The Best Health Care Is Reserved for Congress

By Don Sloan, Caveat Press. Posted July 11, 2007.

The following is excerpted from Chapter 2 of Practicing Medicine Without a License! The Corporate Takeover of Healthcare in America.

Nothing happens in a political vacuum. Nothing. The toe bone is connected to the head bone. Healthcare's place in a country agenda is but a microcosm of where a nation ranks its social consciousness. It reveals the quality of our purpose, our economy, our priorities and where they are placed on the chain of command. Along with education, healthcare tells all about a government and its people.

For without a healthy and literate people, a society cannot succeed. World history has proven that over and over again. Where then does America stand on the ladder of accomplishments when stacked up against the rest of the nations of the world? Sadly, with all of its opulence, power, wealth, and resources, nowhere near high enough.

U.S. foreign aid

For openers, we have often bragged about how generous we are toward the rest of the world as measured by our foreign aid. Politically, it is no secret that we base our aid not on need, but on its service as a tool of our foreign policy. Countries that are friendly to the U.S. power structure are the beneficiaries of our benevolence. Thus, the nations that receive by far the lion's share of our foreign aid are Israel and Egypt, the two nations in the Middle East boiling pot that are most politically aligned with our ideals and ambitions.

If generosity has been properly defined as the giving of what you have little of, then in that context, no matter how benevolent we might seem, we are not a generous nation. Even now, there is that brouhaha over our rehab funding of Iraq. Revelations come daily of contracting through the Halliburton empire and other corporate friends of the Administration, based not on value or need, but on the size of contributions to the various political campaigns or their political connections.

Despite our reputation, the numbers betray it as false. For although we have been ballyhooed as the world's foremost social worker, the truth is sadly the opposite. The United States of America continues to give less overseas aid as a percentage of its Gross National Product (GNP) and income than any other developed nation. With the exceptions of aid to Israel and Egypt, we allocate and spend more in one day on the military operation in the Gulf War than we spend all year on social foreign aid. Likewise, here at home, the Pentagon spends more in fifteen minutes than is federally funded for women's healthcare in a year! Other similar examples abound.

We fall behind most other industrialized nations in just about every area of social need. In percentage of one-year-old children fully immunized against polio, we are number seventeen. China and even Brazil are in front of us. There are lower rates of low birth weight babies born in Egypt and Jordan than here at home. Before the debacle of 1989 that took away its socialized healthcare, the then-USSR was also ahead of us on that list. Lebanon, Libya, and Cuba have more teachers for their children than the USA.

Oh, yes. We are first among western industrialized nations when it comes to percentage of children living below the poverty line, murders of males between ages fifteen and twenty-four, in the number of handguns in the street used by people of all ages, the percentage of citizens incarcerated, energy consumption per capita, and in the emissions of air pollutants.

And, we are by far number one in the rate of people gunned down each year in street crimes and similar violent incidents. In America today, there are more African-American adult males in jail than in college.

Shameful statistics
The World Health Organization (WHO), the arm of the United Nations (UN) that is in charge of the world's state of health, as well as its monitoring and reporting, has often reminded the U.S. that we lag far behind other G-7 countries, including Australia and Canada, in what the WHO states is "healthy life expectancy." Its latest report suggests that there are many "Third World pockets" within U.S. borders. I remind you that over 45 million Americans have no healthcare coverage at all, and it is easily estimated that over 40 million more have healthcare that can only be described as inadequate. Of course, as expected, much of this follows along racial and ethnic lines, with blacks and Hispanics over-represented among the denied groups.

Life spans alone tell the story. White males are at 75.4 years, white women at 80.5; African-American males hover at 69.2, black women are 76.1. These numbers have improved slightly overall in the past decade, but shockingly are in decline compared to other industrialized nations.

In fact, America sits weakly at number twenty-nine of the thirty-five nations included in the latest UN Human Development Report released in 2005, which lists average life expectancy. It is notable that not only have more countries moved ahead of the USA, but also the gap between us and the healthiest country, Japan, with its average life expectancy of eighty-two years, continues to widen.

The WHO report stated that Native Americans, rural African-American males, and much of the inner city poor have numbers that match many Third World nations. Shamefully, our U.S. is the world's only nation that reports its healthcare statistics in two categories, one for black and the other for white citizens. The differences are that stark.

It has been wisely written that the most heinous and pervasive weapon of mass destruction is poverty. Affluent USA has not escaped that dungeon. Even during our greatest periods of economic boom -- strictly subjective depending on who is doing the reporting and whether it is an election year or not -- almost one in five (18.5 percent) U.S. children were living in officially defined poverty as we entered the twenty-first century, with black and Hispanic poverty numbers nearly double that of white and Asian. This, despite our gross domestic product's (GDP) nearly doubling in the last quarter of the twentieth century. It is clear that not everyone gets to enjoy the perks of a strong economy. The streets of America that are "paved with gold" are apparently not trod upon or open to all. ...

How the USA compares

What is the state of healthcare in the U.S. today? Our USA spends over 50 percent more than say, Switzerland, on healthcare per capita, the next country in line. And on average, we spend 150 percent over other industrialized nations. The number of beds per capita in the U.S. is consistently in the bottom quartile on those countries.

And that filters down to all other healthcare expenses, from hospital overheads to medical malpractice to prescription drugs. The latest data from the Organization for Economic Cooperation and Development (OECD) has now confirmed what we already knew. The OECD also points out that although the United States spends more, we do not receive the services we pay for.

Healthcare layout accounts for about 15 percent of the U.S. GDP at a time when only two other countries, Switzerland and Germany, put out more than 10 percent. Averaging over the first years of the new millennium, the United States spends circa $5,200 per person on healthcare. Canada $2,900; Germany $2,800; Switzerland $2,600; Britain $2,200. Yet, each of them boasts of a longer life expectancy, lower infant mortality, and better U5MRs than we. All have a national healthcare service that covers all their people. No one is shut out.

The United States has 2.9 hospital beds per 1,000 residents compared with 3.7 beds/1,000 in the average OECD nation; 2.4 physicians per 1,000 people compared to 3.1/1,000; 7.9 nurses/1,000 compared to 8.9/1,000 among the others.

The U.S. has 12.9 CT scanners per one million population compared with 13.3 elsewhere in the developed world. We do have more magnetic resonance imaging (MRI) machines than the other OECD nations listed, but ours are only in use ten hours daily, compared to fourteen in the others.

The best healthcare is available

The OECD conclusion was not a surprise. We just do not get enough for our buck. But that is not true for everyone in the country. There is an employee/insurance deal in the U.S. that includes unlimited doctor office visits of your choosing; covers all accidents, routine exams, physical therapy, labs and X-rays; and the like; unlimited hospital visits and stays; certain chronic care and rehab; full prescription coverage; and unlimited specialty consultations. For the employee and the entire family. There are no deductibles, no co-pays, and only a $35 monthly fee taken from an annual salary of $158 thou. Thirty-five dollars!

The group awarded this insurance looks forward to a full pension and continued coverage until their deaths. Quite a few, most in fact, were millionaires before they took on their jobs that got them such a perk. Who gets this coverage? It would be nice if it were the underprivileged or the chronically ill and debilitated or our veterans.

But no. For starters, the 535 members of the U.S. Congress, and add to that the few hundred in the upper executive and judicial branches of government. They are also members of a demographic group where seven were arrested for shoplifting, nineteen for writing bad checks, and eighty-four for drunk driving. This bunch also has an overrepresentation of felony indictments, and a few ended up serving time.

And, they are also the very same group who keeps such credible healthcare proposals and bills like John Conyers' HR676 and Barbara Lee's HR3000 holed up in committee, year after year, denying them access to a public hearing and floor vote. In 2005, the president and his cronies up on the Hill voted to slash $10 billion over the next decade from Medicaid. Their own medical benefits stayed intact.

Could it be they don't believe that the rest of America should share in what they are so fortunate to have? We know better. That is the kind of care that we should all have and can afford.

A play with the numbers is even more revealing. Using those same governmental accounting sources, the billions spent on the Iraqi campaign yearly would have given similar healthcare benefits to four out of every five Americans for a year. Think about that.

As the denied are reported to number in the many millions, the profits amassed by the pharmaceutical industry and the robber barons that are the insurance and banking healthcare conglomerates are measured in billions. The arguments used in lobbying against the allowance of pharmacy generics that would slash the costs of drugs to a needy people would mach the New York State Health Department when it wrote that the "quality of life" was not in its purview.

A study of U.S. bankruptcies tells a part of this scandalous story. Harvard Medical School's Steffie J. Woolhandler addressed a meeting of the Society of General Internal Medicine and said, "Among all debtors filing for bankruptcy, 55 percent ... cited one or more medical causes ... This is an incredibly profound indictment of healthcare financing in the United States."

Spending by the general population on its healthcare increases every year, similar to the growing governmental allocations per person for health that we mentioned earlier, now up to over $6,000 an individual. Healthcare expenses are now the third largest overall outlay in the U.S., surpassed only by the government and the retail industry. They are measured in the trillions and account for almost 15 percent of the total economy.

As getting sick is expensive for the individual in our society, so, too, is it costly to the taxpayers, the system, and the facilities. Sickness affects us all. Prevention would be a lot cheaper for everyone. And add to that the loss of a productive person's skills and labor to our diminishing "quality of life."

Our dubious honors

In a puzzling statement, as government think tanks keep crying out how we must control the healthcare dollar with all sorts of tightening-up rules and regulations and practices, the National Academy of Sciences stated that, rather, we must reward high-quality medical programs as a way of making better doctors and providing us with better facilities, from high tech ORs to chronic care nursing homes.

With health costs on the dole mounting, so are our national debts. A Herblock cartoon from 1986, in reporting that the U.S. had just become the world's leading debtor nation, a place we have not since relinquished, sported the headline "We're Number One!" Tragically, we can make other similar dubious claims, as well.

What is the American paradox, as asked by political writer Ted Halstead in preparing us for yet another wild promise in a State of the Union address? That we a nation with the most patents, Nobel laureates, and millionaires. But we are as well the world's leading industrialized country with the highest levels of poverty, homicide, and infant mortality.

We remain without a healthcare program that covers all our citizens. In presenting the data for this book to various publishing outlets and media moguls, I was told by more than one that healthcare and its need does not seem to be that important to people. I guess I should have answered by reminding them that they should think that over when they don't feel so well.

There is nothing more devastating than having poor health, but worse still is having a health deficiency that is undiagnosed, frightening, painful, and goes untreated for one reason or another. Nothing equals that feeling of powerlessness and frustration. Imagine, then, having suck a feeling but with the added burden of never having hope or an avenue of relief of any kind, much less a cure.

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A medical doctor with nearly four decades in private practice, Don Sloan has published more than 85 peer-reviewed journal articles on medical practice and the politics of his profession. Sloan is active in New York healthcare reform organizations and national legislative forums.

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