American Healthcare: An Oxymoron

American healthcare is an oxymoron and the system represents the country's biggest competitive disadvantage going forward. And yet it is the 800-pound gorilla in the room that’s ignored during these Presidential election primaries and run-offs. Nobody touches the fact that this is a huge business and economic issue besides a socio-political one.

Canadians are lucky on this one. We may have line-ups and our newspapers may occasionally publish horror stories about someone left in a gurney for hours outside an emergency room.

But the U.S. system is the worst-executed in the world and its private sector interests have convinced the government to insure the riskiest people – namely veterans, indigents and seniors – while leaving the gravy to private-sector insurers.

Government in the U.S. provides medical care for more than half of the population, in these high-risk sub-groups. But if government covered all the population, younger and healthier, the cost per capita would decline because these would be spread over a less expensive population of clients.

So the private sector gets to do what it wishes which is to cover those that maximize its profits and the governments are drubbed for the costs of Medicare, Medicaid and other programs for the needy or risky.

So the U.S. has two medical systems: One private-sector for the well-off where insurance companies simply pass along costs, rather than wrestle with them, as do privately-owned hospitals, clinics, labs and physician practices. And another that takes care of the old, disabled, impoverished or militarily wounded.

Suffering

It’s hard to imagine the human suffering that has resulted from this situation. Canadians don’t have the anxiety about healthcare that underlies American existence. People there don’t leave jobs, don’t start new ones or businesses because they fear losing insurance benefits.

Insurance companies, according to Congressional testimony by one physician, pay doctors bonuses based on how many claims for medical care they refuse.
And yet, most of the Presidential candidates duck the issue whenever possible, although it’s becoming harder now that Michael Moore’s documentary “Sicko” has done a good job exposing the system.

But the economic problem is overlooked by everybody. The United States is spending 15.3% of his GNP on medicine and that doesn’t include the cost of litigation over medical bills.

The Inadequacies

-- 49 million people without any insurance. The same number inadequately insured.
-- Despite that shortfall, the U.S. spends about $5,700 per capital compared with Canada's $2,900 and has worse results by measures such as lifespan or infant mortality.
-- Costs are high, even though the system is so poorly executed, because the rich are over-serviced and pampered and the poor under-serviced or ignored.
-- Some estimate is that half of the personal bankruptcies in the U.S. are because of high medical bills due to a catastrophic illness.
-- Congress does nothing. The Republicans and Democrats do nothing. All are co-opted by pharmaceutical giants, the American Medical Association (the country’s most powerful trade labor union), insurance companies and ambulance chasing lawyers. See my blog sources (financialpost.com/dianefrancis) for more information.

A recent Congressional report cited the fact that the U.S. spends more money on healthcare than any other country in the Organization for Economic Cooperation and Development and double the average spent by the 30 member countries.

Medical professionals are paid much higher salaries and fees than elsewhere in the world which has resulted in a serious brain drain of personnel from Canada and Europe. Some 9,000 Canadian doctors now practice south of the border and at least that many nurses or other professionals.

For that and many other reasons, Canadians should hope the Americans do some major surgery.