A Fairly Clear Explanation Of Why People Like Sen. Tom Coburn Can Claim that America Has the Best Health Care in the World, Despite the Body of Evidence Against That Claim (In Which I Refer to Rush Limbaugh With Approval)


Opponents of health care reform claim that America has “the best health care in the world,” arguing that changing the present system threatens our nation’s primacy. This argument is so unfounded, so completely contradicted by reality as to raise my frustration and blood pressure to levels I hadn’t experienced since Alberto Gonzales last testified before Congress. I’ve finally come to some understanding about the basis for the “best health care” claim, and, as much as I hate to admit it, I have to credit Rush Limbaugh for helping me figure it out.

Rush,or course, experienced American health care first hand after going to a hospital emergency room with chest pains during a recent visit to Hawaii. During his hospital stay, which included an angioplasty that found nothing seriously wrong, Rush said he experienced the “best health care the world has to offer.” But he made a point of letting his audience know that he paid for it himself, and that he doesn’t have health insurance. According to Rush, his bill was “less than the cheapest car that you will go out and buy today,” and that using health insurance would have resulted in Rush paying an additional 30%. Because he paid cash, “there was not one bureaucrat determining whether or not [he] was gonna get treatment. There wasn’t a death panel here.”

(It’s not clear what Rush, who owns a number of cars, thinks is “cheap”. One hopes he wasn’t thinking about his Maybach 57S, which retails at about $450,000.)

You see Rush’s point. Medical care provided in an American hospital: “the best”; health insurance: expensive, bureaucratic, not so good. And his 30% figure is a good estimate of the additional amount he might have paid an insurance company for the same medical services, though the real number for Rush (who would likely pay the individual rate, as opposed to those in a group plan), might have been as high as 40%. In other words, had he used health insurance, only 60 to 70 cents of every dollar Rush paid would be used to actually pay for health services.

Rush, of course, isn’t concerned with fixing health insurance. In fact, he’s against doing anything with a system that works so well for him. But his basis for deciding we have the best health care system in the world is clear. There are good doctors and good hospitals in this country, available to those who have access. This is what all those politicians, Senators John Barrasso, Richard Shelby, Tom Coburn, Congressman John Boehner and the rest, mean when they talk about the quality of health care in America. It’s fine, great, the best, as long as you can pay for it. But don’t mess with it, because you might screw that up. It’s the reason Tom Coburn thinks it’s relevant that Canadian Danny Williams, the Newfoundland and Labrador premier, came to the United States for his heart surgery. It’s more proof that America provides some of the very best health care that (lots of) money can buy.

In retrospect, I suppose I shouldn’t have been surprised that this point of view is held by so many opponents of changes to the present system. I was blinded though, by my assumptions about Senators and Members of the House. They’re public servants, after all, and I assumed they’d judge the quality of American health care the way most other people and organizations — the World Health Organization, the United Nations, the Center for Disease Control, me, and probably you — would judge it; by comparing the health of those who live in America to the health of people living in other countries. By that standard, our health care system is poor, at least when compared to other developed nations.

The proof is unassailable. According the CIA World Fact Book, America falls behind 47 countries in life expectancy of it’s citizens, and behind 44 countries, including essentially all countries in the developed world, in infant mortality. According to a 2008 report funded by the Commonwealth Group, America was 14th of 14 nations surveyed in the percentage of deaths that could have been avoided with proper health care for people under the age of 75. A 2009 report by the Organization for Economic Cooperation and Development found that our primary care also falls short; the US has the highest number of hospital admissions for asthma and diabetes. Physicians in other countries manage chronic diseases so that they don’t become critical medical problems requiring expensive hospitalization. The OECD also point out in the same report that only the United States, Turkey and Mexico fail to provide universal or near universal care. Other OECD nations achieve better health care results for all citizens, allocating an average of about 9% of their GDP to health; in contrast, the United States gets substandard results for about 16% of GDP.

But there’s good news. Now that it’s clear what reform opponents mean when they talk about the “best” health care, we just need to explain what the rest of us think is important, and what we want them to do. So contact your representatives in Congress and explain that:

We agree that American medicine is fine. But we want everyone in the country to have access to it. Judge the quality of America health care by the health of Americans.

As to our children: some of you think they should have legal protection from the moment of conception on. Surely, we can all agree that our children’s health should be protected after they’re born, and that fewer should die in the first year of life.

Oh, and one more thing — cost. The rest of the world gets quality universal health care and pays a lot less than we do. Can’t America do as well?

Opponents to changing the economics of health care in American proudly proclaim their belief that America’s medical services are the best in the world. Tell Congress that we want them to do the work necessary to ensure that American citizens get the benefit of all that quality car, so we all have the chance to be as healthy as the citizens of the rest of the developed world. To fail to do this, to not even try seems, well, unpatriotic.

4 thoughts on “A Fairly Clear Explanation Of Why People Like Sen. Tom Coburn Can Claim that America Has the Best Health Care in the World, Despite the Body of Evidence Against That Claim (In Which I Refer to Rush Limbaugh With Approval)

  1. Gretchen

    “Health care system reform” is absolutely correct, but too many words to fit on a bumper sticker. And yes, it’s the for-profit insurance aspect of our system that is the major problem, but should we ever get beyond that, we would then bump into two other serious problems: doctors are paid by procedure, and in some cases get a cut of fees for tests; and, one doctor has no idea what other doctors are giving to or doing with the same patient. The Mayo clinic’s system of salaried doctors working in teams with nurses and physicians’ assistants, all having access to the same medical information, makes much, much, much more sense. I would guess that when they know they are working as a team in a system with regular built in reviews of patient care, they would be less likely to order lots of tests for the sole purpose of fending off a possible legal suit.

    Reply
  2. fatuglystupid

    Everybody is the U.S. already has access to the health care system. All anyone has to do is pay for their care or purchase a policy that pays for their care. You just want me (all tax payers) to pay for those people who won’t do for themselves or their family that I do for mine. Health care is not a right. It costs me $1000 / month for health care for myself, my wife and our son. I am all for providing health care to people who truly cannot provide for themselves such as, children, elderly and the truly helpless. I just don’t want to be FORCED to pay for people who are capable of providing for themselves and are either too lazy or aren’t willing to sacrifice in other areas of their life to obtain their own health care. I think you will find that most decent people are willing to help people who cannot help themselves. But the history of socialized entitlement programs proves that it mainly benefits those people who are unwilling to help themselves but are perfectly capable of helping themselves. History also proves that that the U.S government is incapable of running anything in a cost efficient manner. There are ways to lower the cost of obtaining health care insurance (allowing nationwide competition) and lowering the actual costs of health care (tort reform). But a government run health care system or even a system with government control will be a disaster, in my opinion.

    Reply
    1. Tom Joaquin Post author

      @fatuglystupid: Just a couple of points:

      We do have a system of government run health care. It’s called Medicare, and most people who have it are pretty happy with it. You can call it a “socialized” system if you want. It’s semantics. We could say we have socialized highways, military, national park system, etc., but when it comes to running certain things, the government can do a pretty good job — highways, defense and national parks are good examples of programs run well. Everyone complains about the post office, but I can put a stamp on a letter for the cost of pocket change, and have it get anywhere in the country in a day or two. Try asking fedex to do that.

      I know health care is expensive, believe me. The big problem is that we don’t have a free market in health insurance. The health insurance industry has had a statutory exemption from antitrust laws since just after World War II. The AMA recently published Competition in Health Insurance: A Comprehensive Study of U.S. Markets, that determined there has been a “near total collapse” of competition in the market.

      Want proof? In September of 2009 the Kaiser Family Foundation reported that the cost of health insurance increased by over 131%, while the general rate of inflation rose by 28%. That’s why we’re paying a larger and larger portion of our salaries to health insurance. And there’s no reason to think it won’t continue. Anthem, the largest health insurance company in California, recently proposed increasing its rates by 39% People who can’t afford it will just have to go without health insurance. Anthem has the market pretty sewn up in California. Increasing competition is a capital intensive business, and entry isn’t easy. A public option could provide competition, but it doesn’t look like that’s a possibility.

      I’d say that no matter how inefficient you think the government is, there certainly wouldn’t be ten year 131% increase in cost. Every government in the developed world provides universal health insurance. There are lots of different ways they do it: single payer, regulated non-profit private companies, and state provide health care. There are lots of arguments about how to do it. But the bottom line is that health care costs a lot less in those countries.

      I’m not going to defend the idea that maybe health care should be a right. Instead, let me just point out a couple of things. There are lots of people who lose their insurance not out of laziness, but because they loose their jobs, or because they can no longer afford insurance, or the insurance company has decided to cut them off. “They” could be you or me, or someone close to us. Obama says that 14,000 people lose their health insurance every day. That’s an exaggeration. About 14,000 a month is generally accepted as a reasonable estimate. Of course, over the last couple of years, unemployment has gone way up, and people lose their health insurance as a result. Using National Bureau of Economic Research statistics, around 7,000 people a day are losing their health insurance in the present economy. Most of them will get it back when they get a new job, but they’d better hope there are no children with broken legs, and that no one needs to go to the hospital. Or gets pregnant — pregnancy is a pre-existing condition, and insurance companies won’t pay if you get insurance after conception.

      One last point about paying for other people, the people you say are lazy or aren’t willing to sacrifice” to get health insurance. I’m not going to argue with your description, and I don’t need make any ideological arguments about human rights Let me just point out that most people and most children without health insurance do get health care. But, without health insurance, they aren’t likely to bring a child with minor health problem to a doctor. If the child gets sick enough, he or she ends up at the emergency room, getting the most expensive care money can buy for a problem that’s now much worse. The cost of that care ends up being absorbed by the hospital, and the money gets paid by increased hospital rates, ultimately paid in higher insurance rates for you and me. It’d be a whole lot cheaper to let them go to a doctor rather than a hospital, and we’d both have more money in our pockets.

      There are lot of issues that people with different ideologies can disagree about. I don’t think this is one of them. It’s pretty clear that you and I and the rest of the country would benefit financially from instituting the two things that every other country has: universal coverage and some sort of price control. People in those countries get better care cheaper.

      Reply
  3. Kendra

    I am curious about why this debate has been framed around “health care” when it’s mostly about “health insurance”. Calling the issue “care” certainly allows us to look at how our system of funding health care affects our access to care and our health, which is good. But it does open this question to answers like Limbaugh’s, the quality of *care* is fine, it’s our access, our knowledge and our relationships with providers that needs to change.
    Maybe we need to talk about health care system reform.

    Reply

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