Holly Sklar

Time for Health Care for All

When Medicare and Medicaid were signed into law on July 30, 1965, former President Harry Truman received the first Medicare card. He would be shocked that 40 years later, more than 45 million Americans have no health coverage, half of all personal bankruptcies are health-related and lack of universal insurance is increasingly hurting our economy as well as our health.

Truman proposed national health insurance for all Americans in 1945. He said, "By preventing illness, by assuring access to needed community and personal health services ... and by protecting our people against the loss caused by sickness, we shall strengthen our national health, our national defense and our productivity."

If Americans without health insurance were a nation, the population would be bigger than Canada -- plus Michigan, Montana, New Hampshire and Vermont. Canada, like other industrialized nations besides ours, provides universal health coverage.

Contrary to myth, the United States does not have the world's best health care. It has the costliest.

In the words of Dr. Christopher Murray of the World Health Organization (WHO), "Basically, you die earlier and spend more time disabled if you're an American rather than a member of most other advanced countries."

The US is No. 29 in the WHO healthy life expectancy ranking. We lag Canada by nearly three years and Japan by six. The US does worse than 36 countries in child mortality under age 5, well behind South Korea and Singapore.

The US is No. 1 in spending. The Organization for Economic Cooperation and Development reports the US spent 15% of its Gross Domestic Product on health in 2003 compared to an average 8.6% in 30 OECD countries.

The US has fewer physicians, nurses and hospital beds per person, and fewer MRI and CT scanners than the OECD average. Health Affairs reports that Americans had more difficulty making appointments with physicians quickly than people in Canada, the UK, Australia and New Zealand, and were more likely to delay or forego treatment because of cost.

Lack of health insurance is killing many more Americans than terrorism. As the Institute of Medicine documents, uninsured Americans get about half the medical care of those with insurance. They receive too little care too late, get sicker and die sooner. For example, uninsured women with breast cancer have a 30% to 50% higher risk of dying than insured women. Uninsured car crash victims receive less care in the hospital and have a 37% higher mortality rate than privately insured patients.

One out of three Americans below age 65 -- 85 million people -- lacked private or public health insurance for all or part of 2003-2004. Millions more are underinsured.

Average family health insurance premiums will reach a projected $14,545 in 2006, more than double the 2001 average.

Much health spending is squandered on the mountainous red tape, profits and executive pay of private insurance and drug companies.

The National Coalition on Health Care, an alliance of about 100 corporations, pension funds, medical associations, insurers, unions, consumer and religious organizations, says, "Comprehensive health care reform is long overdue. Every year that reform is delayed, tens of millions of Americans live in peril, without health insurance; millions are harmed, and hundreds of thousands die needlessly, because of substandard care."

"The crisis in health care is the central economic problem facing America -- adversely affecting living standards, job creation and retention, wage growth, the adequacy and viability of pension benefits" and the global competitiveness of American business, says Coalition president Henry Simmons.

The Coalition offers four different scenarios for universal coverage: employer and individual mandates and subsidies; expanding Medicare and other public health insurance; creating a new public program modeled on the Federal Employee Health Benefits Plan; and establishing a universal single payer, publicly financed program.

The first three scenarios would net $320 billion to $370 billion in savings over the first ten years; the fourth scenario would save $1.1 trillion.

Like untreated cancer, the health care crisis is spreading throughout our families and economy. It's time for health care for all.

Holly Sklar is coauthor of Raise the Floor: Wages and Policies That Work for All Of Us (www.raisethefloor.org). Email hsklar@aol.com.

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