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America needs Obamacare; we are down the list in healthcare

September 18, 2013
Lehigh Acres Citizen

To the editor:

To those who are worried about, or uninformed about the Patient Protection and Affordable Care Act (PPACA), please consider some of our country's health facts. Specific information about the PPACA is found at:

Universal health care is implemented in 55 other countries, and all industrialized countries with the shameful exception of the U.S; obviously including many developing countries.

Let us start out by saying health care is never free. Everyone has to pay something. We currently have a system where those who don't pay are supported by those who do, which is good and sufficient cause for "some form" of mandate.

The concept that people should be required to buy health coverage was fleshed out more than two decades ago by a number of conservative economists, embraced by scholars at conservative research groups, including the Heritage Foundation and the American Enterprise Institute and championed, for a time, by Republicans in the Senate.

Currently the U.S. health system ranks worldwide:

- 1st in overall health care expenditure

- 2nd in total health expenditure as percent of GDP

- 37th in the World Health Organization (WHO) ranking of the world's health system performance

- 72nd in overall level of health

- 44th of 224 countries in infant mortality

- 121st of 223 countries in overall death rate

- 50th of 224 countries in life expectancy

And the list goes on.

Those who say that the U.S. has the best health care system in the world are wrong. If they are not ignorant then they are disingenuous.

The only ones well served are well off financially.

It's seems obvious we have people in office who like our health care system and the private insurance industry just the way it is. If we are first in overall health care expenditure, and second in total health expenditure as percentage of GDP, but 37th in the WHO ranking of the world's health systems performance, then there seems to be an excessive amount of inefficiency in our system. Maybe there is too much profit, in the place of performance.

Please don't talk about cost. If 55 other countries, including many underdeveloped ones, can manage some form of universal health care for their citizens it's a disgrace and shameful that the United States doesn't. We already know some inefficiency is in our private insurance system, e.g. profits (at the expense of coverage), and the duplicate administrative costs of dozens of private companies.

At a very minimum we need a "not for profit" option to mitigate the excesses (read greed) of the private system. To start, the simplest solution would be to let anyone buy into the Medicare system. It is an extremely efficient mechanism with all the administration already in place.

Ultimately, we need a single payer, not for profit, system that covers everyone, and "everyone" needs to support it. It's essentially barbaric to have a "for profit" system where only those with money get care, and that that care depends on the size of dividends for stockholders.

Our private for-profit system has resulted in a situation where one can't afford the insurance for a service, much less the service.

Does the Affordable Care Act save lives? Yes.

First, according to Wilper and colleagues (2009) in the American Journal of Public Health, approximately 44,000 plus Americans die each year because of lack of access to health insurance. Second, the National Academy of Sciences 2001 report on medical errors estimated that approximately 44,000 to 98,000 Americans die because of medical errors each year. A midpoint approximation is about 71,000 Americans. According to Lucien Leape, MD, from Harvard, who served on the Academy of Sciences Committee, "accidental injuries result from faulty systems not from faulty doctors and nurses ... "

That is, the 71,000 dead per year, who have access to the health care system (i.e. overwhelmingly with insurance) die because of dysfunctional aspects of the system. That means 44,000 without insurance plus 71,000 with insurance die per year because of our current health care system.

If that's not an epidemic, what is? And those with insurance are subject to the roll of the dice, as well. Do we want 1,000,000 plus tragic deaths per decade?

This is not theory. These numbers come from peer-reviewed journals and the Academy of Sciences.

Have the Republicans now been bought by a Mortuary Lobby? One million Americans living, rather than dying, per decade, is a big financial loss to funeral directors. So, now the Republicans are saying, we favor Care for Mortuaries over Care for the Living. Not even the funeral directors are pushing that.

Turning your back on Americans dying is not an American value. Justice Scalia was worried about forcing people to eat broccoli? Are Republicans now saying that taxing Americans so that they are motivated to participate in a health care system that prevents the death of their fellow countrymen and countrywomen unconstitutional?

Nobel prize winning economist Paul Krugman points out that the PPACA landmark health care reform law is already pushing down health insurance premiums.

He explains: "Until now there has been sort of a market - but one that ... is riddled with problems. It was very hard for individuals to figure out what they were buying ... Price and quality comparisons were near-impossible. Under these conditions the magic of the marketplace couldn't work - there really wasn't a proper market."

The main result of Obamacare is that we have real market competition for health care insurance - something that didn't exist before.

Ironically, it's the Republican party - the one that says it supports free markets - that continues to do anything possible to derail the law that seems to be making the market work.

Thomas G. Spencer

Lehigh Acres



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