Since the disastrous launch of Healthcare.gov, the website designed to enroll Americans in insurance programs under the Affordable Care Act, the White House has been struggling to reassure the public that the ACA (commonly called Obamacare) is still going to work.
The political climate surrounding the ACA has grown heated: the New York Times reported on Thursday that a memo had circulated amongst House Republicans, advising them to keep pushing stories of how the botched health care rollout has harmed their constituents.
It seems that the battle over health care in the U.S. is far from over. Indeed, the next few weeks promise to be rife with political battles on Capitol Hill.
Amongst all the political maneuvering, however, it is important to remember what is at stake. The health care system in America has long been criticized as expensive and inefficient, and it is in desperate need of reform.
In 2000, the World Health Organization (WHO) published their annual World Health Report, which ranks the health of countries around the world based on various factors such as life expectancy and infant mortality.
The United States’ ranking was far from good. The U.S. placed 15th in health care performance, despite having the highest health care expenditure of any country. The findings ignited a media firestorm, and since 2010 the WHO no longer ranks countries, but merely publishes the statistics.
Other organizations, however, have continued to compare health care across countries, and the U.S. regularly fares poorly in these rankings.
Bloomberg, drawing on sources such as the International Monetary Fund (IMF) and the WHO, published a list of the most efficient health care systems in the world (last updated in August 2013).
The study’s methodology was as such: “Each country was ranked on three criteria: life expectancy (weighted 60 percent); relative per capita cost of health care (30 percent); and absolute per capita cost of health care (10 percent).” From this, the researcher gave each country an efficiency score. The U.S. placed 46th, with a per capita health care cost of $8,608. Hong Kong placed the highest, with a higher life expectancy (83.4, compared to America’s 78.6) and a much lower cost of $1,409 per capita. Indeed, of the top 10 countries on the list, only Switzerland pays more for health care than the U.S., at $9,121 per capita.
Often the argument put forth against nationalized health care is that private industry is more efficient.
However, many of the healthiest countries in the world have nationalized health care, and they provide it despite spending less of their GDP than the U.S. does.
Forbes in 2007 published research comparing various countries based on factors such as pollution, infant mortality, life expectancy and physician density (the number of physicians per 1,000 people). Northern European countries dominated the list, with Iceland, Sweden, Finland, Germany and Switzerland as the top five, in that order.
A report by the Commonwealth Fund states that in 2010, Iceland spent 9.8 percent of its GDP on its universal health care system. That same year, the U.S. spent 17.6 percent of GDP on health care, despite the fact that an estimated 50 million residents were uninsured.
It seems ludicrous that one of the wealthiest countries in the world cannot ensure the health of its citizens. According to the New York Times, a study by the Institute of Medicine and the National Research Council found that “The United States had the second-highest death rate from the most common form of heart disease, the kind that causes heart attacks, and the second-highest death rate from lung disease, a legacy of high smoking rates in past decades. American adults also have the highest diabetes rates.”
National health care has been a controversial topic for Americans long before the ACA. In 1989, Congress passed the Medicare Catastrophic Care Act (MCCA), designed to protect older Americans from being driven into bankruptcy by medical bills. The Act proved immensely unpopular, and 17 months later it was undone.
The ACA managed to pass, but only after significant bargaining that whittled away many policies Democrats wished to include, such as a single payer system.
Given the growing disappointment over the implementation of the ACA, it is not unreasonable to believe it may meet the same fate as the MCCA.
However, the fact remains that the cost of health care in this country is too high and its need is too vital.