Good Things, Bad Things: Health

This post is part of the "Good Things, Bad Things" series.

Before we got here I thought that the Israeli healthcare system is not a good healthcare system. My mother had just died a month before we moved here, and I was angry with the way her treatment had been administered. It seemed to me that the healthcare system in Israel was too slow on one hand, yet too expensive on the other hand. This may still be true, but I have no doubt in my mind that when it comes to healthcare, the Israeli way is far better than the American way.

I use a report by the World Health Organization (WHO) to compare healthcare systems in the world. According to this report, though the Health Adjusted Life Expectancy (HALE) is high in the US (about 70+ years), it is not significantly higher than other countries, or perhaps even less than some. On the other hand the Total Health Expenditure in the US is one of the highest in the world, with Sweden and Germany (See figure 1.6 in that report). In fact the expenditure for healthcare in the US is so high, at about 15% of the GDP, that it is described as "singular" by the WHO (see page 106), compared even with other "high-income" (or developed) countries, which spend less than 10% of their GDP on healthcare. It is also singular in the fact that only 6.9% of the GDP is invested by the government, whereas the rest of the expenditures (almost 9% of GDP) comes from the private market. Although 6.9% of GDP government intervention is by no means low, the fact that so much more money is invested by the private sector contributes to high inequalities in the American healthcare system. This was not overlooked by the WHO: when it comes to universal coverage, the WHO has a lot to say about the inequalities in the American healthcare system, citing a decline of up to 5 years in the life expectancy of women in more than a thousand counties in the nation, where hazardous material are being disposed of (page 56), and the lack of care for uninsured elderly people (page 57).

In overall, it is thus not surprising that the United States of America is ranked number 37 in the world according to a WHO report that assesses the healthcare systems of countries in the world. What may be more surprising is that among the countries that have a better healthcare system than the USA we can find not-so-developed countries, such as Oman, Colombia, the United Arab Emirates, Dominican Republic, Costa Rica, Morocco, or even Israel (ranked 28). On the other hand, the United Kingdom is ranked number 18, with an expenditure which is only about 6% of its GDP, compare to the 15% in the USA. The highest ranking country is France. Obviously money isn't everything, contrary to common American belief. So, what is important in achieving a capable healthcare system?

The first thing that I can think of is mentioned in the WHO report: universal care. In American lingo this translates to Socialism, however, this is not what the WHO says. One should understand that to be healthy, it is not enough just to pay your ever-growing health insurance policy. It is also important that your neighbor, who may not be as lucky in securing a good healthcare plan as you are, is healthy. For some odd reasons, bacteria and viruses tend to ignore the sum of money you have in the bank, or the type of insurance card you have from your healthcare provider. If your neighbor becomes sick, chances are that you will fall ill as well. Especially if this neighbor is unable to pay for a visit to the doctor, or for the pills prescribed to him. And with 16.6% of Americans uninsured (as of 2007, I believe this percentage will be much higher, as unemployment has risen from about 4% or 5% at that time to about 9.5% today), that means that one of every 6 households are not insured. So, if you live at a house and you have neighbors on all your sides, at least one house around you is uninsured, won't go to the doctor, and there is a high chance you will contract his flu. A proof of that can be seen by the number of H1N1 (swine flu) victims in the USA, which is the highest in the world, 436 confirmed deaths, and it's not even fall or winter here. Yet.

However, it is not enough to make insurance accessible to the lower classes of the population. President Obama suggested a reform that will add a government option for Americans in addition to the private plans. I can't see how this is much different than the existing Medicaid program, but that is only me - I am not a recondite of the American healthcare system. It seems to me that a government run plan as an option is too little too late. Naturally asking for more from the American people, who genuinely believes that it has the best healthcare system in the world, is too much so the president has to settle for this little. Yet, even this is too much for the Americans, and the republican party fights it in every way it can, including scare and slur tactics.

In addition to that, there is a growing anxiety here about president Obama's alleged plans to "socialize" the country. Stemming from the stimulus plans (the first one, which bailed out the banks was actually passed in the term of the Bush administration, but don't confuse the GOP with facts), there were growing concerns about the growing intervention of the administration in the economy and now with the healthcare reform - in the healthcare system. As I wrote in the previous paragraph, I think that the healthcare reform is not enough, but even if President Obama's plans were to socialize the healthcare system completely (as per the GOP's scare tactics), what evil could come from this "socialization"? The worst that can happen, with these kind of expenditures spent on health as they are now, is that the American system will be similar to, and probably exceed, the ones in Germany (ranked 25 in the world), Sweden (23), Norway (11) or France (1). What's wrong with that?