It was one of those rare moments where I sat down one evening and attempted to watch Sunday football. During the commercial break, I was changing the channels absent-mindedly dreading the Monday ahead but then something caught my attention. An infomercial channel dedicated for health insurance shopping at the convenience of your home. Yes, you heard it call 1-800-gonna-be-dead-soon! What was even scarier than the channel itself were the ages of the people who were doing the testimonials; almost everybody was an AARP member. It made me wonder, “Do we only need to see a doctor when we are 65 or older?”
The US spends outrageous amounts of money on healthcare per capita about $US 7,583. Notwithstanding, 47 million of Americans (about 42% of adults) still remain uninsured or underinsured. The US is the only developed nation with no universal health coverage for its citizens (Brin et al, 2009). If we look at another country, say, the UK, health system is provided by the National Health Services. It is a comprehensive health care system that includes primary health care as well as a dental plan and prescription drugs coverage. It is funded by central taxation and the country tries hard to protect its citizens from out-of-pocket medical expenses. The UK spends about US $3,129 per capita on health insurance and this amount is almost half of what the US spends per capita (Schoen et al, 2010).
No one denies that it can be challenging to evaluate the health outcomes of different health systems. However, an influential study published in 2012 by Mckee and Nolte attempted to use amenable mortality as a parameter to assess health services. Amenable mortality is an index for health quality. It includes a list of conditions that people should not die from if interventions were accessed in a timely and effective manner. Some preventable conditions included were diabetes, appendicitis, and simple infections. This study compared the US to the UK, France and Germany. Between 1999-2007, amenable mortality fell by 36.9 % for men in the UK with only 18.5% decrease in the US. In the same study, the US recorded the highest rate of amenable mortality, which was nearly twice as much as that of France. This is not to say that the US has not made progress in health outcomes over the past decade, however, the rate of process does not commensurate with the amount of money spent on healthcare (Nolte and Mckee, 2012).
The US continues to pioneer medical research, innovation, and state-of-the art medial procedures, yet it fails to provide adequate primary healthcare coverage for all Americans. Shopping for health insurance on TV in a country that dominates the free market system goes beyond our expectations and indeed appears ludicrous to outsiders. Critics have attributed this weak health system coverage to two factors: the poor are not represented enough to lobby for coverage and the limited role of the government (Schroeder, 2007).
Obamacare seems promising. Well, don’t we all agree that minimum healthcare coverage is better than nothing? Many critics are taking Obamacare with a grain of salt saying it’s ‘messy.’ According to the New York Times, Families USA (an advocate organization for Obamacare) estimated that last year an American dies every 20 minutes because they didn’t have health insurance. The Obamacare offers the opportunity for many young Americans to have health insurance and access to medical care and preventive medicine. This is not only beneficial to the health of the population but also to the US economy in the long run. It has the potential to save millions of dollars on preventable diseases. It might take some time to achieve the goal of universal healthcare coverage for all Americans. However, Obamacare might be the light at the end of the tunnel if it worked the way it intended to.
Anne-Emanuelle Brin, Yogan Pillay, Timothy H. Holtz. Text Book of International Health: Global Health in a Dynamic World, 3rd edition. 2009. Oxford University Press New York, NY.
Cathy Schoen, Robin Osborn, David Squires, Michelle M. Doty, Roz Pierson and Sandra Applebaum. How Health Insurance Design Affects Access To Care And Costs, By Income, In Eleven Countries. Health Affairs, 29, no.12 (2010):2323-2334
Ellen Nolte and C. Martin McKee. In Amenable Mortality–Deaths Avoidable Through Health Care–Progress In The US Lags That Of Three European Countries Health Affairs, , no. (2012): published online August 29, 2012; 10.1377/hlthaff.2011.0851)
Nicholas Kristof. This Is Why We Need Obamacare. Access online on November 5th, 2013. http://www.nytimes.com/2013/11/03/opinion/sunday/kristof-this-is-why-we-need-obamacare.html?adxnnl=1&adxnnlx=1384127406-JRwOhNoqcMGD+ChwLjRG3Q&_r=0
Schroeder, S. We Can do better-improving the health of the American people. N Engl J Med 2007;357:1221-8.