Column Outlines Top Excuses For Failure To Reform U.S. Health Care System

Main Category: Health Insurance / Medical Insurance
Also Included In: Public Health
Article Date: 12 Nov 2007 - 8:00 PDT

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U.S. residents might think the fact that the nation "spends far more on health care per person than any other nation," yet has "lower life expectancy than most other rich countries," would "make the case for major reform of America's health care system ... irrefutable," columnist Paul Krugman writes in the New York Times. "Instead, however, apologists for the status quo offer a barrage of excuses for our system's miserable performance," Krugman adds.

Krugman writes that one excuse people give is that even if people are uninsured, they still have access to care. Krugman cites President Bush's claim that "people have access to health care in America" because they can "just go to an emergency room." Although Bush "was widely mocked for his cluelessness," many of the "apologists for the health care system in the United States seem almost equally clueless," Krugman writes. U.S. residents are told that "there really aren't many uninsured American citizens because some of the uninsured" are undocumented immigrants and some of the rest are eligible for Medicaid, Krugman continues, adding, "This misses the point that the 47 million people in this country without insurance are an ever-changing group, so that the experience of being without insurance extends to a much broader group."

In addition, Krugman notes that a "large fraction of the population ... is underinsured." The second excuse Krugman discusses is the "bad habits" of U.S. residents. He writes that "obesity and other lifestyle-related problems" might "partially explain America's low life expectancy," but the "big question isn't why we have lower life expectancy than Britain, Canada or France, it's why we spend far more on health care without getting better results."

Another excuse people use to justify high health costs is that health care in 2007 is better than it was in 1950, according to Krugman. He compares that logic to seeing a DVD player priced twice what it costs at other stores and having the salesman tell you "not to worry" because the "machines on offer at his store are a lot better than they were five years ago." Krugman continues, "It is, in other words, an argument that makes no sense at all, yet respectable economists make it with a straight face." The final excuse Krugman describes is "the long, dishonest tradition of peddling scare stories about the evils of 'government-run' health care."

According to Krugman, the "reality is that the best foreign health care systems ... do as well or better than the U.S. system on every dimension, while costing far less money." He writes that the "best way to counter scare talk about socialized medicine" is "to point out that every American 65 and older is covered by a government health insurance program called Medicare" and that they "like that program very much" (Krugman, New York Times, 11/9).

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