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Doctoring the Health Care System
by Fr. John S. Rausch
November 2007
Michael Moore’s movie, Sicko, opens with a man sewing up his own leg-wound because he lacks health insurance. The audience then learns that 18,000 Americans without health insurance die each year. Those with insurance still face a managed care system that gives a bonus to doctors with a high rate of treatment-denials. One doctor confesses in her testimony that in 1987 she denied a man a necessary operation that caused his death. Her company told her she was "not denying care, just denying payment."
At my video store, Sicko was tagged "comedy." Given that the movie unabashedly promotes universal health care to save lives, is Michael Moore a comedian or a contemporary moralist?
The numbers reveal a sick medical delivery system getting sicker. Reuters reports the number of Americans lacking health insurance rose to 47 million, a spike of 8.6 million from 2000 to 2006. For workers, erosion in employer-provided health insurance registered its sixth straight year of decline leaving just 71 percent of the workforce with health insurance, down from 75 percent in 2000.
With so many Americans uninsured, the U.S. still has the most expensive health-care system in the world. In 2004 U.S. per capita spending on health care averaged $6,280, which amounted to 16 percent of GDP. In comparison, other countries with universal health care spent far less staying healthy: Canada 10 percent, Australia 9 percent and England 7 percent.
Because our patchwork medical delivery system misses people, we rank poorly in the World Health Organization’s latest survey that puts the U.S. as 37th among nations for quality health care. Our infant mortality rate with 77 babies, on average, dying every day in the U.S. rates us 42nd in the world. Life expectancy is shorter in the U.S. than all but 34 countries. Canadians with universal health care live three years longer than we.
In essence, universal health care is neither an economic nor health issue. It is a moral issue. The Catholic Health Association, rooted in the Church’s social teachings, maintains that health care remains the service of healing that can never simply be a business. To affirm human dignity health care cannot merely be a consumer good, but must be a "birth right," hence, a human right.
A strictly market based medical system has failed to deliver. The free market approach has created a two-class system with some patients receiving the most advanced medical care in the world and others going without. Talking with primary health providers in clinics throughout Appalachia–the ones who treat the uninsured and people not covered by Medicare or Medicaid, I hear resounding support for a single-payer system (SPS) for health care.
With more than half of America’s low-wage workers (those making less than $20,000 a year) without health insurance, people of faith are seeing universal health care as a matter of justice that could be addressed by SPS. It eliminates out-of-pocket payments, preserves free choice of providers and establishes public accountability.
SPS is not socialized medicine, but a government-run payment system. The plan pays the medical provider directly without relying on an insurance intermediary. Currently between 15 to 30 percent of health premiums in the private sector go to overhead and profits, while a single-payer system, like Medicare, spends only 2 percent of its revenue on administrative costs.
When one million people file for bankruptcy each year because of medical bills–with 68 percent of them having health insurance when they filed, the system is sick. Advocating for SPS represents the needed therapy for this strained system.
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