[NYTr] Krugman: Health Care Excuses

[All the News That Doesn't Fit]

[It's a sign of progress, pitifully small but progress nonetheless,
that there's no longer any doubt even among the liberals that the
"American" health-care system (and much else) is not the "best" in the
world.  For years it was impossible to impart this idea -- "USA: Number
One" in all things was the smug, comfortable belief among the majority,
even the poor for whom it was definitely not "number one."  Now, even
the ruling elite who read and write in The New York Times, et al.,
don't question the obvious. At least they won't go down without their
profound doubts about what was the prevailing wisdom for the last 50
years.  Maybe they'll even support giving up their wasteful pork-barrel
high-tech, often-useless, fat research and want to spend the money on
basic medical care and prevention.  If there is any money left. Maybe
they'll want to string up the corrupt billionaires behind the
pharmaceutical industry's giant frauds.  Maybe. In the meantime, it's
nice to see their bubble has popped. -NY Transfer]


sent by Ed Pearl


The New York Times - Nov 9, 2007
http://www.nytimes.com/2007/11/09/opinion/09krugman.html

Health Care Excuses

By PAUL KRUGMAN

The United States spends far more on health care per person than any
other nation. Yet we have lower life expectancy than most other rich
countries. Furthermore, every other advanced country provides all its
citizens with health insurance; only in America is a large fraction of
the population uninsured or underinsured.

You might think that these facts would make the case for major reform
of America’s health care system — reform that would involve, among
other things, learning from other countries’ experience — irrefutable.
Instead, however, apologists for the status quo offer a barrage of
excuses for our system’s miserable performance.

So I thought it would be useful to offer a catalog of the most commonly 
heard apologies for American health care, and the reasons they won’t
wash.

Excuse No. 1: No insurance, no problem.

“I mean, people have access to health care in America,” said President
Bush a few months ago. “After all, you just go to an emergency room.”
He was widely mocked for his cluelessness, yet many apologists for the
health care system in the United States seem almost equally clueless.

We’re told, for example, that there really aren’t that many uninsured 
American citizens, because some of the uninsured are illegal
immigrants, while some of the rest are actually entitled to Medicaid.
This misses the point that the 47 million people in this country
without insurance are an ever- changing group, so that the experience
of being without insurance extends to a much broader group — in fact,
more than one in every three people in America under the age of 65 was
uninsured at some point in 2006 or 2007.

Oh, and finding out that you’re covered by Medicaid when you show up at
an emergency room isn’t at all the same thing as receiving regular
medical care.

Beyond that, a large fraction of the population — about one in four 
nonelderly Americans, according to a Consumer Reports survey — is 
underinsured, with “coverage so meager they often postponed medical
care because of costs.”

So, yes, lack of insurance is a very big problem, a problem that
reaches deep into the middle class.

Excuse No. 2: It’s the cheeseburgers.

Americans don’t have a bad health system, say the apologists, they just
have bad habits. Overeating and teenage sex, not the huge overhead of
America’s private health insurance companies — the United States spends
almost six times as much on health care administration as other
advanced countries — are the source of our problems.

There’s a grain of truth to this claim: Bad habits may partially
explain America’s low life expectancy. But the big question isn’t why
we have lower life expectancy than Britain, Canada or France, it’s why
we spend far more on health care without getting better results. And
lifestyle isn’t the explanation: the most definitive estimates, such as
those of the McKinsey Global Institute, say that diseases that are
associated with obesity and other lifestyle-related problems play, at
most, a minor role in high U.S. health care costs.

Excuse No. 3: 2007 is better than 1950.

This is an argument that baffles me, but you hear it all the time. When
you point out that America spends far more on health care than other
countries, but gets worse results, the apologists reply: “Sure, we
spend a lot of money on health care, but medical care is a lot better
than it was in 1950, so it’s money well spent.” Huh?

It’s as if you went to a store to buy a DVD player, and the salesman
told you not to worry about the fact that his prices are twice those of
his competitors — after all, the machines on offer at his store are a
lot better than they were five years ago. It is, in other words, an
argument that makes no sense at all, yet respectable economists make it
with a straight face.

Excuse No. 4: Socialized medicine! Socialized medicine!

Rudy Giuliani’s fake numbers on prostate cancer — which, by the way, he 
still refuses to admit were wrong — were the latest entry in a long, 
dishonorable tradition of peddling scare stories about the evils of 
“government run” health care.

The reality is that the best foreign health care systems, especially
those of France and Germany, do as well or better than the U.S. system
on every dimension, while costing far less money.

But the best way to counter scare talk about socialized medicine, aside
from swatting down falsehoods — would journalists please stop saying
that Rudy’s claims, which are just wrong, are “in dispute”? — may be to
point out that every American 65 and older is covered by a government
health insurance program called Medicare. And Americans like that
program very much, thank you.

So, now you know how to answer the false claims you’ll hear about
health care. And believe me, you’re going to hear them again, and
again, and again.