The most moving part of President Barack Obama’s powerful speech Wednesday night was undoubtedly the letter from which he read, sent to him from “our beloved friend and colleague” Ted Kennedy. Kennedy had asked, back in May when he wrote it, that the letter should not be opened until after his death. As Obama reported, Kennedy “expressed confidence that this would be the year that health care reform—‘that great unfinished business of our society,’ he called it—would finally pass,” and in doing so, define “the character of our country.” Indeed, it is amazing that while Kennedy served for more than four decades in the Senate and dedicated much of his energy and superb legislative skills to the passage of just such a program, the problem has only gotten worse over time.
Given the degree of the problem, it can difficult to understand, writes Serge Halimi, editor of France’s prestigious Le Monde Diplomatique, why Barack Obama, who has established himself as one of America’s most effective diagnosticians of what ails our health care system, is proposing so modest a reform to address its failures. As the president told a Montana town hall meeting this past August, “We are held hostage by health insurance companies that deny coverage, or drop coverage, or charge fees that people can’t afford for care they desperately need … We have a health care system that too often works better for the insurance industry than it does for the American people.”
Halimi answers his own question: “American politics is so poisoned by money flowing from industrial and financial lobbies that the only proposals ensured a smooth ride through Congress are those that cut taxes.” Indeed, according to BusinessWeek, in 15 states more than half of the “market” is held by one private health care company, and this kind of monopoly profit is not going to go off quietly into the night. And yet this essential fact is often missing from a media debate that focuses on nonexistent, often crazy issues like imaginary “death panels” and whether or not Sarah Palin would be forced to murder her own child.
Late in the dog days of August, The Washington Post published a piece by T.R. Reid, a reporter who has left the paper and written a book called The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, delineating what he called “five myths about health care around the world.” It’s worth reading the piece, not only for the information it offers, but for the picture of just how far our debate has drifted from reality. Barack Obama is right. We do have a health care system that is not only unsustainable in the long term, but a great shame on the heads of those of us who can afford to buy the health care we need whenever we need it. Not only are the alleged horror stories about “socialized medicine” untrue, but its superiority to our own system is largely absent from our debate.
In addition to the issues Reid raises—I have not yet read his book—I did some research on this question while writing Why We’re Liberals, and I found the following:
- The United States and South Africa are the only two developed countries in the world that do not provide health care for all of their citizens.
- Nationally, 29 percent of children had no health insurance at some point in the last 12 months, and many get neither checkups nor vaccinations.
- The United States ranks 84th in the world for measles immunizations and 89th for polio. These figures are particularly shocking given that Americans spend almost two and a half times the industrialized world’s median on health care, nearly a third of which is wasted on bureaucracy and administration.
- 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 19th percentile of industrialized nations. Doctors here perform more high-end medical procedures, such as coronary angioplasties, than in other countries, but most of the wealthier Western countries have more CT scanners than the United States does, and Switzerland, Japan, Austria, and Finland all have more MRI machines per capita. Nor is our system more efficient. The United States spends more than $1000 per capita per year—or close to $400 billion—on health care-related paperwork and administration, whereas Canada, for example, spends only about $300 per capita. And, of course, every other country in the industrialized world insures all its citizens; despite those extra hundreds of billions of dollars we spend each year, we leave 45 million people without any insurance.
- Meanwhile, the Finns, for instance, devote less than half of what we do to medical care, as a percentage of GDP, and yet their infant mortality rate is half that of the United States—and one-sixth that of African-American babies—while their life expectancy rate is greater. The United States ranked 42 in life expectancy behind not only Japan and most of Europe but also Jordan, Guam, and the Cayman Islands, according to the most recent census figures.
Conservatives, members of the American medical industrial complex, and other defenders of the U.S. status quo frequently berate the European health care alternative because they say the care that patients receive there is both less responsive and less advanced than that available to Americans, however much more we may have to pay for ours. But American patients wait longer, on average, for routine treatments than those in France and Germany. Moreover, hospitals in those two nations also provide new mothers more than four days to recover, while insurance companies insist that doctors send American mothers home after only two.
Swedes enjoy better success rates treating cervical and ovarian cancers. The French best the American system when it comes to stomach cancer, Hodgkin’s disease, and non-Hodgkin’s lymphoma. The French also benefit from more cancer radiation equipment than Americans. And despite so many American boasts on exactly this topic, Germans get the most hip replacements. In the area where one hears the loudest cheers for the American system—making new cancer treatments available to patients as quickly (however expensively) as possible, the United States is merely tied with Austria, France, and Switzerland.
I could go on—almost indefinitely. And perhaps there are good reasons why we cannot match the performances of all of these countries when it comes to providing decent health care to our citizens despite being the wealthiest nation in the world. But the arguments related to economic efficiency are demonstrably false. Conservatives so consistently denigrate the amazing achievements of 21st-century Europeans that one can’t help but wonder what has them so worried. “If you want a lower standard of living,” conservative policy experts Grace-Marie Turner and Robert Moffit argued in a December 2006 op-ed, “the Europeans have the right prescription.” Their argument echoes views, as The New Republic’s Jonathan Cohn noted, that are popular across the conservative spectrum, from Newsweek’s Robert Samuelson (“Europe is history’s has-been”) to The National Review’s Jonah Goldberg (“Europe has an asthmatic economy”) to The New York Times pundit David Brooks (“The European model is flat-out unsustainable”).
Conservatives have been making exactly these arguments for roughly five decades now, yet these same European nations have by almost every measurement—individual rights and community, capitalist enterprise and social solidarity, and even personal mobility—demonstrated results that Americans can only envy. (You can find the details supporting these claims in chapter one of Why We’re Liberals.)
In the meantime, shouldn’t we be able to at least discuss these issues, instead of largely ignoring them and focusing on the shouts and screams of hysterical crazy people who accuse our president of being a racist, a Communist, and a Nazi, only to be rewarded with guest appearances (and even their own shows) on Fox? Can America have fallen so far that this is our answer to Ted Kennedy regarding the content of our character? Barack Obama gave one answer last night but, let’s face it, it rested on “hope.” Congress and the American people will give a more final answer in the coming months; let’s hope it demonstrates a different form of “character” than that on display on CNN, MSNBC, and Fox, alas.
Eric Alterman is a Senior Fellow at the Center for American Progress and a Distinguished Professor of English at Brooklyn College. He is also a Nation columnist and a professor of journalism at the CUNY Graduate School of Journalism. His seventh book, Why We’re Liberals: A Handbook for Restoring America’s Most Important Ideals, was recently published in paperback. He occasionally blogs at http://www.thenation.com/blogs/altercation and is a regular contributor to The Daily Beast.