Article

Health Care: A SiCKO America

Approximately 45 million Americans lack health insurance. Health care costs are increasing faster than wages, and six in ten insured Americans are "worried about being able to afford the cost of their health insurance over the next few years."

JUNE 22, 2007 by Faiz Shakir, Nico Pitney, Amanda Terkel, Satyam Khanna, and Matt Corley
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HEALTH CARE

A SiCKO America

Approximately 45 million Americans lack health insurance. Health care costs are increasing faster than wages, and six in ten insured Americans are “worried about being able to afford the cost of their health insurance over the next few years.” But these high prices aren’t buying the world’s top care. Even while U.S. health spending per capita is higher than any other country, America is not necessarily the best country in which to get sick. Documentary filmmaker Michael Moore highlights the deficiencies in the U.S. system in his new movie, SiCKO, which opens nationwide on June 29. Moore travels to Great Britain, France, Canada, and Cuba, comparing the accessibility and costs of those systems with health care in the United States. He finds that his own country often comes up short for Americans who can’t always afford high premiums. “Every American has a human right to know that when he gets sick, he can go to the doctor without worrying if he can afford it,” Moore said. Moore recently spoke with Oprah about America’s broken health care system, which you can view here, along with clips from the film.

MYTH #1 — THE CARE IS WORTH THE MONEY:
In 2006, Bush promised that his administration would “confront the rising cost of care, strengthen the doctor-patient relationship, and help people afford the insurance coverage they need.” He has not lived up to his promise. Instead, our health care system is pushing millions of hardworking Americans into relentless financial constraints and sending thousands to early graves. Health care costs skyrocketed 87 percent over the last five years, despite wages increasing just 20 percent. As Moore highlights in SiCKO, these costs are significantly higher than what people in other nations pay for care. According to a 2004 study published in Health Affairs, more than “one-quarter of U.S. adults (both insured and uninsured) spent more than $1,000 out of pocket on health care in the past year, far exceeding expense burdens in the other countries.” As a result, nearly half of all sick adults in the United States “said that they did not see a doctor when sick, did not get recommended treatment, or did not fill a prescription because of cost.” Perhaps not surprisingly, U.S. health care spending also significantly outpaces the spending of other countries. “Health spending per capita in the United States is much higher than in other countries — at least 24% higher than in the next highest spending countries, and over 90% higher than in many other countries that we would consider global competitors.” According to a CNN poll from May, 64 percent of the public believes the “government should provide a national health insurance program for all Americans, even if this would require higher taxes.” Compared to people in other developed countries, Americans are the most likely to say that their health care system needs to be completely rebuilt.

MYTH #2 — THE UNITED STATES HAS THE BEST HEALTH CARE IN THE WORLD: One of the myths that Moore tackles in SiCKO is that the United States has the world’s best health care. As Center for American Progress Distinguished Senior Fellow former Sen. Tom Daschle notes, this myth is that “we have the best health system in the world — and changing it will lower quality, reduce access, and hurt our businesses. The perception of excellence stems, rightly, from the exceptional performance of many of our health professionals, researchers, and institutions. Yet, some of our self-image results from the mistaken belief that we get what we pay for — which, in health care, is a lot.” Still, the right wing continues to perpetuate this myth, arguing that it is dishonest to highlight the deficiencies in the U.S. health care system. “The fact is, the United States provides the best health care quality in the world,” said Sean Hannity this past Sunday on his show Hannity’s America. Earlier this month, Fox News’s John Gibson argued, “In the film, Moore says that our health care system is inferior to dozens of other countries. So why are so many people from other countries coming to America for medical attention?” But unfortunately, what often distinguishes the United States is “its relatively poor performance.” The United States is behind in preventing asthma-related deaths, vaccinating children against polio, and providing flu shots to seniors. The “likelihood of surviving a kidney transplant is 6 percent higher in Australia, 13 percent higher in Canada, and 4 percent higher in the United Kingdom and New Zealand than in the U.S.” Additionally, one in three sicker Americans “who seek care suffers some type of error,” and U.S. patients experience approximately 98,000 medical deaths per year.

MYTH #3 — AMERICANS ARE THE HEALTHIEST IN THE WORLD: While no health care system is perfect, the American public recognize that the U.S. arrangement needs an overhaul. A 2006 poll found that 96 percent of Americans believe that there are problems with the health care system in the United States. Health care reform is an urgent priority, as Americans on average die at a younger age compared to the average age of death of comparable nations. The U.S. infant mortality rate is 6.9 deaths per 1,000 live births, while Japan and Sweden have rates below 3.5 deaths per 1,000 live births. And the obesity rate among adults in the United States is 30.6 percent, the highest rate of developed countries; this rate is nearly 21 percent higher than the rate of the second highest country, Mexico. An estimated 45 percent of Americans had a chronic illness in 2000, a number that is projected to rise to 50 percent by 2020. Additionally, the “number of people with diabetes has doubled in the past fifteen years,” and one in three persons born in 2000 can expect to have diabetes in his or her lifetime. As Center for American Progress Senior Fellow Jeanne Lambrew notes, “Certain racial and ethnic minorities are particularly vulnerable: the rate of diabetes is 59 to 80 percent higher among African-Americans than it is among non-Hispanic whites.”

PROGRESSIVE PRESCRIPTIONS: A “hallmark of high-quality primary care is an emphasis on preventive care, counseling, and awareness of patients’ health concerns.” The United States continues to be plagued by preventable diseases — such as asthma and Hepatitis B — with proven preventive services remaining largely unused. “About 70 percent of deaths and costs in the U.S. are attributable to chronic diseases like cardiovascular disease, diabetes and cancer — diseases that can be prevented or controlled.” A new approach is needed. The Center for American Progress has proposed a progressive prescription for a healthy America, a “practical approach to guaranteeing an American right to affordable, quality health coverage,” while improving the health of Americans. A key component of this plan is the Wellness Trust, a groundbreaking proposal that would ensure that all Americans receive preventive care through an expanded delivery system. This system would include doctors, schools, workplaces, and communities.

UNDER THE RADAR

ENVIRONMENT — SENATE PASSES FIRST FUEL ECONOMY HIKE ‘IN NEARLY TWO DECADES’: In a 65 to 27 vote, the Senate approved a “sweeping energy legislation package…that would mandate the first substantial change in the nation’s vehicle fuel-efficiency law since 1975 despite opposition from auto companies and their Senate supporters.” The energy bill, which still requires House approval, will “require cars, trucks and sport-utility vehicles to achieve 35 miles per gallon by 2020.” Furthermore, the bill requires “that the use of biofuels climb to 36 billion gallons by 2022” and sets “penalties for gasoline price-gouging and would give the government new powers to investigate oil companies’ pricing.” While the bill’s passage is considered a major victory for the Senate over car manufacturers and oil companies that “fought for a much smaller increase,” Senate Majority Leader Harry Reid (D-NV) expressed disappointment in “the Administration and most Senate Republicans,” who “successfully blocked a crucial component of the Democratic plan that would have raised taxes on oil companies by about $32 billion and used the money on tax breaks for wind power, solar power, ethanol and other renewable fuels.” Sen. Charles Grassley (R-IA) explained his support of the measure saying, “We’re taxing the oil industry to get a renewable energy industry started. … I hope you’ll understand that God only made so much fossil fuel and that there’s got to be a follow-on if we’re going to have growth in our economy.” Sen. Dianne Finestein (D-CA), echoing the Union of Concerned Scientists, released a statement in which she explained the impact of the new fuel economy standards: “By 2025, the fuel economy increases would: Save.. nearly the amount of oil imported today from the Persian Gulf [every day], achieve up to 18 percent reduction of carbon dioxide emissions from anticipated levels, or the equivalent of taking 60 million cars off the road in one year, and save consumers $79-98 billion at the pump.” Feinstein, “who has been fighting for years” for such a bill, told the Los Angeles Times, “It’s just amazing. … I’m flabbergasted.” The “leery” White House called the bill simply “a step in the right direction.”

IRAQ — PETRAEUS: U.S. HAS BEEN IN IRAQ LONG ENOUGH THAT WE HAVE ‘BECOME LIBERATORS AGAIN’: In an interview with the Times Online (UK), U.S. Iraq commander Gen. David Petraeus was asked whether the troop escalation could mitigate the rising sectarian violence in Iraq. Petraeus argued there was a “golden hour” of “omnipotence” in the early stages of the war where the United States was “viewed as a liberator.” He then claimed the United States is being perceived as “liberators” once again in Iraq, this time freeing them from the bloody civil war instigated as a result of the U.S. occupation. “Inevitably, it does not matter how much you were viewed as a liberator, over time you will be seen as an occupier. The interesting dynamic here is that we have been here long enough to become liberators again for certain sectors of the population, those that are affected by extremism,” he said. Prior to the war, Dick Cheney, Donald Rumsfeld, Paul Wolfowitz, and other administration officials claimed the United States would be welcomed as liberators in Iraq. Petraeus appears to be pandering to those fantasies. In fact, the great majority of Iraqis do not perceive the U.S. as liberators. A poll taken in Sept. 2006 revealed that seven in 10 Iraqis “want U.S-led forces to commit to withdraw within a year.” Furthermore, six in 10 approved of attacks on U.S. forces. That was nearly four months before the escalation. Since the escalation officially began in February, violence “has increased in most provinces,” “[s]uicide attacks more than doubled across Iraq,” and civilian casualties rose to “more than 100 a day,” according to a recent Pentagon report. Recently, the Iraqi parliament passed a resolution to try to force an end to the occupation.

HUMAN RIGHTS — WHITE HOUSE DIVIDED OVER GUANTANAMO BAY CLOSURE: “The Bush administration is nearing a decision to close the Guantanamo Bay detainee facility and move its terror suspects to military prisons elsewhere,” the AP reports today. “Senior Administration officials said Thursday a consensus is building for a proposal to shut the center and transfer detainees to one or more Defense Department facilities, including the maximum-security military prison at Fort Leavenworth, Kan., where they could face trial.” The White House has officially denied the AP’s report, however, saying “no decisions on the future of Guantanamo Bay are imminent, and there will not be a White House meeting” on Friday. “There has been significant opposition from Vice President Cheney as well as from the Justice and Homeland Security departments, and officials said yesterday that they are not on the brink of a decision.” But the administration’s detainee policy, of which Guantanamo is a centerpiece, has taken a series of blows recently that could hasten the administration’s desire to close the facility, a move that President Bush has said he ultimately wants to see. Last week, an appellate court ruled that Bush cannot order the military to indefinitely imprison civilians, even if they are suspected to be members of al Qaeda. Two weeks ago, two separate military judges ruled that the revised military commissions set up by the administration currently have no jurisdiction over any of the detainees at Guantanamo Bay because “there was a flaw in the procedure the military has used to file such charges against Guantanamo detainees.” As former Secretary of State Colin Powell recently said on Meet The Press, Guantanamo Bay is “a major problem for America’s perception” in the world, and it should be closed “not tomorrow, this afternoon.” Ken Gude, the Center for American Progress’s Associate Director for International Rights and Responsibility, has argued that the administration should “close the prison at Guantanamo, and shift detainee operations to Ft. Leavenworth, KS,” a move that the administration appears to be considering.

THINK FAST

“House Judiciary Committee Democrats warned yesterday they would pursue a contempt of Congress motion if the White House fails to respond to subpoenas for testimony and documents” related to the U.S. attorney scandal by June 28. “If the White House does not comply, it opens the possibility of a constitutional showdown between the two branches.”

29: Percentage of Americans who say the U.S. is winning the war against terror networks.

“The recent rise in U.S. troop deaths in Iraq is the ‘wrong metric’ to use” in assessing the effectiveness of escalation, outgoing Joint Chiefs chairman Gen. Peter Pace said yesterday. “[I]t’s not about levels of violence. It’s about progress being made, in fact, in the minds of the Iraqi people, so that they have confidence in their government in the way forward.”

Asked about the National Archives’ effort to have the Justice Department determine whether Vice President Cheney is exempt from an executive order designed to safeguard classified information, a DOJ spokesman said, “This matter is currently under review in the department.”

Pollution and smog standards are “too weak to protect people from the air they breathe,” Environmental Protection Agency administrator Stephen Johnson said Thursday. Yet “under pressure from big business,” Johnson ignored the recommendations of EPA scientific experts and “left the door open to keeping the rules as they are.” 

In a “rebuke to President Bush,” “House Democrats narrowly passed a measure yesterday to provide contraceptives to overseas organizations that had been banned from receiving foreign aid because they provided or promoted abortion.”

A House committee voted yesterday to give the Food and Drug Administration “more power to monitor the side effects of medicines after they reach the market,” though lawmakers also “lowered the potential fines for failure to comply with FDA directives to $50 million from $100 million after Republicans complained they were too high.”

And finally: A dozen Senators celebrated the first day of summer yesterday by donning seersucker outfits. Sen. Mel Martinez (R-FL) “made the unpardonable sin of wearing black shoes” with his outfit. Sen. Trent Lott (R-MS), wearing matching pink socks and tie set, boasted that he was “looking good.” “The clear fashion winner, though, was the debonair Sen. John Warner (R-VA), who accessorized his suit with a red tie and brown and white spats.” See photos here and here.

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GOOD NEWS

Congressional leaders yesterday released a “Greening the Capitol” report, which listed “recommendations to make the House carbon-neutral by the end of the 110th Congress. It also called for a 50 percent reduction of energy consumption in 10 years.”

STATE WATCH

KANSAS: “Kansas State Historical Society said it won’t allow city officials to demolish the former all-white school that was at the center of the Brown v. Board of Education case.”

ENVIRONMENT: Mayors in 36 cities are “going green” by utilizing alternative fuels and energy-efficient streetlights.

NEW JERSEY: State legislature passes bill capping greenhouse emissions at 80 percent of 2006’s levels by 2050.

BLOG WATCH

THINK PROGRESS: Former Attorney General John Ashcroft: U.S. attorney scandal has not damaged the Justice Department.

MINNESOTA MONITOR: Embattled Minnesota U.S. Attorney Rachel Paulose had to endure an “awkward moment” this week when the majority of her staff cheered for critics who had resigned earlier this year in protest of her leadership.

BIBLE BELT BLOGGER: Religious right’s Family Research Council appeals to a prayer group for President Bush’s homophobic surgeon general nominee James Holsinger.

THE CRYPT: Sen. Pete Domenici’s (R-NM) direct call to former Deputy Attorney General Paul McNulty “was a significant factor” in the firing of former New Mexico U.S. Attorney David Iglesias.

DAILY GRILL

“There has not been any serious disagreement about the program that the president has confirmed.”
— Attorney General Alberto Gonzales, 2/6/06

VERSUS

“Former Attorney General John Ashcroft told the [House Intelligence Committee] in a closed session that the Bush administration was sharply split over the legality of the domestic eavesdropping program.”
— New York Times, 6/22/07

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