Why U.S. Health Care Needs the Glass-Steagall Principle
The extreme low rankings of health condition in the United States, compared with 15 other OECD nations studied in the newly released report, U.S. Health in International Perspective: Shorter Lives, Poorer Health, focuses attention on problems which cry out for reinstating the Glass-Steagall law, as gateway for the credit to rebuild the physical health care delivery system in the U.S., and restore the principle of commitment to the public good, and provision of health care for all. This outlook was codified in the U.S. as of the 1940s, under the famous Hill-Burton Act; but then, by the 1980s, the commitment was taken down, to the point under Obama today, of killer-policies, as summarzied below.
The terrible devolution of the United States, is shown in the dramatic, detailed comparisons of poor health parameters in the USA contrasted with those in such other nations as Japan, Australia, Canada, France, Britain, and 10 others. (see EIR, vol. 40, no. 2)
However, the rapidity of the financial and economic collapse internationally, and imposition of austerity as the (Hitlerian) "solution" — especially in the Transatlantic — is causing terrible rates of sickness and death in Europe.
In Britain, the subversion of its nation-serving, 60+year old National Health System, has reached the stage of a program — the Liverpool Care Pathway — to hasten death for designated victims, in order to "save money" — exactly the Hitler T-4 principle of eliminating lives not worthy to support.
These instances all show that fascism is coming back full-fledged, unless this gateway to hell is defeated, and fast.
U.S. Health Care Compared
The new, 378-page report on "Shorter Lives, Poorer Health" in the United States, published by the National Academies Press, and done by several agencies, including the National Institute of Medicine, covers the period going back to the 1980s.
U.S. health care spending per capita is far beyond any other nation, at about $9,000 per capita as of 2012. This is 2.5 times the OECD average, twice that of France or Germany, and about three times that of Japan. Spending as a percent of GDP, at over 17.6%, is also much higher. The OECD includes not only Europe and the U.S., but also South Korea, Turkey, and Mexico.
Yet, at the same time, the U.S. has fewer practicing physicians per 1,000 population, at 2.4, lower than the OECD median of 3.3. Americans make fewer physician visits per year, 4 compared to the OECD average of 6.4, and have fewer and shorter hospital stays, although these cost much more. The short hospital stays also mean that ill Americans, including the elderly, are being sent home from hospitals to be nursed by relatives or friends — if they are available.
Prescription drugs are also much more expensive in the U.S. In Germany or Great Britain, prescriptions for insured patients, i.e., all national citizens and residents, are either free, or cost the equivalent of $10-$20, and no more.
The International Federation of Health Plans comparative price report for 2011, documents that U.S. fees for doctor and hospital visits, as well as just about every clinical test or procedure, are double or even more than those of other developed nations. Costs in Canada were closer to the U.S., but still significantly lower. For office visits, Americans paid two to five times as much. Charges for hospital stays, averaging almost $16,000, are three times those of Germany, and almost four times those in France, although hospital stays are longer in both those countries.
In sharp contrast to the heavy financial burden health care imposes on Americans, personal bankruptcy, or even amassing heavy debts due to medical expenses, is simply both impossible and inconceivable in western Europe or Japan, because the coverage under these systems is comprehensive. In the U.S., medical costs are the cause for 62% of bankruptcy filings, according to a study by the American Journal of Medicine published in 2009. Some 75% of those bankrupted by medical costs had or had had medical insurance.
Thus, the reasons for the big differences in the costs for health care in the U.S., and in nations with regulated systems, are simple. They include assured, mega-profits for the private insurers, administration costs which are at least 30% of the expenditure, advertising (!), and the cost of delivering extremely expensive emergency or hospital care to the un- or under-insured, for many illnesses or conditions which, as the reportU.S. Health in International Perspective: Shorter Lives, Poorer Health emphasized, could have been detected and either cured or at least effectively treated much earlier if the patient had had access to primary care. In addition, physicians do not have to pay the insane, hyper-inflated costs of higher education they do in the U.S., nor are they subjected to the insanity of excessive malpractice litigation, a plague traceable at least in part to the excess of lawyers in the U.S.
The Bismarck "Solidarity Principle" System
One outstanding difference between health care delivered in the U.S. and that in the 15 other nations studied in the new report, is that the U.S. today, is the only one which does not even require, let alone attempt to ensure, universal access to health care for all citizens and residents. Look at some relevant history, of the principle of government regulation involved in providing access to care.
Whether the German system, dating back to the Bismarck era of the late 19th Century, which is based on private Krankenkasse insurance funds, and is the model for most of the public-private cooperative systems used in continental Europe and Japan, or the single-payer National Health Service in Great Britain, an essential element of these varying systems, is that these health care systems are all strictly REGULATED by state and/or national governments, in cooperation with the insurance funds themselves. The health insurance funds exist, as the public utilities in U.S. once did [not that long ago!], to deliver an essential service, not to make a profit, and are regulated accordingly. In the Hill-Burton era in the United States, most of the health insurance was private — for example Blue-Cross/Blue Shield—but non-profit and regulated.
These health care systems are also all based on what Germans call the solidarity principle. The German Krankenkasse were set up as part of Bismarck's original program for general welfare, which included old-age and disability pensions. Everyone pays a regulated percentage of earnings [about 8%, matched by your employer], which provides the same comprehensive health care for everyone, regardless of income, age, existing health problems, or anything else. You keep the same insurance your entire life: if you are unemployed, disabled, or retired, the insurance is covered by government funding, so no one ever loses health care. Fully private health insurance is also available throughout western Europe, but, because it is also strictly regulated, it delivers far more comprehensive benefits for the premiums paid than U.S. plans do.
USA: The Hill-Burton Build-Up, Then the Takedown;
Now the Hitler-Obamacare
In the United States, the principle of universal access to care, and the commitment to provide the physical system to deliver that care, was respected and codified in the 1940s Hill Burton Act. The "Hill Burton Principle," as it came to be known, set forth in merely 9 pages, the authorization to provide a network of hospitals cross-country, with specified ratios of modern beds and services per 1,000 citizens in each county, and networks of accompanying services. Hill-Burton also required that hospitals built with federal funds provide free or low-cost care to those who could not afford to pay.
With the still-sound financial and credit system — notably secured under the 1933 Glass-Steagall Act—there was an extensive expansion of medical facilities, under the joint funding between states, localities, and the Federal Government, which allowed the attempted provision of treatment for all. For example, public health measures were taken, to roll back TB, and conduct and apply R&D on other diseases, for example, universal inocculation to defeat polio, etc. This all continued up through the 1960s.
Then, this very commitment of care-for-all, and delivery systems to provide it, were undercut drastically, in two key turning point periods. First, there was as of the 1970s, the onset of the casino economics era, which included, in particular, the passage of the 1971 HMO Act. Over the ensuing decades, U.S. health care infrastructure contracted, all the while that privatized, for-profit insurance increased its percent of rake-off.
The level of general health in the United States began deteriorating in key ways, including even that, by 2000, for the first time in a century, the U.S. saw a measurable increase in the rate of infectious disease.
Next, in response to the general economic decline, came still more extreme degradations in the U.S. health care system, following the lead of the Tony Blair (1997-2007) period initiatives against the British National Health Care System. These were based on the Hitler 1939 principle of designating lives-not-worthy-to-be-maintained. In 1999 Blair put in the NICE death panel (National Institute for Health and Clinical Excellence), to decree what treatments would be denied for whom; and by 2003, he launched a wholesale subversion of the NHS physical delivery system, through for-profit privatization.
This was pushed hard in the United States 2000-2010, and implemented under Obama. In fact, Blair's very NICE originator, Simon Stevens, personally came over to the United States, to the United Health insurance firm, which now is the biggest profiteer insurance operation in the U.S., with over 75 million policies. Thanks to this subversion process, the U.S. has the highest health care costs in the world, and a plunging quality of health.
The United States needs the Glass-Steagall standard system of regulation for its vital health care as much as it does for its banks!