If I found myself in a conversation with a citizen from a country where healthcare is socialized, I would be more than likely to speak with candor by expressing my disapproval for the nature of America's healthcare industry. As the same time, I would connect this to the more general nature of America's economy, political culture and socioeconomic hierarchy. The healthcare industry's monetarily-based exclusivity is consistent with most other aspects of public life in America such as the distribution public services, access to education and infrastructural maintenance. The way that Americans experience all of these things is highly subject to socioeconomic status. That said, I would explain quite simply that this constitutes one of the single greatest flaws in American public governance.
Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports (CR) (2008), which finds that "health-insurance premiums have grown faster than inflation or workers' earnings over the past decade, in parallel with the equally rapid rise in overall health costs. Industry spending on administrative and marketing costs, plus profits, consumes 12% of private-insurance premiums." (CR, 1) This reiterates a case stated with reference to question 1 as well, which is that the undue imposition of costs by the healthcare industry -- a reflection of a free-market industry with little to no regulatory oversight -- has negatively impacted the accessibility and quality of healthcare for many of the poorest users.
As with many private industries operating within the United States, the healthcare industry promotes a system within which wealthy corporate enterprises constitute a significant fraction of the U.S. economy. This is a deceptive claim though. The healthcare industry contrasts many other such industries by imposing significantly higher costs upon system users than even the substantial profit generated for an affluent few. Moreover, we can see that the industry is failing even to serve the interests of its own continuity. In spite of the high cost imposed upon users simply to gain coverage and access to reasonable-priced treatment, there remain few formal ways of measuring the quality or effectiveness of the system at meeting its responsibilities. According to Hussey et al. (2009), "efficiency measures have been subjected to few rigorous evaluations of reliability and validity, and methods of accounting for quality of care in efficiency measurement are not well developed at this time." (Hussey et al., 784)
This points to another dimension of our healthcare system that, I would impart to my new friend, demonstrates that the industry is not designed to favor the interests of the end user. A lack of accountability seems to mark the industry, with many hospital facilities, pharmaceutical companies and, particularly, health insurance companies being given relative carte blanche with respect to the cost and access experienced by the American public. And with insurance premiums reflecting one of the most staggering costs for so many users, the failure of the government to intervene with pricing suggests that its interest aligns with that of private industries first and foremost. Accordingly, the chief priority of the healthcare system across all of its fronts appears to be the ability of the end-user to pay into the system at a substantial rate. Those lacking this ability are, in light of the free-market nature of the U.S. economic, left out of the system. To this point, we consider the article by Gawande (2009) which reports that "in a 2003 study, another Dartmouth team, led by the internist Elliott Fisher, examined the treatment received by a million elderly Americans diagnosed with colon or rectal cancer, a hip fracture, or a heart attack. They found that patients in higher-spending regions received sixty per cent more care than elsewhere. They got more frequent tests and procedures, more visits with specialists, and more frequent admission to hospitals." (Gawande, p. 5)
This, I would explain in the present conversation, is a demonstration of the way that a largely privatized healthcare industry functions. The shift of emphasis to profitability makes it largely impossible to pursue operations under strictly or even marginally humanitarian pretenses. These are not realistic within the context of America's 'pay-to-play' system. Unfortunately, I would be inclined to point out, this has produced neither a system which ensures a high quality of care nor one which has achieved a high level of functional operational efficiency. To this point, labor concerns continue to plague the industry, with nursing shortages and low worker morale diminishing the quality of experience for healthcare professionals and the quality of care for patients. The offshoot of this is a level of turnover which itself impedes upon the ability of the healthcare system on the whole to provide healthcare as an 'inalienable right.' So reports the article by Waldman et al. (2010), which tells that "turnover includes hiring, training, and productivity loss costs. Minimum cost of turnover represented a loss of >5% of the total annual operating budget." (Waldman et al., 206) This cost suggests that the poor regulatory oversight of our healthcare industry is not just impeding on the access of the patient to the system but is also impeding the ability of the system to reach more patients.
This denotes an industry actively participating in the destruction of its own consumers' buying power and its own sustainability. Though the recent legislative efforts of the Obama Administration demonstrate a growing interest on the part of the government to mover closer to socialized healthcare, the strength of the bill was significantly impeded upon by the effort and influence of the various vested private industries. This denotes the uphill climb for the healthcare industry in an economic culture where profitability trumps all.
Consumer Reports (CR). (2008). High Health Care Costs. Consumer Reports Health.org.
Gawande, A. (2009). The Cost Conundrum. The New Yorker.
Hussey, P.S.; Vries, H.D.; Romley, J.; Wang, M.C.; Chen, S.S.; Shekelle, P.G. & McGlynn, E.A. (2009). A Systematic Review of Health Care Efficiency Measures. Health Services Research, 44(3), 784-805.