The American Healthcare Mess …

… It May Get Messier

June should be on the radar of millions of Americans who currently receive subsidized health insurance as part of the Affordable Healthcare Act (ACA). (We’re not talking about the vast majority of Americans who receive subsidized healthcare insurance without realizing they do; that is, employer-sponsored plans.) In June, the U.S. Supreme Court should hand down its decision regarding the legality of the federal government providing subsidies to low income people. Truthfully, though, all Americans should be concerned because, ultimately, a decision against the subsidy provision can potentially increase the already astronomical cost (currently just shy of 18%, nearly double that of the UK, Canada, France, and others [World Bank, 2014]) for everybody.

ACA from its inception has proven very divisive. The vociferous caterwauling of those opposed to the law is hard to avoid and seemly unending. Less heard from are those campaigning for a real American healthcare system; they, too, find ACA an inadequate law and an incremental improvement at best.

It would appear that part of the healthcare problem is reality. Americans have a hard time accepting reality, especially when it counters their notion of being the best at everything. For instance, when you tell people that our country has the highest number of incarcerated citizens and the second highest rate of incarceration, exceeded only by the Seychelles, (International Centre for Prison Studies), many are surprised and many flat-out don’t believe it.

Same holds with healthcare. Of 11 developed countries, the U.S. comes in dead last when rated on efficiency, equity, and outcomes (Commonwealth Fund, 2014 Survey). For many reasons, some of them ideological, many people continue to insist we have the best healthcare in the world (or had, before ACA).

Admittedly, understanding what’s wrong with healthcare in America isn’t easy. Yes, it’s a big, complex machine with many moving parts. That invested parties do their damnedest to confuse and distort the basic facts makes the task no easier. Combined with people wondering how they benefit from helping others obtain affordable healthcare throws up more barriers to accepting the reality of the situation: that a healthier population helps everybody to healthier lives and lowers the overall cost to everybody, too.

We can’t do anything about the pending Supreme Court decision. We can, however, suggest two ways to learn more about our current situation and how we got the inadequate half-baked solution we now have.

First, take a look at “8 facts that explain what’s wrong with American healthcare” based on research by Sarah Cliff of Vox. It’s as close to reality as you’re going to get on the subject. It also includes some video, amusing at that, so it’s not all drudge.

Second, for a good examination about how we got the employer-based health insurance system we have today and how we ended up with ACA to fill in some of the gaps, read Steven Brill’s

America’s Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System. Brill explains why we went wrong, when we went wrong, how we attempted to rectify our mistakes, why we failed, and how what we ended up with, the ACA, has left pretty much everybody disgruntled.

Blame it on the vested money interests: hospitals, doctors, insurance companies, and pharma; blame it on politics and our historical ideological divides (like the socialism bugaboo); blame it on a generally uninformed population, many of whom are happy to work against their own best interests. There are certainly plenty of places to point to.

You can hold any opinion you wish on healthcare in America and how to pay for it. But opinion without fact isn’t worth much. So take a look at sources we suggest that avoid most of the polemics. c/w


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