'A Healthy New Year.
By Paul Krugman
The New York Times
Monday 01 January 2007
The U.S. health care system is a scandal and a disgrace. But maybe, just maybe, 2007 will be the year we start the move toward universal coverage.
In 2005, almost 47 million Americans - including more than 8 million children - were uninsured, and many more had inadequate insurance.
Apologists for our system try to minimize the significance of these numbers. Many of the uninsured, asserted the 2004 Economic Report of the President, "remain uninsured as a matter of choice."
And then you wake up. A scathing article in yesterday's Los Angeles Times described how insurers refuse to cover anyone with even the slightest hint of a pre-existing condition. People have been denied insurance for reasons that range from childhood asthma to a "past bout of jock itch."
Some say that we can't afford universal health care, even though every year lack of insurance plunges millions of Americans into severe financial distress and sends thousands to an early grave. But every other advanced country somehow manages to provide all its citizens with essential care. The only reason universal coverage seems hard to achieve here is the spectacular inefficiency of the U.S. health care system.
Americans spend more on health care per person than anyone else - almost twice as much as the French, whose medical care is among the best in the world. Yet we have the highest infant mortality and close to the lowest life expectancy of any wealthy nation. How do we do it?
Part of the answer is that our fragmented system has much higher administrative costs than the straightforward government insurance systems prevalent in the rest of the advanced world. As Anna Bernasek pointed out in yesterday's New York Times, besides the overhead of private insurance companies, "there's an enormous amount of paperwork required of American doctors and hospitals that simply doesn't exist in countries like Canada or Britain."
In addition, insurers often refuse to pay for preventive care, even though such care saves a lot of money in the long run, because those long-run savings won't necessarily redound to their benefit. And the fragmentation of the American system explains why we lag far behind other nations in the use of electronic medical records, which both reduce costs and save lives by preventing many medical errors.
The truth is that we can afford to cover the uninsured. What we can't afford is to keep going without a universal health care system.'
Lees verder: http://www.truthout.org/docs_2006/010207L.shtml