Saturday, September 21, 2013

Health care in America is funded by the government to a greater extent than in Canada (reprise)

Little known fact: Health care in America is funded by the government to a greater extend than in Canada. Between Medicaid, Medicare, Military Health Care, and emergency room services for the non-insured or the under-insured, the American government pays US $2,728 per person per year for health care.

In Canada, the government pays only US $1,893 per person per year. That's 30% less.

With that money, the Canadian government manages to cover everyone with world-class quality care. Even though the American government is paying more per head, its money only manages to cover a small fraction of its population, with the rest being left to fend for themselves with private insurance companies. These companies charge higher prices for coverage than even the USA government spends, let alone the Canadian government (about US $8000 per year) and outright refuses to offer their services to 20% of the population.

This leaves the United States with the largest population in the world without access to health care, and the highest rates of bankruptcy. In the US having a medical emergency often means going bankrupt. Bankruptcies arises whether or not you have private health insurance coverage since private insurances cover so little (when they do offer coverage) that their disbursement are rarely sufficient to avoid bankruptcy. 62% of all bankruptcies are caused by medical events.

The strangest aspect of American health care is the presence of folks who are rabid defenders of the American system, who speak without any awareness of the current system's failings, and without any knowledge of the alternatives.

The case of death panels angst is particularly poignant, since one keystone pillar of the new health law is to force private insurances to abolish their "Do Not Treat" list -- from 20% (mentioned above) down to near zero. The law:
  • Forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that)
  • Says health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit".
  • Says insurers can't just drop customers once they get sick.
  • Forbids "pre-existing conditions" for kids under the age of 19.
and on January 1st, 2014,
  • no more refusal of care because of pre-existing condition at all.
The law does all this without establishing any new form of government coverage (Medicare, Medicaid, Military health care, and uninsured health care remain largely unchanged.) What list could "death panels" possibly be referring to? Nothing at all, that's what.

Then there are the claims about the amount of money different governments have to spent, claims that certain numbers ought to be ruinous, yet the arguers never put in the effort needed to look up the numbers. In many anti-Obamacare posts, the key thing to notice are the appearances of the word "handout", which reveal the nature of their conception of the role of government.

While governments are generally constructed to take care of domains where the private sector does poorly (such as health care -- the specific economic reasons are too long for this post, but are covered in most introduction to economics textbooks, if you are curious). Anti-handout people understand governments principally as a transfer of wealth to receivers of handouts. This attitude is also known as class-war-ism, and is one of the most corrosive forces in modern American politics.

Government Number Source, Wikipedia

For more details on the content of the new Obamacare law, read this fantastic post in the fantastic subreddit titled Explain It Like I'm Five.