Affordable Healthcare Act (Obamacare) Review – Rob Bujan

Dan Udell videotaped a presentation on the US healthcare system by Rob Bujan on 3/25/17. I could not attend so I watched Dan’s YouTube video – 

 The discussions towards the end of this presentation (about minute 50) concerning single-payer systems would have been more vigorous and perhaps useful with a little international context. We live in a world where every other developed country has universal healthcare and has had for decades. So, there is plenty of experience with a range of different structures to deliver healthcare to every person as a right.

The US spends ~$9500 per capita per year while our closest competitor Switzerland spends ~$6900. That is 27% less than us. UK, Canada, Denmark, Australia, Japan and other competitor countries spend ~$4000 to $4500 per capita per year. These are more than 50% less than our spending.

Meanwhile the health outcomes from this enormous amount of money are woeful. The US ranks near 40th in the world on longevity and infant mortality, two key indicators of healthcare system effectiveness. This is happening because the healthcare providers are setting the prices and living in a “market” that drives the production of procedures and prescriptions, not health. Read this recent NYTime’s article “Those Indecipherable Medical Bills? They’re One Reason Health Care Costs So Much” by Elizabeth Rosenthal (3/29/2017) for an example of this fact in action.

.Our debate of what to do needs to start from a recognition that our healthcare system is extremely bloated and ineffective. The healthcare outcomes if you are poor and non-white (excepting poor rural white men have similar bad outcomes) are third world. Second, we need to clearly recognize that healthcare is not a market. One’s health is not like buying corn or a car. The only people being served by the endless prattle by the Republicans and Democrats about increasing competition in the medical system are the already rich doctors, hospital administrators, and insurance and pharmaceutical  executives. No other country in he developed world believes that healthcare is suitable for market controls.

We need to develop the political will to tell the healthcare industry that we will no longer spend 19% of our economic output on bad healthcare. We need to get our spending in line with our competitor nations and improve the health deliverables radically at the same time. This will take a lot of political will and time. You can’t shrink a sector that represents 1/5 of the economy to 1/10 of the economy over night. But we have to do this. In a low growth era that we are certainly in, we simply cannot afford the waste of resources. And we should not accept the terrible performance of this vital sector when we have plenty of real world examples from around the world of how to do it better. We need to develop some real outrage over how we are being ripped off by the healthcare system and served extremely badly.