Friday, January 11, 2013

US health care: A lesson in market failure

by Richard Mellor

US health care delivers the worst bang for the buck compared to most industrialized nations and we have a worse infant mortality rate than Cuba. In 2012, the US spent $8,233 per year per person on health care, that’s two and a half times more than most developed nations.  And US health care consumes almost 18% of GDP twice that of some countries and one and a half times the OECD average.

The US sickness industrial complex and mass media boasts of our superior technology and research which is true, but the most important aspect of a nation’s health care is public health.  As I have pointed out many times before, the diseases and death (infant mortality and low life expectancy for example) in the third world, is due to infrastructure and poor public health systems, not specialized care or the lack of liposuction procedures or laser surgery.  This is an economic and political problem, a by-product of the market. A report on PBS last October pointed out that for this 17c on every dollar we spend on health care we don’t get such a great deal noting that:

In the United States:
  • There are fewer physicians per person than in most other OECD countries. In 2010, for instance, the U.S. had 2.4 practicing physicians per 1,000 people -- well below the OECD average of 3.1.
  • The number of hospital beds in the U.S. was 2.6 per 1,000 population in 2009, lower than the OECD average of 3.4 beds.
  • Life expectancy at birth increased by almost nine years between 1960 and 2010, but that's less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. The average American now lives 78.7 years in 2010, more than one year below the average of 79.8 years.
A new report by the National Research Council and Institute of Medicine published this week finds that things have not improved, “Americans die younger and have more illnesses and accidents than people in other high income countries” the Wall Street Journal quotes the report as saying.  This is even the case with wealthier, insured and college educated Americans.

The study reports that the US comes close to the bottom when measured against 17 other “affluent” countries; the bottom in life expectancy, and "high rates" of infant mortality, obesity, diabetes, heart disease, chronic lung disease and more. “The US health disadvantage is pervasive….” the study states, affecting “...all ages up to 75…”.

The authors of the study attribute these extremely poor statistics given our wealth and technological supremacy to many factors not least the huge chasm between the haves and the have nots in US society which has a greater inequality gap than China. 

The problem is that in the US, medicine is a business and is market driven.  It is not a moral question, people die like flies in the third world for the same reason, food is a commodity, health care is a commodity.  For the market to provide these basic human necessities the private owners of capital must make profit; you can’t pay for food, you don’t get it. If Profit can’t be made out of providing health care, they won’t provide it and you die. It’s basic market economics.

To stave off social unrest and due to the struggles of generations of workers building Unions and political parties, other industrial countries have national health care systems, cheaper and more efficient than here in the US that's why they have this advantage.  But these too are under attack, ideologically and politically under pressure from the IMF, World Bank, EU and other market proponents. More efficient for the owners of capital though doesn’t mean greater access for the public whether health care or transportation; it means more profits. That the most powerful capitalist economy in history cannot provide decent health care, housing, or transportation for its citizens says something about the market although the capitalist class will blame workers, patients, riders whatever, anything but their mode of production.

It's true that these other “affluent” countries are capitalist economies, but workers and workers’ parties social gains have not yet been completely dismantled and there remains advantages we as Americans don’t have although these are being eaten away also.  But we are in the belly of the beast here, without money you are nothing, “you’re on your own baby.” Hero, veteran, work all your life, small community business, if you fall on times it is a ruthless environment as the recent Great Recession has shown. You have to “pull yourself up by your bootstraps” like George W Bush and Donald Trump.  As JP Morgan said; “I owe the public nothing”, when he owed the public everything.

US workers prior to the crash worked on average about two months a year longer than our brothers and sisters in other advanced capitalist countries with less to show for it. It's why we were more productive, we were on the job longer, have less leisure time. The insecurity, pace of life, and living in a 24-hour marketplace takes its toll---we are always customers. In most advanced economies ads for prescription drugs on TV are not allowed.  For us we are bombarded with ads warning us of diseases we have never heard of and the need for their pill to cure them. We are consistently preyed upon by the coupon clippers who must extract their pound of flesh and the TV is their window to the home. This is a major reason for the statistics we read above on illnesses, the social power the capitalist class has and a profit driven health system. A public national health care system is what will open the door to improving the situation

Naturally, the free market gurus and their supporters will oppose such measures and even refer to it as communism which is not uncommon. I can’t help bringing the readers’ attention to Hilary Clinton’s comments in the latest Business Week, a piece covering her trips around the world on behalf of the bankers and US corporations. “If you can’t compete, fairly, honestly effectively…” she tells Business week, “ government should intervene”.

In the light of recent events when the US taxpayer made available about $16 trillion to US banks to drag capitalism from the abyss, I am wondering if we live on the same planet.

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