A Private Obsession (Krugman on lack of health care in US)

E-mail: krugman@nytimes.com

http://www.nytimes.com/2005/04/29/opinion/29krugman.html?th&emc=th

April 29, 2005
OP-ED COLUMNIST
A Private Obsession
By PAUL KRUGMAN


American health care is unique among advanced countries in its heavy reliance on the private sector. It's also uniquely inefficient. We spend far more per person on health care than any other country, yet many Americans lack health insurance and don't receive essential care.

This week yet another report emphasized just how bad a job the American system does at providing basic health care. A study by the Robert Wood Johnson Foundation estimates that 20 million working Americans are uninsured; in Texas, which has the worst record, more than 30 percent of the adults under 65 have no insurance.

And lack of insurance leads to inadequate medical attention. Over a 12-month period, 41 percent of the uninsured were unable to see a doctor when needed because of cost; 56 percent had no personal doctor or health care provider.

Our system is desperately in need of reform. Yet it will be very hard to get useful reform, for two reasons: vested interests and ideology.


....The most striking inefficiency of our health system is our huge medical bureaucracy, which is mainly occupied in trying to get someone else to pay the bills. A good guess is that two million to three million Americans are employed by insurers and health care providers not to deliver health care, but to pass the buck to other people.
........

...and the two million dollar cabin in the Rockies.

Who lives in them? Doctors and health insurance executives.

is a good, efficient public health care system.
Medicare is bad enough, I mean it causes political eruptions
every time they try to gut it.

American health care is unique among advanced countries in its heavy reliance on the private sector. It's also uniquely inefficient. We spend far more per person on health care than any other country, yet many Americans lack health insurance and don't receive essential care.

This week yet another report emphasized just how bad a job the American system does at providing basic health care. A study by the Robert Wood Johnson Foundation estimates that 20 million working Americans are uninsured; in Texas, which has the worst record, more than 30 percent of the adults under 65 have no insurance.

And lack of insurance leads to inadequate medical attention. Over a 12-month period, 41 percent of the uninsured were unable to see a doctor when needed because of cost; 56 percent had no personal doctor or health care provider.

Our system is desperately in need of reform. Yet it will be very hard to get useful reform, for two reasons: vested interests and ideology.

>>snip

http://www.nytimes.com/2005/04/29/opinion/29krugman.html?

As a user of the american health care system for 43 years, the whole beauracracy is incredible inefficient. Just my $0.02 for a universal, single-payer system.

America is being crippled by it's mythology of "privatized services are more efficient and/or competitive than public services"

It may be better at some things in some circumstances, but the production and delivery of health care, water and power and guaranteed public pension funds are best left to the public sector.

Privatization is a socio-political fad and a harmful one at that. In the fields just named, privatization will only allow a few people who already have more than enough money to make some more and do nothing to produce or distribute goods and services. Is there a nation in the world with a public health care system, even one beset with problems, that would trade it for a system modeled after ours? It's long past time that we modeled ours after those that work; ours doesn't.

This aspect of the problem does not receive enough focus. Compared to their international competition, US firms have to spend more for their insurance coverage putting our industries at a disadvantage. The problems GM is having now are directly linked to the rising burden of health care costs.

The social justice argument for universal health care is compelling for a lot of people, but not sufficient on its own to build momentum for support. Democrats would do well to hammer home the point that our lack of an efficient health care system is costing us jobs.