I know that I am something of a contrarian. I have the bad habit of doubting popular opinion and this habit is not always limited by whether or not popular opinion is based on fact. My first instinct is to doubt--irregardless of subject--, when I hear the words, or even the strong implication of the words, "Everyone knows."
I have known, for most of my life, that a national single-payer health care model would be a bad thing for the United States. Or rather, I have known that 'everyone' knows this. Genetically and environmentally prone to being contrary, I have never actually believed it, but never bothered to do enough research to satisfy myself that my opinion did not merely represent another instance of my own contrary nature.
I recently decided to find out what it is that "everyone knows" on this subject and whether they know what they "know".
Asking people what they thought of the government taking over the financial burden of paying for everyone's health care, I got the expected answer. My friends--the people most us mean when we say "everyone"--mostly believe it would be a bad idea. (The exception to the 'mostly' were, by and large, those who grew to maturity in another country that does have national health care. )
Everyone knows that we cannot afford national, single-payer health care. Everyone's taxes would increase, I was told, to pay to cover the uninsured. A subset of my "everyone" believes that it might be financially feasible to have national health care if we could manage to send all the illegal immigrants away, because their care is a huge factor in the nation's health care expense. Another subset believes it would be too expensive because the government is so incompetent that any health care plan overseen by them would actually increase the expense of medical care and lead to things like taxpayer dollars paying $100 for an aspirin.
Interestingly enough, of the members of my "everyone" that I talked to, some of the "illegal immigrants drive up costs" people are legal immigrants and most of the "incompetent government would drive up costs" people are Los Angeles County employees.
This unscientific research,--conducted by asking my friends, "What do you think of the idea of national health care?" and nodding a lot to encourage them to give me the full benefit of their wisdom on the subject, --convinced me that "everyone" does indeed know that we cannot afford single-payer national heath care.
It turns out that my "everyone" does not know quite as much as they think they do.
- FACT: The vast majority of people lacking health insurance in the United States were born in the United States.
- FACT: A large percentage of those lacking health insurance are employed full time.
- FACT: Many of the people who have health insurance lack actual access to care because they are under-insured and cannot afford deductibles and co-pays required by their insurance provider.
- FACT: Many people who are fully insured currently will lack access if they experience a serious illness when they lose insurance coverage because of a job loss or are dropped by their insurance provider.
- FACT: The U.S. government already pays for much of the health care in the nation. With programs to cover some elderly and/or disabled adults, some children and some impoverished U.S. residents and with laws mandating emergency room treatment, We-the-People already are the single largest health insurance provider in the nation, providing coverage--back in 2004--for approximately 45% of the nation's health care costs.
- FACT: Although the U.S. is one of the few nations in the world that does not guarantee health care for everyone, counting only U.S. government expenditures, this nation is among the top 10 nations in the world in terms of per capita health care spending.
- FACT: Once we add the cost borne by employers, individuals and other non-government health care funding to the cost borne by the government, We-the-people pay more per capita than any nation in the world for health care, but--according to the World Health Organization--the care we get ranks 37th in overall performance and 72nd in overall level of health among the 191 nations compared.
We-the-people seem pretty convinced nowadays that we have to make certain that everyone has access to health care, but "everyone" seems convinced that the way to provide that access is by forcing everyone who can afford it to buy private health insurance and by paying for/helping to pay for private health insurance for those who cannot afford it.
Contrary me looked at a sample of the facts available and decided that the cheapest, most efficient way to go is single-payer. We-the-people have a responsibility to each other to guarantee heath care and the cheapest, most reliable way to do that is NOT to pay a health insurance company to pay a health care provider. We tried that already and the result is paying more and getting less for our money.
It is clear to me that we cannot afford not to have a single-payer, national health care plan.
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JAMA. 2003;289:1165.
It is only partially true to say that the United States does not currently have a national health care system. The Centers for Medicare & Medicaid Services (CMS) estimated the 1999 government share of total US health spending as 45.2% ($548 billion).1 This estimate includes funding for Medicare, Medicaid, workers' compensation, the Department of Veterans Affairs, public hospitals, and government public health activities. Thus, public funds directly pay for the health care of many people in the United States. Read the entire JAMA article.
One out of six Americans under age sixty-five lacks health insurance, a situation that imposes sizable hidden costs upon society. The poorer health and shorter lives of those without coverage account for most of these costs. Other impacts are manifested by Medicare and disability support payments, demands on the public health infrastructure, and losses of local health service capacity. We conclude that the estimated value of health forgone each year because of uninsurance ($65-$130 billion) constitutes a lower-bound estimate of economic losses resulting from the present level of uninsurance nationally. Read the entire Project Hope article.
Wikipedia article with links to sources.
Data below from US Census Bureau, August 2007 release.
The number of people without health insurance coverage rose from 44.8 million (15.3 percent) in 2005 to 47 million (15.8 percent) in 2006.
Overview
- The number of uninsured children increased from 8 million (10.9 percent)
in 2005 to 8.7 million (11.7 percent) in 2006.
Race and Hispanic Origin (Race data
refer to those reporting a single race only)
- The number of uninsured, as well as the rate without health insurance,
remained statistically unchanged in 2006 for non-Hispanic whites (at 21.2
million or 10.8 percent). For blacks, the number and percentage increased,
from 7 million in 2005 to 7.6 million and from 19 percent in 2005 to 20.5
percent. The number of uninsured Asians remained statistically unchanged,
at 2 million in 2006, while their uninsured rate declined to 15.5 percent
in 2006, from 17.2 percent in 2005.
- The number and percentage of uninsured Hispanics increased from 14 million
(32.3 percent) in 2005 to 15.3 million (34.1 percent).
- Based on a three-year average (2004-2006), 31.4 percent of people who
reported American Indian and Alaska Native as their race were without coverage.
The three-year average for Native Hawaiians and Other Pacific Islanders
was 21.7 percent.
Nativity
- Between 2005 and 2006, the number of U.S.-born residents who were uninsured
increased from 33 million to 34.4 million, and their uninsured rate increased
from 12.8 percent in 2005 to 13.2 percent. The number of foreign-born who
were uninsured rose from 11.8 million in 2005 to 12.6 million, and their
rate was statistically unchanged at 33.8 percent in 2006.
Regions
- The Midwest had the lowest uninsured rate in 2006, at 11.4 percent, followed
by the Northeast (12.3 percent), the West (17.9 percent) and the South (19
percent). The Northeast and South experienced increases in their uninsured
rates — their 2005 rates were 11.7 percent and 18 percent, respectively.
States
- Rates for 2004-2006 using a three-year average show that Texas (24.1
percent) had the highest percentage of uninsured. The rates for Minnesota,
Hawaii, Iowa, Wisconsin and Maine were lower than the rates of the other
45 states and the District of Columbia. The rates for these five states
were not statistically different from one another.
- Fifteen states had an uninsured rate that was statistically higher than
the national rate of 15.3 percent, while 29 states and the District of Columbia
had rates statistically lower than the U.S. average. Six states had rates
that were not statistically different from the national average.
