United States healthcare programs to citizens compare with the healthcare provided to residents in other countries? That question will be the focus of this paper, along with the background to the decision of major health insurance companies to support the candidacy of Republican Mitt Romney.
Where does the U.S. stand in the world when it comes to healthcare?
According to a statement by the Speaker of the House of Representatives, John Boehner, the U.S. has "…the best health care delivery system in the world" (Politiface.com). Boehner, who was a guest on the CBS Sunday program "Face the Nation," was commenting on the candidacy of Mitt Romney. On the July 1, 2012 program, Boehner said he supports Romney for president because Romney "…understands that Obamacare will bankrupt our country and will ruin…" that healthcare system that the speaker believes is best in the world (politifact.com).
Meanwhile on Fox News Sunday (also on July 1, 2012) the U.S. Senate Minority Leader Mitch McConnell of Kentucky said the United States has "…the best healthcare delivery system in the world" (politifact.com). When asked to cite specific studies that back up Boehner's contention, the speaker's staff noted that when it comes to "preventative care categories" a recent study has shown that the U.S. rated well against other "advanced industrialized nations" and U.S. medical facilities are rated high when it comes to "strong survival rates…for patients with cancer" (politifact.com).
However, when fact-checking the assertions by Boehner and McConnell, the politifact.com writers found that according to the World Health Organization (WHO), the U.S. ranks 37th out of 191 countries. WHO is a component of the United Nations, and its report was based on five factors: a) "Health Level" (life expectancy) is given a 25% weight in the research; b) "Responsiveness" (availability and speed of healthcare services; choice of doctors, "quality of amenities") a 12.4% weight in the survey; c) "Financial fairness" (how "progressive or regressive the financing of a country's healthcare system is") a 25% weight; d) "Health Distribution" (how are the resources allocated throughout the nation?) 25% weight; and e) "Responsiveness distribution" (how well do the healthcare resources respond to needs?) a 12.5% weight in the survey (politifact.com).
Another study by the Commonwealth Fund determined that the U.S. healthcare system's performance was "mediocre"; compared with Australia, Canada, Germany, New Zealand, the UK and the Netherlands, the U.S. healthcare system "…ranks last or next-to-last on five dimensions of a high performance health system" (politifact.com). Those five dimensions include "quality, access, efficiency, equity, and healthy lives" (politifact.com).
In the Commonwealth report's Executive Summary (Davis, et al., 2010), the U.S. has ranked last in 2004, 2006 and 2007. The U.S. is "last on dimensions of access, patient safety, coordination, efficiency and equity" (Davis, p. v). Most notable in terms of the way the U.S. is ranked differently from the other seven countries is "…the absence of universal health insurance coverage," Davis explains. That said, the health reform legislation signed into law by President Barack Obama "…should begin to improve the affordability of insurance and access" when the Affordable Care Act (ACA) becomes fully implemented in 2014 (Davis, v).
The U.S. is "lagging" badly in the promotion of "primary care, quality improvement, and information technology," Davis continues (vi). The Commonwealth Fund -- a non-partisan research organization -- has been researching healthcare programs since 1998.
Meanwhile an article in The Hill reports that doctors in America are "more likely to report problems" with healthcare system components than their medical peers elsewhere in the world. Just fifteen percent of primary-care doctors in the U.S. said that the healthcare system is working smoothly and needs tiny tweaks to bring it up to speed (Viebeck, 2012, p. 1). The survey that Viebeck references -- published in Health Affairs -- shows that physicians in nine other countries reported higher satisfaction with their healthcare systems. Thos countries included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the UK and the U.S.
To wit, 61% of doctors in Norway reported higher satisfaction with their healthcare systems; 54% of doctors in Holland also reported higher levels of satisfaction with their healthcare program; in France 37% of doctors say their system is working well (Viebeck, p. 1). Also, 59% of U.S. doctors surveyed report their patients "…have difficulty paying for care they need and 52% of U.S. doctors indicated that "…staff time spent navigating coverage restrictions is a major problem" (Viebeck, p. 1).
Meanwhile the cost of healthcare services in the United States is shockingly high. Considering how far down the international list the U.S. is in terms of the quality of its healthcare, the cost of healthcare services in America is exorbitant. For example, in the per capita spending data (provided by the WHO) the U.S. spends $6,719 per person compared with much lower figures drawn from international health care data: in the UK it's $2,815 per capita; in the Russian Federation it's $698; in Japan it's $2,581; in Italy, it's $2,631; Germany's per capita spending on healthcare is $3,465 and in France it is $3,465; in China the per capita cost for healthcare is $216 and in Canada it is $3,673.
When it comes to nurses and midwives per 10,000 population, the UK has the most (128), Canada has 101, Japan has 95 and the U.S. has 94 (WHO data). The only country that has fewer hospital beds per 10,000 people than the U.S. is China, with 22 beds per 10,000 citizens. The U.S. has 31 beds per 10,000 people; the UK has 128; Canada has 101; Germany and France 83 and 73 respectively and the Russian Federation has 97 (WHO). For many statisticians and scholars the bottom line in terms of how healthy a country is can be based on life expectancy. The life expectancy in the U.S. is 78 years (same number as in Cuba); in the UK it is 80 years; in Japan people average living 83 years; in Italy it is 82; in Germany it's 80 and in France it is 81 years (WHO). Only two nations listed by the World Health Organization have a lower life expectancy than America -- Russia's average is 66 and in China it is 74 years (WHO).
Advantages / disadvantages of universal health care
Certainly there is a great need in the U.S. For better healthcare services. According to the U.S. Census Bureau, "…a record 50.7 million residents from nearly every demographic and geographic group had no health insurance in 2009" (Doherty, 2011, p. 119). And while the Affordable Care Act (ACA) was not written in order to provide universal coverage -- it was designed to fill in caps and assure that millions who are not insured could become insured -- Doherty sees the possibility that Republicans could block (or attempt to block) the insurance exchanges that the bill allows states to set up. The exchanges would (will) allow citizens who do not have insurance to sort through several options, most of which will presumably be less expensive that the highest price tags from big insurers.
Some states (with Republican governors) are already showing resistance to allowing these insurance exchanges to be set up, which is clearly a sign of resistance to Obama's signature legislation. [Note: not one Republican member of the House of Representatives voted in favor of the Affordable Care law; some saw this recalcitrance as a unified attempt to block anything that Obama proposes.] If there is this much resistance to simple exchanges designed to help citizens become insured it is obvious that any proposal for universal healthcare would meet stiff resistance from Republicans. That said, the advantages of universal healthcare are many: a) patients would be encouraged to practice preventive medicine (presently uninsured people shy away from preventative care due to the cost); b) start-up businesses will have an easier time since they won't have to pay for their employees insurance; c) medical professionals can concentrate on healing and helping patients rather than worrying about insurance paperwork, etc.; d) when people have access to healthcare, they live longer and healthier lives; and e) a universal system "…automates and standardizes medical records, which can [then] be accessed by all participating entities" (good information leads to "better decision-making" by doctors which decreases the number of medical errors and helps avoid malpractice suits (Sykora, 2010).
There are some potential disadvantages as well, namely: a) taxes might go up nationally leading to cutbacks in other important services; b) healthy people might wind up paying for those who aren't healthy (and those who smoke or are obese); c) "profit motives, competition" have led to "cost control" and that might be lost; and d) the number of patients a doctor would see will go up dramatically creating the possibility of less complete service (Balanced Politics).
Why did the big health insurance companies back Romney? The obvious answer to this question is that Romney promised in numerous campaign appearances and in interviews that he would try to trash the Affordable Care Act (ACA). Many insurance companies…