"Oh, and no healthcare"
One of the things I hear bandied about a lot in the UK, whenever the conversation swings to criticism of America (as has been happening a lot recently), is that "and they're fucked because they've got no health care". This is always accompanied by statistics of huge numbers of people without health insurance.
So, what exactly does the US provide, and how is it doing versus the rest of the world? Is the richest nation in the world really letting the poor die of horrible diseases at home while fighting wars overseas, providing massive financial aid to the third world and donating record-breaking amounts to ending disease in Africa? Does this really seem plausible to anyone?
The obvious truth is that this isn't true. But what's really the case is more surprising.
Point one: how much does the US spend on healthcare versus other nations, as a percentage of GDP? That article has a lot of data, but the quick answer is in my snazzy graph over there: the US beats the crap out of us. This is 1999 data, but even after the massive increases in UK spending on the NHS under Labour, we're still less than 10%, and the US has risen even further.
Oh, I hear you say, but it's not free! Well, no it's not, unless you're over 65, or very poor, or a veteran, or you live in Minnesota, or hundreds of other ways. Poor people certainly have a lower standard of health care than rich people in the states. But they're not left dying on the streets either.
Of course, that's not to say there aren't problems with the way the US does healthcare. There are plenty:
Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world’s median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations. ... despite those extra hundreds of billions of dollars we spend each year, we leave forty-five million people without any insurance.
So their system is broken, and inefficient, and fails quite a lot of people. But it does exist, and it works for the majority of people -- 45 million people is still only 15% of their population. So let's get off our high horses shall we? The picture is a lot more nuanced, and our own healthcare systems have serious flaws as well.
Comments
Graham
Yes, if you are ultra poor then you might be able to get some meagre Medicaid coverage. But there's a huge section of society that doesn't have insurance and doesn't qualify for aid, who live in terror of becoming seriously ill, since it will effectively destroy them. It forces people to stay in jobs they hate because they won't be able to get coverage if they leave. The whole system is simply dreadful, and the fact that the US throws so much money into something that is basically broken just makes it worse. (The UK system is also often quite bad, but we hear plenty about that in the UK media).
15% is 1 in 6. That's a lot.
ed
Fun fact: For-profit health insurers are the least efficient form of insurer (as measured by the percentage of premiums spoent on admin costs). Not-for profits are better, and the GOVERNMENT (you know, the ones who can't do anything right) is much, MUCH better (admin costs for Medicaid/Medicare are like 1%, compared to a whopping 20% for companies like Aetna)
I'd agree that the situation is complicated, but having spent a lot of time reading about this, I've concluded that the US healthcare system is a complete mess. I don't know much about the UK system, but from what you've told me, it sounds a hell of a lot better (to say nothing of the French system, generally regarded as amazing. Of course, they're going broke, so...)
Laurie