Category Archives: Health Care

The health of our citizens

COVID-19 compared to the H1N1 Virus

COVID-19 compared to the H1N1 Virus

There has been considerable discussion about comparing the current virus to the 1918 Influenza pandemic. There also has been a lot of misinformation. In 1918 the Spanish flu terminated the lives of an estimated 35 million folks. Despite the name, the H1N1 virus started in Kansas. At the time, no one knew how it was transmitted, and there were no NPIs (Non-Pharmaceutical Interventions) in place. Items like social distancing, closing establishments based on group settings, contact tracing, and other measures were not even considered. Our ability to provide testing and track the sources of the virus was extremely limited. About 35% of all people living at the time contracted the virus, and the mortality rate was estimated at 2%. If our current NPI, testing, and tracking procedures been in place at the time, there is no doubt that the number of cases would have been just a small fraction of what occurred.

We really do not know the actual mortality rate of COVID19. The reported rate in the U.S. is 6%, but that is not accurate. The best estimate based on countries that have done a better job on testing is that it is about 2% or about the same as the Spanish Flu. This is about twenty times the mortality rate of the common flu at .09% (a bit under one in a thousand will die from the flu.)

What is alarming is that, as of May 2020, the USA has 4.5% of the world’s population but almost 29% of the COVID19 related deaths. We can learn a lot from studying both the countries that are doing a better job as well as those few that are doing worse.

Healthcare Revisited – Summary of Preceding Several Weeks’ Posts

Healthcare Revisited – Summary of Preceding Several Weeks’ Posts

Medicare for all is an interesting idea, but I’m not certain it will be as effective overall when compared to some of the other “proven” systems. It will almost immediately reduce some administrative and “profit” factors, but this will only have a small impact on costs. Baselining is the idea of not re-inventing the wheel and makes common sense. By evaluating several effective systems, it allows us to choose the very best aspects of each. In addition to evaluating the systems “process” it will be important to understand how savings can be achieved within each individual component that contributes to costs.

Regardless of which system is chosen (or designed), we will improve our quality of care.

Currently, we have several “special” interests that are making big money from our current system. They will not go along with any system that threatens their activity and profits. They are Insurance companies, drug companies, the legal profession, physicians, and hospitals. Achieving pricing equity even close to the five baseline countries will negatively impact significant industries. For this reason, any new system should include a “phase-in” period which would allow these industries to adjust.

Why do I say that this topic is by far the most important issue facing us today?

“As of 2019, the per capita cost of healthcare in the US has exceeded $11,000 for every adult, child & infant. Our per capita cost is almost three times the average of the EU Countries and more than what is required for a family to provide for other essentials. Nationwide we are spending almost $3.5 trillion a year on healthcare.

If a family of four had to pay their share of this cost, they would be facing almost $44,000. Allowing for reasonable funds to provide for basic housing, food, transportation, clothing, repairs & maintenance, insurance & a modest contingency fund it is evident that anything less than a family income of $75,000 per annum will require some form of subsidy just to cover the basics.

Currently, about 1/3 of the cost is being funded by the government in the form of Medicare & Medicaid. Another 1/3 (or slightly more) is funded through company healthcare plans, and the remainder is paid by citizens in the form of premiums, deductibles, and co-pays. From a company point of view, this high cost to them reduces the funds available for wage compensation.”

Our healthcare system and special interest involvement imposes a heavy tax on the public in 2 ways. First, it causes Government funding for both Medicare and Medicaid to be at least $500 billion more than it should. Next, it results in insurance premiums, both for employers and private payers, to be at least 1 trillion dollars higher than they could be. Of the $3.5 trillion that is paid out annually at least $1.5 trillion of it goes into the coffers of special interests.

“Families on private health plans pay an average annual premium of $4,968 or $414 per month. The average deductible and co-pays for these plans is $ $3,879”.  Source: https://brandongaille.com/average-cost-private-health-insurance-per-month/

Between the premiums, the deductibles and copays the average family will pay almost $9, 000 per year for health insurance, and this does not include the amounts that are being provided by companies or being subsidized by the government. This regressive healthcare tax is a heavy burden on the middle class. Employers are also facing the decision to pay higher wages or continue to fund escalating insurance prices. In many cases, employers are forced to hold increases on wage levels and increase employee funding participation in insurance plans.

Assuming that we can change our system and eliminate the current $1.5 trillion in tax, the next question is how to distribute the savings. $500 billion will occur through a reduction in the current level of Medicare and Medicaid spending. The remaining $1 trillion should provide employers and private pay individuals with a reduction or elimination of premiums. That amount would add an average of $6,300 to every wage worker annually if distributed equally.

This one issue has the potential to reduce the national budget deficit to an acceptable level and at the same time, increase the average wage for the middle class.

One final comment. While the actual amount of medically related bankruptcies is in dispute, there is no doubt that it comprises a significant portion of all bankruptcy events.

Healthcare Revisited – Relative Quality of Life

Healthcare Revisited – Relative Quality of Life

More important than longevity is the length of time that we experience “quality” life experience. The following chart again shows how we compare to other countries.
Following was taken from http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
 
 

– HEALTHY LIFE EXPECTANCY (HALE)

Health attainment, level, and distribution in all Member States
Disability-adjusted life expectancy at birth (years) Adjusted for years spent in disability. When compared to longevity, the chart is revealing. It indicates that the last ten years of life are not pleasant (on average) and also likely very expensive.
   
 Rank  Country                Total      Male     Female
1       Japan                                   74.5            71.9            77.2
2       Australia                              73.2            70.8            75.5
3       France                                  73.1            69.3            76.9
4       Sweden                                73.0            71.2            74.9
5       Spain                                    72.8            69.8            75.7
6       Italy                                      72.7            70.0            75.4
7       Greece                                 72.5            70.5            74.6
8       Switzerland                         72.5            69.5            75.5
9       Monaco                               72.4            68.5            76.3
10    Andorra                                72.3            69.3            75.2
11    San Marino                          72.3            69.5            75.0
12    Canada                                 72.0            70.0            74.0
13    Netherlands                        72.0            69.6            74.4
14    United Kingdom                 71.7            69.7            73.7
15    Norway                                71.7            68.8            74.6
16    Belgium                               71.6            68.7            74.6
17    Austria                                 71.6            68.8            74.4
18    Luxembourg                       71.1            68.0            74.2
19    Iceland                                70.8            69.2            72.3
20    Finland                                70.5            67.2            73.7
21    Malta                                   70.5            68.4            72.5
22    Germany                             70.4            67.4            73.5
23    Israel                                    70.4            69.2            71.6
24    United States                     7 0.0            67.5            72.6

It is interesting to note that all of the five baseline countries rank well above the United States and 3 of the five rank in the top 5: Japan, France & Spain.