Thursday, February 28, 2008
Healthy living, not socialized medicine
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Paul Taylor
Taylor works in the health care industry in Roanoke and lives in Salem.
Steve Huff, in his recent column, "The health care market is killing us" (Jan. 28), voiced a great deal of concern for the state of our current health care system and how it has impacted his patients.
In his opinion, we would be better off copying France, where employees are covered by a state-run system and nonemployees buy in separately. Private insurers would compete for supplemental coverage.
His assertion that this is not socialism is subject to debate. If not socialism it is socialized medicine. According to Wikipedia, socialized medicine -- or state medicine -- is a term primarily used in the United States to refer to publicly funded health care. It can refer to any system of medical care that is publicly financed, government administered or both.
Huff contends that the most glaring deficiency is lack of health coverage for all citizens. Although we do have a problem in this area that needs to be addressed, it is not nearly as bad as some politicians would have us believe.
To start with, the figure of 47 million uninsured Americans that everyone talks about includes about 10 million who are not citizens. Many are illegal immigrants and would probably not be covered if we had national health care.
The number also fails to take full account of Medicaid, the government's health program for the poor. For instance, it counts millions of the poor who are eligible for Medicaid but have not applied. These individuals, who are healthier on average than those who are enrolled, could always apply if they ever needed significant medical care. They are uninsured in name only.
The 47 million also includes many who could buy insurance but haven't. The Census Bureau reports that 18 million of the uninsured have annual household income of more than $50,000, which puts them in the top half of the income distribution. About a quarter of the uninsured have been offered employer-provided insurance but declined coverage.
A small percentage of Americans have trouble obtaining health insurance. However, any reform focusing on this group should be careful to avoid disrupting the vast majority for whom the system is working.
Huff also argues that since France's state-run health care system is less expensive as a percentage of gross domestic product than ours -- 9.8 percent vs. 16 percent -- the problem must once again be our free market model. He wants to make us think all we have to do is to make the government the primary payer and most of our troubles would be eliminated.
According to a recent Purdue University study, 74 percent of American health care costs are due to lifestyle-related behaviors and, therefore, are preventable. Obesity is the second leading cause of preventable death in the United States, reports the American Obesity Association.
Consider the rates of obesity. While 31 percent of American males and 33 percent of American females are so severely overweight they are technically obese, only 11 percent of the French are obese.
It is important to note that this number is a recent development. In 1997, approximately 8 percent of French adults were obese. Because health problems due to excess weight take time to develop, current French health statistics reflect the impact of lower obesity rates in the past.
Infant mortality rates also reflect broader social trends, including the prevalence of infants with low birth weight. Low birth weights are in turn correlated with teenage motherhood. The rate of teenage motherhood, according to one study, is nine times higher in the United States than in France -- 49 per 1,000 versus 9 per 1,000.
The bottom line is that many statistics (including but not limited to cost as a percentage of GDP) on health outcomes say not so much about our health care system as it does about our social problems.
According to a Wall Street Journal opinion column by John Stossel, co-anchor of "20/20," "Patients in countries with government-run health care can't get timely access to many basic medical treatments, never mind experimental treatments."
He concludes, "If government takes over, innovation slows, health care is rationed, and spending is controlled by politicians more influenced by the sob story of the moment than by medical science."
If you investigate the root of our problems instead of the symptoms, one should conclude that we do indeed have an excellent health care system. Unfortunately, too many of our people are making poor lifestyle decisions that lead to health problems that no other system in the world has to face. This is a serious problem that will not go away simply by turning over our health care system to the government.
