Category Archives: Broken in the USA

guns & gas

The Healthcare Issue Revisited, again….

The Healthcare Issue Revisited, again….

One of my top soapbox issues is the status of our broken Healthcare system. It continues to bother me to no end. I suspect that I will continue to revisit this subject often. Here are a few bullet points that I hope will garner your attention:

  • Our country has by far the most expensive system among all counties
  • In 2018 the cost of our healthcare system was $11,600 for every man, woman & child!
  • The average per capita cost for the EU, Canada, Australia & NZ was about $3,800 or 3x our cost.
  • According to the WHO (World Health Organization) almost all of these countries deliver a superior healthcare product. (We rank 37th among all counties)
  • We spent $3.8 trillion on Healthcare in 2018 (over 18 % of GDP) making it by far our largest industry. https://www.forbes.com/sites/danmunro/2014/02/02/annual-u-s-healthcare-spending-hits-3-8-trillion/#17694b3a76a9 
  • The Government pays for less than 30% of this, $1.1 trillion in the form of Medicare & Medicaid. The remainder is paid either by companies’ insurance benefits or by the tax payer in the form of premiums, co-pays and for some self-insured it is simply out of pocket. I could not fund a breakdown between what employers’ pay vs. others.
  • The Cost of Medicare & Medicaid is the single largest Budget Expense at almost twice that of what we spend on Defense and it the major contributor to the annual deficit.
  • Since there are much cheaper and better systems available to our leaders their inaction levies a very high tax on the tax payer. I have referred to this as a “hidden” tax since you do not realize that you are paying it.

Many smaller industries have their hand in our very lucrative system. For details on those I would refer you to earlier posts to my blog. The solution is not very complicated and the reason that it will likely never happen has to do with so much money being made in the private sector. Again, I would refer you to prior posts on this same subject for the details.

The high cost of health care can have several negative effects, including the following:

  • When the government spends more on health care, the national debt increases and/or funds available for other programs decrease.
  • When people spend more on health care, they have less money to spend for other things, and when health insurance is paid by their employer, they are paid less.
  • When employers spend more on health care, the costs of their products and services increase, and jobs may be moved to countries with lower health care costs.
  • More people cannot afford health care insurance. When people without health care insurance receive health care, they usually cannot pay for it. As a result, this care is paid for by other people who are paying into the health care system. Or, people without health care insurance may not seek care when they need it and thus develop a serious disorder that could have been prevented.
  • Medical bills that are not covered by health insurance can lead to bankruptcy.  https://www.merckmanuals.com/home/fundamentals/financial-issues-in-health-care/overview-of-health-care-financing

The Electoral College

The Electoral College

The following is taken from an earlier post: “Critics argue that the Electoral College is inherently undemocratic and gives swing states disproportionate influence in electing the President and Vice President. The Electoral College gives a numeric advantage in the election of the president to the smaller states, as the minimum number of electors for the small states is three compared to one for the election of representatives. On the other hand, the winner-take-all method of voting favors the larger states. On four occasions, most recently in 2000, the Electoral College system has resulted in the election of a candidate who did not receive the most popular votes in the election. A number of constitutional amendments have been proposed seeking to alter the Electoral College or replace it with a direct popular vote.”

Currently 18 states control the destiny of elections with 63% of the votes. Money is a significant factor in determining the winner and as a result the most populated states receive the lion’s share of campaign funding. In the last 125 years there have only been two elections where the winner of the EC did not win the popular vote, both Republicans. The most recent example was in 2016 with the election of Donald Trump where he won 56% of the EC, but only 46% of the popular vote. In fact, his opponent secured just under 3 million more  popular votes!

The EC was a practical solution when it was established over 200 years ago. Gathering, counting ballots & combining the results was problematic given the distances involved among the states. The EC just made sense. In the electronic age the problems of distribution no longer exist. It appears to me that there is no valid reason keeping the voters from making the decision on whom is to be President.

Recent polls indicate that over 60% of voters are in favor of abolishing the EC.

Gallup trends show that Republicans were far less supportive than Democrats of abolishing the Electoral College in late 2000, when Republican presidential candidate George W. Bush had lost the popular vote, but was fighting a legal battle to win Florida and therefore the Electoral College. Since then, however, Republicans have gradually become less protective of the Electoral College, to the point that by 2011, a solid majority of Republicans were in favor of abolishing it.

I do wonder why no action is taken to make this change? There are two reasons: 1. It would require a constitutional amendment, which is near impossible. 2. A state can decide to apportion the EC votes in the ratio of the popular votes. This only is effective if all states do this and so far only two states have taken this action: Maine & Nebraska. States resist this as the thinking is that it diminishes the impact of a candidate winning the state and the states influence on the outcome.

Life Expectancy vs HALE

Life Expectancy vs HALE

I recently read an ED OP in our local paper that was a reprint from a publication from a Minnesota paper. The writer was pointing out that while most EU countries were making positive progress to improve Life Expectancy, the US has been heading in the opposite direction for several years. The narrative stated that the CDC has placed part of the blame on drug overdoses and suicides. I did a bit of math on these areas and discovered that the increases in these areas has only had a minimal impact. The writer pointed out deficiencies in our health care system and noted increases in pregnancy mortality & heart disease, but again these numbers do not even come close to explaining away the problem.

My opinion is that the issue lies with our broken and extremely expensive healthcare system in combination with our inability (or unwillingness) to maintain our immune systems through regular exercise and moderation of caloric intake. Our healthcare system costs, on average, 2 ½ times that per capita average for EU countries. Yet, according to the World Health organization we only rank 31st in terms of quality of care. It is interesting that this is exactly the rank that the US has with respect to Life Expectancy, again 31st. You would think that since we spend so much on health care we should be getting the best?                                                                     I think it important to not be fooled by Life Expectancy as a true measure of quality. The better measure is one termed HALE (Health Adjusted Life Expectancy). Following is taken from Very Well Health: “How Is Healthy Life Expectancy Calculated? This is a bit complicated and uses lots of different data sources for each country. In a nutshell, the World Health Organization takes a country’s data like mortality rates and health status information and crunches them to look at things like how long people are expected to live with about 135 health conditions. The calculation looks at the mortality rate for different health conditions and adjusts it for the duration or severity of the illnesses.”

What this measures is your expectation of a healthy life span, not just how long we can keep you alive! Again, we fall far behind the EU and in fact we fall to 35th overall. The difference is significant. Currently our Life expectancy from birth stands at 79.3, but our HALE stands at only 69.1. Keeping us alive those additional 10 years is expensive and they are not our best years.

You might be surprised to learn that the following countries have a better HALE than the US: The United Arab Emirates, Slovenia, Malta, Maldives, Costa Rica, Chile & Cuba. Our HALE is equal to that of China.