The staggering cost of private health insurance in America

Posted: Tuesday, March 09, 2010

We have been swamped with information and opinion about health care reform - much of it deceptive and blatantly self-serving, and most of the rest obscure and confusing.

What's been missing is a clear explanation of the costs of our existing system relative to health insurance systems elsewhere. That's essential for honest discussion on how to reduce the cost of providing quality health care for all Americans. Fortunately, reliable data is easy to access.

The Organization for Economic Cooperation and Development was established after World War II to help implement the Marshall Plan. It evolved into what might be called the economic analysis department of the developed world. The OECD maintains enormous databases on economic activity, including health care, in its 30 member countries, including the United States, Canada, Mexico, western Europe, Japan, New Zealand, and Australia. (Source: OECD Health Data 2009 - Frequently Requested Data) All cost data is expressed in U.S. dollars, corrected for purchasing power, making it easy to compare how we fare relative to other developed nations.

I've selected six other countries for this abbreviated analysis - Canada, our closest and largest trading partner, Japan, the only Asian OECD member and a major economic competitor, France, Germany and the UK, the major democracies of western Europe, and Switzerland, which is similar to the US in having a private health insurance system.

These numbers - from 2007, the last full year of comparative data - are pretty stark, and getting worse. (The estimated "percent of GDP" figure for the United States in 2009 is up to 17.3 percent.) Private health insurance imposes enormous, unnecessary costs on our economy, decreases our competitiveness, hurts small business, and gets only mediocre overall results.

• We spend nearly 50 percent more of Gross Domestic Product on health than Germany does, and almost 100 percent more than Japan.

• If we spent the same per capita as the Germans or French - who enjoy very high- quality care - we'd save about $3,700 per year for every man, woman and child in the country, freeing $1.1 trillion per year for more productive uses in our economy.

• That extra $1.1 trillion is a hidden tax we Americans pay to keep private insurers in business.

• If you absolutely insist on a private insurance system, a very tightly regulated Swiss-style system wouldn't save as much, about $2,900 per person per year, but would still be a huge improvement.

• Lightly regulated U.S. private health insurance is grossly inefficient, spending more than 30 percent of all health care dollars on administration. Other democracies - and our Medicare system - typically spend less than 10 percent.

• The competitive cost to American corporations is enormous. Less understood is the burden on small business and the self-employed. If health care insurance was universal and attached to the individual, small businesses would be freed from the huge cost, uncertainty and administrative burden of supplying health insurance. It would help them to compete for top employees and level the economic playing field with our international competitors.

• In 2008, 44,789 deaths were associated with health insurance issues (Source: University of Washington / Center for Disease Control data) and 18,314 of those deaths were directly attributable to not having insurance (Source: Institute of Medicine). Of these deaths, 2,266 were military veterans (Source: Harvard Medical School) under the Medicare qualifying age of 65 - five times the number that died in combat that year. Such shameful statistics are simply unheard of in other western democracies.

So, when someone says we should "go slow" on reform, or defends the rapacious status quo, claiming that single payer or public option systems are "un-American" or "socialism", remember what we pay to maintain that ideology - $1.1 trillion and many thousands of needless deaths each and every year. Isn't it time to do the right thing?

• Greg Fisk has been an Alaskan since 1959 and a Juneau resident since 1981. He is self-employed as fisheries development consultant.

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