The US washing its hands of healthcare responsibilities?

liverbird04 · January 29, 2007

http://news.bbc.co.uk/1/hi/programmes/from...ent/6302043.stm

Senator Barack Obama, an early frontrunner in the 2008 presidential race, advocates something the US has never had - universal health care, but just how bad a state is America's health care service really in?

Senator Barack Obama believes health care is a right for everyone

It was the summer of 1981.

Mrs Thatcher was only two years into her first term and Ronald Reagan only months into his.

I was starting out as well. Writing stories for the Beaver newspaper at the London School of Economics (LSE) about students throwing eggs at government ministers and the iniquities of low-cost coach travel to Greece.

I had arrived in London from a boarding school in the West Country and a black and white world had suddenly burst into colour.

My room mate in our hall of residence was a cheerful American with lively eyes and a vague resemblance to Bruce Springstein (a resemblance of which he was enormously proud).

Bo Nora was exotic. My friends at school had been called Patrick or Adrian, and mostly hailed from Somerset.

Bo came from Chicago and studied at the University of California. He was at the LSE for only a few months.

Parting company

Bo and I never felt the slightest bit mortal.

I remember us listening to a programme on the local London radio station where people with emotional problems would call in for counselling.

We laughed.

We had no problems.

I said goodbye to Bo on Great Portland Street tube station and we stayed in touch for a few years.

And then life took over and Bo Nora became a memory.

I moved to Northern Ireland, back to London, to Brussels and here to the US.

Insured but unwanted

A few months ago, 25 years after that central London goodbye, I tracked Bo down.

I found his e-mail address and sent him a message.

His reply talked of marriage and career and children and then came these words: "After several years of increasing physical difficulties, I saw a doctor in 1991 and was diagnosed with multiple sclerosis. I retired due to further disability and incapacity. Presently, I am spastic quadriplegic."

Bo is expensive and the insurers do not want him... and they make it obvious

I went to see Bo the other day in his home on the outskirts of Chicago.

We had supper.

Bo's eyes flashing with recognition as we talked about London and university and people we had known.

His wife fed him.

Bo is not a bitter person - funny how happiness is wired into some people whatever life brings - but one subject genuinely pained him.

Bo has health insurance, I presume provided by the law firm he worked for when he was diagnosed.

This is good news for Bo - bad news for the insurance company.

Bo is expensive and the insurers do not want him... and they make it obvious.

'Cut no slack'

Every year Bo gets a letter asking him if he is still ill.

The story of American healthcare is one of huge expenditure for little obvious benefit

Someone has to fill in a form for him: "Yes, I am quadriplegic; no, no miracle appears to have happened."

He told me recently he had to have a minor procedure associated with the condition.

The bill was $78,000 (£40,000).

In the end he paid only a small part of it himself but of the various entities that chipped in - the state, the insurer, the hospital - you can bet that no-one wanted to, and everyone would have got out of it if they could.

Americans who fall ill are cut no slack. A society which expects everyone to pay their way, expects it of them as well.

As a jolly man selling life insurance pointed out to me the other day, most personal bankruptcies in the US are the result of illness.

Endless letters
The story of American healthcare is one of huge expenditure for little obvious benefit.

By head of population America spends twice the amount Britain does on health.

But life expectancy here is lower and infant mortality is higher, way higher in some ethnic groups.

Most of the money seems to go on overheads and on profits for the many private companies providing care, the hospital groups, the drug manufacturers, and above all the insurance companies which write letters to Bo inquiring about his MS and write incessantly to all their other customers as well, endlessly negotiating, fussing, harassing.

As the costs spiral upwards and private employers ditch their health care schemes to stave off bankruptcy, increasing numbers of Americans have reduced their health insurance to the barest minimum, and when something goes wrong they are dependent on the back-up provided by the state.

So in a nation where socialised medicine is a phrase to be spat out contemptuously, Americans are on course by the year 2050 to spend every cent the government takes in tax, on health-related claims. Nothing left even for the tiniest war.

For the time being, Bo Nora will go on getting his annual letter but all of America is cottoning on to what Bo has known for years: there must be a better way of looking after sick Americans.

If Iraq is eventually resolved, the issue waiting next in line for the president, or more likely for his successors, is restoring health to American health care.

that article on the BBC website brought this to mind which I read a few months back

http://www.guardian.co.uk/frontpage/story/0,,1947278,00.html

Open up NHS to our drug firms, White House demands

Sarah Boseley, health editor
Tuesday November 14, 2006
The Guardian

The White House is lobbying British ministers to allow the world's main drug companies unrestricted access to the NHS as part of a package of free market reforms for the service. The US government is positioning itself behind the giant pharmaceutical firms, predominantly based in America, which have been piling pressure on the body that approves drugs for use in hospitals and for prescription by GPs.
The drug companies claim that they are being held back by the National Institute for Clinical Excellence and have separately lobbied for it to be reformed.

In a surprising intervention, the US deputy health secretary, Alex Azar, forced the issue in London yesterday, ahead of talks with officials following a trip to the US last week by the health secretary, Patricia Hewitt. He said attempts to use rationing mechanisms such as Nice to cut soaring drugs bills would stifle innovation - an argument that is constantly made by the pharmaceutical industry.
Allowing all new drugs to be used in the NHS would result in the companies "fighting it out" on price, Mr Azar said, which would drive the drug bill down.

He made it clear that he was also in favour of the drug companies being allowed to advertise directly to patients. At the moment they may only advertise to doctors.

He also wanted to share the US experience of offering private insurance packages to people on Medicare - the healthcare scheme provided by the government to the poor and elderly. It might be possible for the UK government to consider something similar, he suggested, so that everyone could choose either a basic healthcare deal or top it up themselves if they wanted to pay for more than the state could afford.

Speaking to the Guardian, Mr Azar said healthcare systems in all wealthy countries were expensive, and costs were increasing at a time when budget constraints were getting more real as the population aged. "On the other side we have to focus on long-term innovation," he said. "How are we making sure that we don't take steps on cost containment that are short-sighted and prevent the investment in long-term biomedical research and development and innovation, so that when my kids are senior citizens we have the next generation and next, next, next generation of drugs?"

It does worry me what direction The NHS is going in ,could you imagine if the whole country had the mess of trying to get health insurance? ,what also worries me is the US putting pressure on the british govt to open up the NHS to its companies ,trying to give us some 'friendly' advice about how we can learn all about healthcare from them ,we all know how easy it is to lean on this govt

January 29, 2007