Total expenditure on health as % of GDP (2004): 15.4
Moore appears to be wrong that Cubans live longer. We live longer, by about six months. But, alas, our child mortality rate is still higher. And we find that, by spending only 6.3% of its GDP, Cuba essentially matches the U.S. in terms of the basic health indicators of it citizens.
These, then, are the facts as they stand. Our health care system is appallingly expensive, and it returns meager results. Any honest debate on the topic must address this data. If it does not, it is not an honest debate, and facts are being withheld for the purpose of controlling the debate. If we hear the charge that socialized medicine is associated with higher taxes, we can now rightly rebut that this is “guilt by association.” Whatever other expenditures exist in these countries, the cost of health care is less.
We must also be on guard against the charge that single-payer health care reduces “choice.” While I have no doubt that this could be the case in some countries, the only relevant question is whether it is necessarily so. There is clearly no reason why it must be so, especially when so many other countries accomplish such remarkable results while spending so much less than we do. We should be able to provide exemplary universal health care to every single American, and make private, “luxury” services available to those wealthier individuals who simply “must have it.”
Take, for example, the French system, as recently lauded in a radically left-wing publication called Business Week:
France relies on a mixture of public and private funding, as does the U.S. But unlike Americans, every French citizen has access to basic health-care coverage through national insurance funds, to which both employers and employees contribute. Some 90% of the population also buys supplementary private insurance to provide benefits that aren’t covered, and the government picks up the tab for those out of work who cannot gain coverage through a family member. “We pay higher taxes in France, but at least we get something for our money,” says Leslie Charbonnel, an American who has lived in Paris for two decades.
The key to France’s success is that its system, like the U.S.’s, values patient choice and physician control over medical decision-making. But France does it for far less, with per capita health-care spending in 2004 at just $3,500, compared with $6,100 in the U.S., according to the World Health Organization. All told, France spends 10.7% of gross domestic product on health care, vs. 16.5% in the U.S.
Keeping Rates Low
“The French model suggests that you can have universal coverage without relying totally on the state, without restricting patient choice, and without abolishing private medical practice and the insurance industry,” says Victor G. Rodwin, a professor of health policy and management at New York University’s Robert F. Wagner School of Public Service.
(The article also notes that the UK’s health care system is problematic mess, a perception which I’m sure many of Moore’s critics will be quick to assert. So be it - at least it is a mess which provides longer lives and healthier children than our mess currently does).
Here is another charge which we must be on guard for - that the higher cost of health care in the U.S. is somehow related to our being on the “forefront” of medical research from which the entire world benefits. That we are at the forefront is an arguable point and worth considering, but, unfortunately for those professional obfuscators wishing to scare the public away from demanding socialized medicine, medical research accounts for only 5.5 cents out of every health care dollar. (Source). Forefront or not, research cannot account for our bloated expenditures on health-care.
Ultimately, the debate about U.S. health-care will bump up against a greater, uncomfortable truth, one which - unless meticulously handled by corporate spin doctors, employing endless smoke and many well-placed mirrors - threatens to undermine edifices aside from those erected by the health care industry. Namely, that even our most basic assumptions about our rights and privileges as Americans in a free society have been bought up and cashed in by a corporate class whose greed is unbounded, whose reach of power has penetrated and assimilated every public institution we deem essential to the democratic process, and which continues to manipulate the very means by which we perceive reality itself. We, as a nation, may soon be approaching a “blue pill vs. red pill” moment of public consciousness.
Andrew S. Taylor is the Associate Editor of Menda City Review, an online journal of literature and political commentary. His own short stories, which veer towards the experimental wing of the speculative fiction/slipstream fantasy genre, have appeared online and in print in various publications. He has also contributed numerous articles and reviews to American Book Review and Ghetto Blaster Magazine.
He holds an M.A. from the Creative Writing Program at The City College of New York, and currently resides in Brooklyn.
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