The Worst and the Most Expensive Health Care

Algernon Austin presents an excellent, concise, and wonderfully read scholarly examination of the complicated landscape of race, class and popular perception. Besides the prison industrial complex, black strides in education, poverty rates, crime and other indices contradict claims that blacks are “moving backward.”
--Jeffrey O. G. Ogbar, Director, Institute for African American Studies, University of Connecticut and author of Black Power: Radical Politics and African American Identity (The Johns Hopkins University Press), 2004 and Hip-Hop Revolution: The Culture and Politics of Rap (University Press of Kansas), 2007.

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The number of Americans under age 65 without health insurance coverage rose to 45.7 million in 2008. Although 2009 data is not yet available, there is every reason to assume that the number of Americans without health insurance continued to grow in 2009. And that it will continue to grow in 2010, and in 2011, and so on. It spite of this dreadful trend, it seems that some are determined to do nothing. What's more, they are determined to stop anyone who tries to address the problem.

Among rich nations, the United States, without question, has the worst health care system. We are the only rich nation that this problem of the uninsured. In Australia, everyone has health care. In Japan, everyone has health care. In Switzerland, everyone has health care. In the United States, almost 50 million do without.

Not only do we have a large population that lacks good access to health care, we pay more for it. Other rich countries pay less per capita in health care costs than we do. The Australians and the Swiss pay about half what we pay per capita. The Japanese pay even less. Again, these countries cover their entire population. We don't.

If we do not find a way to reduce the cost of health care and slow its growth, health care will bankrupt the country. By the end of the century, rising Medicare and Medicaid costs are projected to cripple the federal government. A step in the right direction would be to make our health care system more like Australia’s or Switzerland’s or Japan’s which could cut current costs in half.

The final cherry-on-top of our health care dysfunction is that we have some of the worst health outcomes among rich countries. We have the highest infant mortality rate, the highest obesity rate, and, in life expectancy, we are near the bottom. Americans should be screaming for health care reform, not against it.

If reason played a role in American politics, we would have spent part of last year being educated about how other countries manage to provide health care for all, pay less than we do, and deliver high quality health care. (See PBS' Frontline: Sick around the World for what this education effort would look like.) The fact of the matter is that different countries do different things to provide universal health care. We could have reviewed a menu of options and voted for what we liked. That would have been the reasonable thing to do.

Reason, however, does not seem to work in American politics. Now, it seems that the only way the American health care system will ever be reformed is when the millions of uninsured mobilize and organize and demand it from our politicians. Until then, petty politics will ensure that we continue to have the worst and the most expensive health care.

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--Algernon Austin, Ph.D.

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