Friday, February 08, 2008

American healthcare system

By Adnan Gill

Each year the UN publishes a report known as the Human Development Index (HDI). It is a report card that grades the standards of life in 177 nations. Three dimensions are used to measure human development: life expectancy, education, and Purchasing Power Parity (PPP per capita)/income. The US is one of the richest nations that enjoys the PPP of US $ 41,890, only second to Luxembourg (PPP US $ 60,228). Despite its 13 plus trillion dollar economy, it is placed at the 12th place on the HDI.

One of the major reasons why the world’s largest economy was placed at the embarrassing 12th place was its commitment to health of its citizens: resources, access and services. According to the 2007/2008 HDI report, Iceland received the coveted first place on the HDI. Iceland, whose PPP is $ 36,510, spent 8.3 percent of its GDP on the healthcare whereas the US spent a meagre 6.9 percent of its GDP on healthcare. What really separated the two apart was the disproportional life expectancy rate at birth. In Iceland, the life expectancy at birth is 81.5 percent while the same in the US it is 77.9 percent. Paradoxically, a country that spends about 50 percent ($ 450 billion) of the world’s total military spending ($ 910.6 billion) is awarded a dismal 31st place, out of 177 nations, for the mortality rate.

The US is the only industrialised nation in the world that lacks some form of universal healthcare. Roughly 60 percent Americans have access to health insurance through employers and the workers’ contributions. An estimated, 47 million Americans remain uninsured. Health insurance in the US remains very expensive. The ever-increasing insurance premiums outpace the inflation rate, which is unduly burdening the employers and consumers.

According to a study on health, half of personal bankruptcies in the US involve medical bills.

The ominous condition of US healthcare system also stands out when compared to its northern neighbour — Canada. In 2000, the World Health Organization ranked the American healthcare system’s performance at 72nd and Canadian’s at 35th place out of 191 member nations. In 2004, America spent double the amount ($ 6,096 per-capita) on its healthcare system than what Canada did ($ 3,038).

The jury is still out on whose system is better. But it will be hard to overlook certain undeniable facts, like health insurance and drugs, which are much more expensive in the US than in Canada. Supporters of the US healthcare system allege that Americans get bigger bang for their buck. In other words, the medical care in the US is superior to what is available in Canada.

However, the critics retort that what good is the superior medical care if it is not available to 47 million Americans, to begin with? Critics also allege that the American system favours the special interests of those quarters that are more interested in profits rather than the patients, such as pharmaceutical giants and health insurance companies.

Ironically, Americans find that it is much cheaper to re-import prescription drugs from Canada. On average, the Canadian drugs cost as low as one-eighth of the US prices. That is why, in an effort to reduce the healthcare costs, some of the US states are also contemplating on re-importing drugs from Canada. The burden of expensive drugs mostly falls on the elderly and the disabled, many of whom live on fixed incomes and are forced to choose between prescription drugs that can prolong their lives and the immediate necessities of life like rent, food, heat, electric power, telephone service, etc. Consequently, for the last one decade or more, the Americans have been crossing the Canadian border for getting lower-cost prescription drugs.

The mere fact that Americans are forced to travel to Canada in busloads to re-import prescription drugs is a sad commentary on the dysfunctional American healthcare system. It should raise red flags for the policymakers that the system is in dire need to be rescued lest every American have the same chances of surviving an ailment as the citizens of any other industrialized nation do.


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