as renowned columnist Paul Krugman have pointed specifically to France. France has been ranked by the WHO as having the best healthcare in the world (Tanner 4). Some conservatives unfairly draw parallels between universal healthcare and the policies of the USSR. This is an unfair way of proving a point, but the liberal Western democracies of France, Canada, and Great Britain do put into perspective the push for nationalized American healthcare.

The French have long been touted as being “the best showcase for what universal health care can achieve,” (Tanner 7). The French have the third most expensive healthcare in the world behind the US and Switzerland at 11 percent of the country’s GDP as well spending the third most on private insurance out of pocket which is not to be expected in a country where “universal coverage” is provided (Tanner 8). French spending on healthcare would suggest that the country possesses plenty of medical technology, however, “the United States has eight times as many MRI units per million people and four times as many CT scanners as France,” (Tanner 10). This leads to the obvious outcome of patients being put on long waiting lists because equipment is not available which becomes de facto rationing of care. Despite all of this, France is at the top of the WHO’s healthcare rankings survey (Tanner 4). They did not get there by retarding free market forces though, as many would believe. They tend to fill gaps in coverage through “relatively unregulated insurance markets” which is in effect moving toward the “evils of capitalism” that nationalized healthcare supposedly eradicates (Tanner 12). The French do have a first tier healthcare system, but they do well through market like practices as opposed to the stereotypically fully nationalized system that many believe they possess.

The British were the vanguard in implementing a nationalized healthcare system. The process began after WWII when the government thought it was necessary to introduce a safety net with the creation of the NHS to protect against the hardships the country had faced prior to the war (Stevens 32). While France seems to be the role model for universal healthcare (which is not exactly universal or nationalized), Great Britain seems to be the system is an example of what not to do. The British have had numerous issues with their healthcare system. The British face all the issues that have been associated with universal healthcare including rationing of care and prolonged waits for care (Tanner 24). There are 750,000 British citizens currently on waiting lists to NHS hospitals and more than half of them will wait longer than 18 weeks before receiving treatment (Tanner 24). “Patients judged too ill or aged for the procedures to be cost effective may be denied treatment altogether,” (Tanner 24). The horrors of universal healthcare are very real for Britons. The British fare worse than other countries with universal healthcare because they have one of the most centralized government regulated systems.

Canada is also mentioned as among the advanced nations possessing a superior healthcare system to our own, though upon closer inspection, this claim can hardly be taken seriously. Long waits for treatment are a recurring problem in countries with national healthcare, and Canada’s are among the worst where even the Canadian Supreme Court Chief Justice Beverly McLachlin has admitted that “patients die while on the waiting list” (Tanner 32). Many proponents of universal healthcare counter this with the claim that citizens in these countries receive better preventive care than in the United States, which is not true in Canada (Tanner 33). Canada’s healthcare service does not seem to be a good model of universal healthcare for the United States or any other country.

The countries of France, the United Kingdom, and Canada are among the most comparable countries to the United States, but they are not without their differences. All of these countries have significantly smaller populations than the United States, which makes an effective bureaucracy that is inherent in universal healthcare more easily implemented. They also have very different national characters than the United States. This is especially evident in France where “by a three-to-one margin, the French believe the quality of care they receive is less important than everyone having equal access to that care” which could not be said about Americans (Tanner 11).

Americans will continue to disagree over how healthcare should be reformed. The healthcare system will ultimately rise to the demands placed upon it. However it is imperative that we do not place utopian demands on the healthcare system and that we continue to practice “rugged individualism” to avoid problems faced by those who do not.

Works Cited

"America's Headache." The Economist 28 Jan. 2006: 12. 18 Oct. 2008. EBSCO. Galileo. Russell, Milledgeville. 18 Oct. 2008. Keyword: Universal healthcare.

Stevens, Phillip. "Fully Socialized Medicine: A Warning from the United Kingdom." Fraser Forum (2007): 31-32. 18 Oct. 2008. Galileo. Russell, Milledgeville. 18 Oct. 2008. Keyword: Universal healthcare.

Tanner, Michael. "The Grass Is Not Always Greener." Cato Institute. 18 Mar. 2008. Cato. 18 Oct. 2008 <http://www.cato.org/>.