The three urban myths of healthcare reform

July 20, 2009

Peter Pitts— Peter J. Pitts is president of the Center for Medicine in the Public Interest and a former FDA associate commissioner. The views expressed are his own. —

When it comes to healthcare reform, as Aldous Huxley said, “Facts do not cease to exist because they are ignored.”

Three of the most common “urban myths” of American healthcare are that:
1. The lower life expectancy in the U.S. “proves” the total inadequacy of our system;
2. There are 47 million uninsured Americans — proving the inequity of our system; and
3. We spend “too much” on health care — proving the wastefulness of our system.

As the Ol Perfessor used to say, “Let’s look at the numbers.”

1. Lower Life Expectancy: According to N. Gregory Mankiw, Professor of Economics at Harvard University, “The United States has lower life expectancy and higher infant mortality than Canada, which has national health insurance.”

This fact, according to Mankiw, is often taken as evidence for the inadequacy of the U.S. health system. But a recent study by June and Dave O’Neill, economists at Baruch College, from whom these numbers come, shows that the difference in health outcomes has more to do with broader social forces.

Americans are more likely than Canadians to die by accident or by homicide. For men in their 20s, mortality rates are more than 50 percent higher in the United States than in Canada, and the O’Neills show that accidents and homicides account for most of that gap. Maybe these differences have lessons for traffic laws and gun control, but they teach nothing about the U.S. system of health care.

Americans are also more likely to be obese, leading to heart disease and other medical problems. Among Americans, 31 percent of men and 33 percent of women have a body mass index of at least 30, the dividing line between overweight and obese, versus 17 percent of men and 19 percent of women in Canada. Research by the Harvard economists David Cutler, Ed Glaeser and Jesse Shapiro concludes that the growing obesity problem in the United States is largely attributable to its ability to supply high-calorie foods inexpensively.

Infant mortality rates also reflect broader social trends, including the prevalence of infants with low birth weight, which is correlated with teenage motherhood. Whatever its merits, a Canadian-style system of national health insurance is unlikely to change the sexual mores of American youths.

2. 47 Million Uninsured: This number from the Census Bureau is regularly cited by President Obama and almost every proponent of “universal healthcare” as evidence that the health system is failing for many families. Yet by masking tremendous heterogeneity in personal circumstances, the figure exaggerates the magnitude of the problem.

The 47 million includes about 10 million illegal immigrants. And all the current legislation being considered in Congress specifically excludes illegal immigrants from government healthcare. The “Big Number” also includes millions of the poor who are eligible for Medicaid but have not yet applied. They could be insured, on the government’s dime, tomorrow. And about a quarter of the uninsured have been offered employer-provided insurance but declined coverage, often because of cost. The solution to this isn’t Uncle Sam, MD, but smarter insurance regulation.

A new study by University of Minnesota economists Stephen Parente and Roer Feldman shows that Congress could boost by more than 12 million the number of people who have health insurance without spending taxpayer dollars. The change required is to allow people to buy health insurance across state lines, so they can shop for less expensive policies. For example, a typical health-insurance policy in heavily regulated New York costs more than three times as much as in less regulated Iowa ($388 a month versus $98 a month for the same coverage).

3. We Spend “Too Much” on Healthcare : In 1950, Americans spent about 5 percent of their income on health care. Today the share is about 16 percent. According to Harvard’s Mankiw, “many pundits take the increasing cost as evidence that the system is too expensive. But increasing expenditures could just as well be a symptom of success.”

And he hits a homerun with a clear, concise, and common sense explanation. “The reason Americans spend more than their grandparents did is not waste, fraud and abuse, but advances in medical technology and growth in incomes. Medical science has consistently found new ways to extend and improve lives. Wonderful as they are, they do not come cheap.”

Consider the question posed by economists Charles Jones of the University of California and Robert Hall of Stanford: “As we grow older and richer, which is more valuable: a third car, yet another television, more clothing – or an extra year of life?”

As the old saying goes, everything you read in the newspaper is true, except for those things you know about personally. Healthcare reform is too important (and too complicated) to permit reform by sound bite.


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#3 would only be true if we had longer life spans than countries that spent less. You have extended the marketing mantra of “I’m worth it” to healthcare, forgetting that you have crossed from luxury consumption to necessities.

Take a look at recent Canadian crime statistics – the murder rates in the two countries are converging (still lower in Canada) yet the Canadians spend far less on health care and still live longer. Overall crime rates in Canada are very close to those in the US, which implies to me that stress and other health risks associated with crime would be similar.

Incomes have increased considerably since 1950, so even if the percentage of income spent on health care remained constant, the absolute spending would have increased. The reality is that the percent of income increased by a staggering amount, and incomes also rose. The combination should not be ignored and certainly is not a “symptom of success”. What is the logical end to this progression – will you declare total victory when health care costs are 50% of income? 95%? The percentage has tripled in approximately 60 years – in another 60 years, the percentage will be close to 50%. We can extrapolate this trend to mean almost 100% of income going to healthcare in 100 years time. Success? I have a 2-year-old – how can I live with myself knowing I have guaranteed she will be bankrupted by healthcare costs?

Would you like to revisit #3 with more persuasive arguments?

This article is “anti-reform by sound bite”. Shame.

Posted by David | Report as abusive

Very good points. I would suggest also, that much of the problem with the healthcare system is the fact that we already have at least the two large government run programs, Medicare and Medicaid and overregulation of the insurance industry. It is difficult for any private insurance company to provide and expand their offerings when they are competing against government programs that are subsidized by taxpayer money. It would be the death of all private insurance if a third ‘public option’ is mandated. Many folks that choose not to purchase insurance now also know deep down that they will get at least emergency care because government (our politicians) has mandated it… So, why should they bother? We don’t need more government regulation and programs. We need less.

Posted by Ann | Report as abusive

In my opinion is that “Peter J. Pitts” is not doing a good job to the american people, but is only his own opinion and of course not framed on a real and deep analisys of the american society in terms of social and especially about the health system, one thing that is of key interest to the prosperity of the americans as a country.

If USA wants to be a real great country must be great also in the “health system” giving to all, at affordable prices (specially to all american people, and of course the people who visit the USA).

I am an alien who visited a lot of countries as tourist, and traveled through many places of Canada and I know more or less the health system from this country.

I traveled much more through USA (east and west) and unfortunately I had to go to an hospital because I felt sick. I was there during 10 hours and they giving me a very poor attention (but giving an excessive attention to some other details, only to justify and catch a great amount of money in the end, at point that the final bill was so huge that I considered completely a robbery (I say this with great respect to all american people, but I think that this incident don’t deserve any respect). What I count here, in my country would be considered completely unacceptable.

The americans with less money deserve better, because waht I count here, is what happens to who don’t have enough money to pay for health (that wasn’t much my case), or even worse, because the “the doctors and insurances” present bills to pay much more that the service they provide to the people.

Sorry for this long text, but I think that I am providing a better service in order to inform the american people and making them to be more aware about this problematic.

Posted by Carlos | Report as abusive

Wow, what an amazing effort to obfuscate the facts about healthcare in America. I wonder which insurance lobby is paying Mr. Pitts.

Point 1 — while gun violence is clearly not a healthcare issue; the obesity epidemic and teen pregnancy certainly are. At a minimum they are serious public health issues, and any compentent nation would address these issues as part of a comprehensive approach to national health.

Point 2 — one can argue the numbers of the uninsured (and more seriously the underinsured who pay for worthless insurance), but that fact that a significant fraction of our population lacks insured access to appropriate health care is a moral blight. Shame on you Mr. Pitts for your “I have mine — too bad for you” attitude.

Point 3 — one word — France. Anyone that can argue that the US, by spending twice a much per person, but getting a fraction of the results is clearly on the insurance lobby payroll, pocketing the difference. It is not success to line insurance pockets instead of providing care.

What a shameful editorial, Mr. Pitts.

Posted by Jeff Hovis | Report as abusive

Wow! This article ought to be required reading for every legislator, with copies to His Highny.

Posted by Anson Galyon | Report as abusive

Health care is not a new car. it is not a luxury or a privilege to be based on class and income. the health and very lives of Americans is not a product.

“many pundits take the increasing cost as evidence that the system is too expensive. But increasing expenditures could just as well be a symptom of success.”

this is what this says. it may as well be referring to a new development in air-bags.

there is a problem sir. a very large one. I will not copy and paste quotes and figures to express something which affects my life. the plain fact is the $98 dollar insurance you speak of is a joke. no American who tries for affordable insurance would agree that it benefits anyone but the company. these companies very foundations lie in the denial of payment, treatment administered to a client is referred to as a “medical loss” in their own terminology.

the average lifespan of Americans is affected by the lack of preventative medicine, a symptom of the aforementioned “medical loss” approach to the administration of medicine. to many Americans it is not an option unless they wish to go into insurmountable debt.

our system is nothing short of greed unchecked.

this is the only civilized nation on the face of the planet without socialized health care. we are not an island, we do not always know best. the systems implemented around the world in countries like England, whos currency is worth twice ours, is not only universal but highly successful for all parties concerned.

the question that arises in our country much too often is this: how much money do you really need?

Posted by jeremy | Report as abusive

Great article…it’s frightening to think what hasty politicians have done throughout history.

Posted by Mike | Report as abusive

#3 Yes, we are spending more because of advances in technology and more disposable income, but why are we spending so much more than other countries with high tech healthcare systems and high standards of living? It isn’t all because we are fat, bad drivers with guns. There is huge waste and inefficiency in a system that doesn’t provide any basic primary and preventive care to millions and then intervenes and spends the most healthcare dollars in the last days of life – when most want to die with dignity.

Posted by Stew | Report as abusive

We spend more because we take care of our seniors. We just buried my mother-in-law who had returned to her native country to live out the rest of her years. Universal Health Care killed her. The first night she went to the hospital they sent her home because saying she was dehydrated. The next morning she went back to another hospital to die. She had developed a hole in her intestines that had led to septic chock. My sister-in-law, an ICU doctor, read the reports from the first night and was in shock. In this country, the discharging doctor would have been facing criminal charges (let alone a lawsuit).

Sh was 75. So I guess she had a decent life expectancy – but she probably wouldn’t have died if she had been over there. The doctors in the European country (greece) just shrugged and said they would look into it (and to be fair, the government did order an autopsy because it was considered an unusual death) because there are no reprecussions. At least the private hospital that she went to on the second day did everything right – it was just too late to clean up the socialized one’s mistakes.

This is our future. Over 70, all bets are off.

Posted by Susan, NYC | Report as abusive

The Three Urban Myths the Insurance companies believe in.

1) We have the best system on earth and we don’t need change anything

2) Fantastic health insurance is cheap and everyone can afford the best health care in the world.

3) Insurance companies take care of their policy holders and never get between your doctor and yourself.

4)Your great policy will always be there for you even if you get seriously ill. (see: rescission)

5) Your policy will never get more expensive if you get sick and need that great care.

Posted by Ray | Report as abusive

It is obvious from the comments that one hears precisely what one wants to hear.

Posted by Ron | Report as abusive

It’s really quite humorous to read opinions regarding health care. I have a decent chunk of my paycheck go to healthcare and yet the company refuses all medical procedures I have gone for. I am going for preventative care, which apparently is not covered. And this came after trying to get treatment for a “pre-existing condition” (which they did not cover). So…the insurance giant does not cover care to stop pain before it begins nor do they cover care to stop pain once it starts. Remind me again why I’m paying? Did I mention they only cover less than 10% of my pharmacy costs at the moment? Thanks. Thanks for that, Aetna.

I would like to know who of the legislators and pundits who are anti socialised health care have actually gone without. I did for 5 years and it was a scary time, but since monthly coverage was more than my monthly income, I had to make do and assume the concussion wouldn’t kill me.

Posted by Caty | Report as abusive

I think health care would be much cheaper if the drug companies did not spend their dollars on TV advertising for various prescription drugs with the advise “ask your doctor”
TV time is expensive, and doctors time can be better spent than answering all the patients who want to be evaluated for drugs with serious complication.

Posted by barbara | Report as abusive

This piece is an anti-reform political advertisement which does not deserve a place on a Reuters page.

Posted by Ralph Dratman | Report as abusive

Following the article:
1. Lower Life Expectancy:
This can be carried further. Higher rates of obesity, smoking, infant mortality, and physically destructive behavior are found in lower income groups where uninsured people are concentrated. Ditto occupational exposure to accidents and carcinogens and some differences in exposure due to place of residence.

2. 47 Million Uninsured:
“…The change required is to allow people to buy health insurance across state lines, so they can shop for less expensive policies. For example, a typical health-insurance policy in heavily regulated New York costs more than three times as much as in less regulated Iowa ($388 a month versus $98 a month for the same coverage).”

Nearly everything costs less in Iowa, attributing the difference in medical care costs to regulations in NY is disingenuous. Wouldn’t insurance costs reflect the state of residence? The suggestion also gets states out of regulating health insurance and places it in Washington only. Why does a nominal conservative advocate that? When most of us consider a more efficient medical care system, we didn’t have in mind reducing lobbying expenses.

3. We Spend “Too Much” on Healthcare :
Countries like Germany use more expensive modern medical technology too. Yet they spend a lower percentage GDP on medical care with equal or better results. The US medical care system is not a result of capitalism and markets – it’s a product of decades of pay to play in Washington and state capitols plus tax payer funded basic R&D. Medicine and the financial sector will take 1/4 US GDP in a year or so and are gobbling up the US economy required to support them.

The US medical care/insurance system seems to be the biggest reason for the lack of employment for Americans over 50 or so. That is a real reality disconnection – no economy can pay for increasing lifespans and decreasing workspans.

A little OT – pharma companies are now actually betting billions that they will discover drugs that will retard and treat human aging as such. First likely out of the gate will be Resveratrol derivatives. My guess is that the pharma companies will attempt to limit the distribution of Resveratrol as a drug and sell their derivatives for very high prices.

We might actually start to see a marked separation in life and health spans from income levels. That would add a new dimension to the idea of social and economic classes that could be destabilizing. However, many of the benefits of Resveratrol can apparently be gained by lifestyle changes, especially caloric intake restriction. So the benefit of Resveratrol-based drugs might be to allow the user to live like a slob and survive anyway. People will accept that as a result of ability to pay for the drugs. They may not accept too expensive lifespan extending drugs otherwise nor really expensive but very effective cancer treatments only available to very high incomes.

Posted by maguro_01 | Report as abusive

As one of the few surviving black men in his 20’s left in America after the great (stereotype) gang wars, I must contest: I have never declined employer offered medical nor have I, despite applying twice, been approved for Medicaid.

So what you’re saying is I should just go love myself sidewards and die so you can squeeze in another latte before lunch?

I’ll take genuine reform of an obviously broken (for those of us that fall into that 40-million uninsured) system over your baseless, statistically inaccurate and stereotypical opinion any day.

Posted by Jarrett | Report as abusive

I think people should be aware that Center for Medicine in the Public Interest receives some of it’s funding from the pharmaceutical industry. I think the influence of that funding is evident in the bizarre belief that “increasing expenditures could just as well be a symptom of success”. I guess Mr. Pitts is unaware or unconcerned that medical related costs is the leading cause of bankruptcy in this country.

Posted by Sean | Report as abusive

Buying health insurance across state lines is a facile argument, usually pushed by those who think that deregulation is the answer to everything. It would remove almost all the consumer protections currently in place, giving insurance companies free reign to overpromise and underdeliver.

On the face of it, the lower premiums seem attractive, but the investment banks did a stellar job last year of showing us how well unregulated industries do when it comes to protecting their customers and stakeholders.

Posted by Brent Billock | Report as abusive

Lets lay the problem of health care costs where it belongs. At the feet of the trial lawyers and punitive damages. We should establish a fund for providing care to the people that were abused by doctors, hospitals and business that need to be punished for their crimes and negligence. Individuals can draw from this fund to maintain quality of life. Limit the ambulance chasers to a percentage of actual damages rather than the amount of punitive damages. This would reduce liability insurance to doctors and hospitals, reduce the number of ‘cover your ass’ tests and ultimately reduce the costs. While we are on the subject, we should drive the doctors out of the profession when they exhibit performance that clearly demonstrates that they are more concerned with the money they can make than the wellness of their patients. The insurance companies have a database on every individual that is fed information from the health professionals. Why not do the same for the doctors that are continually sued for malpractice. You might get rid of a lot of crackheads this way. There is no one, NO ONE that can get a decent doctor to tell the truth about a incompetent physician. Doctors are people, people make mistakes but some doctors are forever making the same mistakes. How many doctors have their licenses to practice medicine revoked? It is a crime the way these spineless sycophants will not testify against doctors that are doing a disservice to the profession by failing to offer the truth.

Posted by Ed Smith | Report as abusive

The fastest way to lower health care costs in America is to simply put a 2 million unmoveable cap on lawsuits and require insurance companies to pass the reduced cost to customers. The major reason doctors costs are so high is the extreame cost of thier malpractice insurance which is forced by the unrealistic law suit awards.

Posted by Les Thompson | Report as abusive

Perhaps my story will shed some light upon why we indigent don’t simply trot down and pick up our Medicaid cards:
Having been a stay-at-home mom for 9 years, I suddenly found myself divorced and about a year later lost complete custody of my children after I could no longer afford to hire a lawyer to represent me. There are a whole lot more wrinkles to this story, but let me simplify and explain that entering the job market after 9 years at home during our deep recession and in a great hurry, meant that my choices were extremely limited. Now, working at two part time jobs which allow me no more than 5 hours continuous sleep on any given day and net me a gross income of maybe $1200 per month, I have also been forced to pay child support in the amount of $500 per month. My credit is ruined, my house in foreclosure, but when I went down to the welfare office they said I earned too much money to qualify for anything. I am going to be technically homeless very soon and there is no way that I can afford to rent my own anything if I am going to continue to drive my 15 year old car to work each day. The best part of this story: According to the documents presented at court, my ex earns over $97,000 per year.
My point:
I can’t even begin to afford healthcare coverage through my employers, and having had national healthcare while living overseas during my 20’s, I can tell you that it is hands down, wonderful. We do not need to pay our doctors the enormous amounts of money they receive here in the US. In most other countries, doctors earn a very respectable salary, but nothing like here. We can have highly trained midwives, nurses and Physician Assistants performing most of the services generally necessary in a public health setting with a doctor supervising and referring more serious/specialized cases elsewhere. That is also the norm in other countries. We also need to provide an environment for pharmaceutical research to safely take place without the current emphasis on gouging consumers and finally, get the insurance industry under control or mostly out of the picture. If people want additional coverage beyond what is offered by a national plan, by all means let them pay for that. However, basic regular healthcare should be an undeniable human right. Viewing healthcare as a juicy for-profit opportunity rather than being for the purpose of keeping people healthy is unethical and is the real reason behind our current healthcare deficits.
In need of several basic services but unable to afford them, yours truly.

Posted by Susy | Report as abusive

Why isn’t anyone talking about regulating the great American lottery called lawsuits… Surely that is where the greatest savings in healthcare/insurance can be made!!!

Posted by James | Report as abusive

The reason for health care cost being so high has nothing to do with Medicare and Medicaid.
Most of the people I know who are not insured are not because they cannot afford it.
The one that is offered to them thru their employer is way too high.

You think people don’t want to have health insurance?
How wrong you are.
Myself I know 10 people who need insurance but can’t afford it.

I know one lady who was on disability raising her grand children, has only one leg, had HIV and could not get health insurance private r thru the state.
She finally got it after fighting for 2 yrs but now she has full blown Aids from not getting her meds she needed.

Another young man who is 23 attending college has a part time job , no health insurance he has seizures and panic attacks again no health insurance.

Another one who has a full time job , he needs surgery and now has to put out $1,500 b4 they will do the much needed surgery , money he cannot afford

The way things are now DOES NOT WORK!
Something has to change.
Right now the ones who have health insurance pay more partly because the ones who don’t have to use the ER when they get sick because they ER has to treat them.
Then they get this huge bill they cannot afford so what happens the bill goes unpaid , passing the cost onto others who pay. May not seem right but its the truth.

If you are one of the ones who have health insurance and you think things work as they are how wrong you are.
Heck insurance companies can and will deny coverage of certain things.
And companies if they get wind of a lot of charges within the insurance company that is driving up the cost to the company they can and sometimes will find a reason to can your butt.
oh but in now way will they let on this is the reason , they know they can’t

We need change in our health insurance so everyone can afford it.

Posted by Becky | Report as abusive

Perfect irony, the amount of effort in both this document and in the US Health system… both producing utter rubbish. I recall a highway man phrase that can better describe the US Health System, “your money or your life”. Would you charge your neighbour to drink from your tap on a hot day, shame on you. You speak of free speech, yet wire tap everyone with a beard. You speak of being communism as the greatest evil, but are the highest donaters per capita in the world. You need free health care more than the rest of the world.. the problems you have in the US are exactly like the 3rd world only you are not starving to death but you still think you know better than everyone else and that everything’s running fine. What we see from the outside is as barren and desolate, creating unending misery for the majority of the people. In a place like that, you’d need 200 baseball games a year to distract you from the blatantly obvious.

Posted by John | Report as abusive

jeremy, your statement “ much money do you really need?” statement is frightning. It is not your business to say someone earns “too much money.” The reason we are the leading nation in the world is due to our free market economy. Also, I lost my job 8 months ago. I was suddenly without insurance, and I have a heart problem. I did obtain an insurance policy on my own for $288 per month, with a $500 deductible and $25 co-pay. There was a pre-existing clause about heart disease. For 12 months from the date the policy went into effect I was not covered for surgical or diagnostic procedures with a specialist. But I was covered for physicals, as well as tests-including ekg’s, blood tests and a non nuclear mri. It is possible for people to obtain insurance without the help of government.It never crossed my mind to take money from you or any other American to pay for my insurance.

Mr. Pitts is correct in saying one solution is to allow shopping for insurance outside one’s own state. It is NOT ALLOWED BECAUSE OUR GOVERNMENT prohibits it. I could have obtained the exact same policy if I had been allowed to buy it from an insurer in Idaho-the cost was only $119. But because of people like you who wanted the government making health care rules, I could only purchase in my own state at more than twice the cost.

If we need to provide insurance to the “truly” uninsured, why not cover these people with the same health plans our Congressman have? That idea has been rejected by lawmakers. Interesting that.

Posted by David | Report as abusive

Aside from the ideological and ethical issues of socialized medicine, there are two main issues that health care reform are supposed to address: spending, and coverage for “all” Americans. No matter how you slice it BOTH of the healthcare bills currently in committee in the House and Senate will cost MORE and will NOT cover all of the uninsured (not my analasys, but the CBO’s), and overall quality WILL decline, so may I ask…what the F?!?! If you think this isn’t true then you are lying to yourself. Do a little reasearch and self reflection, open your freaking eyes and mind, and realize that government is not the answer. Honestly, I’m getting pretty tired of the dead weight of liberal ideology – is there anything that you a-holes don’t want a governement agency to do?? Maybe they can come in and wipe your a** in the morning too? And by the way, I’m one of those millions of uninsured, and I STILL see that the DMV equivalanet of healthcare is a crap idea.

Posted by Emily | Report as abusive

Still arguing the health care issue in terms of cost. Once again the root of all of our problems is showing itself. The article focuses on where the money is and where the money should go or not go.

But in health care, it’s HEALTH that is the main issue. The fundamental view that it’s more important to “save” money (for who?), than it is to provide skilled and thorough care is the reason we have the problems in health that we do.

The doctor wants to treat the patient. But the insurance company wants to figure out how to get away with paying for as little treatment as possible while taking in as much in premiums as possible. The two ideas don’t mix and never will.

Profit motive should never be the reason for a health based business.

Posted by Benny Acosta | Report as abusive

Have to agree with Peter Pitts however he did not touch on how poor the health care is in the countries that have national health care. In my previous life I was in the Health care industry and traveled Europe. What our politicians are saying about how good National health care is just an all out lie!

Posted by Pip | Report as abusive

Peter Pitts is right on target, but there are even more myths that have been perpetrated by those critics of our healthcare system that while enjoying the benefits of the American system, somehow want to implement some unknown and unproven system with which they have no direct experience. Using a little common sense on healthcare quality – ask yourself the question, if you had a life threatening disorder, i.e. cancer, heart condition requiring surgery, any other surgery or severe injuries due to an accident, where would you want to be treated if you could access the very best treatment available in the world? Canada? Well, many Canadians come to the US for treatment of these life threatening conditions. I know of no one in the US who goes to Canada (or France or England or Germany or Cuba or another country with socialized medicine) to get the best care when it really counts. For example, the leading proponent of socialized medicine, Ted Kennedy, didn’t go to Canada for brain surgery and cancer care, he didn’t even stay in his home state of Massachusetts. He went to Duke University which provides the best care in the world for brain cancers. (Note that under the current house bill, you would be limited and I assume Senators would be as well, to providers serving your zip code, regardless of their record of quality or cost). Do you know that if you are in many areas of Wisconsin and Minnesota, the quality and cost of your healthcare is competitive with other “developed countries”? Peter Orszag knows because I learned that in person from his presentation. Healthcare is expensive in the US, but that is true of many other things. Ever had to hire a lawyer to stay out of jail or bankruptcy? A Public Accountant to audit your small business? A construction Engineer for your home addition? We are a rich country. Don’t be fooled by life expentancy statistics, the only life expentancy statistic that matters is your life and that of those close to you. For my money, I will pay more to get the best care in the world here in the US at the very best facility for that condition. My 14 year old daughter would be more concerned with having a father now than what the projected costs are at some indeterminate point in the future. She’s smart enough to solve that problem when it occurs. Federal Government healthcare reform is about power and control, Congressman, Presidents and their administration, Bureaucrats and partisans preserving their positions and building their power and wealth. If you believe better quality care at a lower cost for all is what drives the government healthcare agenda, you are either naive or simply mistaken. Either way, I have a nice surgeon and hospital in Manitoba waiting for you when you need your open heart surgery.

Posted by Robert Trinka | Report as abusive

I would like to say, the United States government currently runs two companies:
1. The U.S. Postal Service. This well run government showcase lost $1.9 BILLION in the second quarter 2009-yes it lost $1.9 BILLION. The postal service lost $2.8 BILLION in 2008. And now the USPS wants to go to 5 day delivery, instead of 6.

2. Amtrak has not made a profit since it started operations. Amtrak loses $1 Billion per year.

Now if our government can’t do better with these two services what do you people think it can do with health care? You need to consider that government bureaucrats will run health care the same way they run Amtrak and the USPS.

Posted by David P. | Report as abusive

Great article. You’ve created a compelling argument that blends hard numbers with a readable, informative writing style. Sure would be nice if those out there trying to “re-invent the system” truly just sat down and looked at the numbers. It’s insanity what is going on in Washington.

I am very tired of people simply watching the talking heads and our omnipresent President on TV and gathering their information through clips and one-liners, instead of exploring the issue and trying to actually figure out what is:
a) Going on
b) what is proposed, and
c) How bad this new system will be for America

People don’t want to hear about how the average wait time for an MRI in Canada is over 10 weeks. They don’t want to hear how Canadians actually come HERE for healthcare, because their system is so backwards. They’d just rather sit back, and have the government do everything for them. Then complain when the healthcare they are actually delivered skyrockets their taxes (Even though Obama promised no one under $250k would see an increase) and how they have an even TOUGHER time getting medical treatment. They also don’t seem to understand the extremely simple concept that should the gov step in, they will undercut private insurance companies, forcing them out of the market. That, in turn, will remove healthcare from over 200 million Americans, almost 66% of those with private insurance right now. Its insanity

Sure there are some avenues for reform, ie malpractice reform, insurance reform (like you spoke of), etc…. but a universal healthcare system? No way.

Keep up the fine work!

Posted by Will | Report as abusive

The “Health Care Reform” that is being offered is a misnomer. They aren’t reforming anything. All they are doing is creating a big government insurance company and compelling everyone to participate in it via the tax code. Real reform would entail studying the factors that make health care expensive, that make health insurance expensive, and then working to influence the reduction of such components. This is not being done by congress. Real competition, not regulation, brings about cost reduction. If you let the insurance companies really compete, reduce the malpractice burden on doctors, and eliminate the fraud in the current system, I think we’d quickly see real reform happening. Keep your Uncle Sam out of your pockets.

Posted by Glen | Report as abusive

Having read many of the posts, the problem is obvious
liberals believe it is proper and moral to force
someone else to pay for their healthcare. Socialized
healthcare in the UK, Europe and Canada are certainly
not the shining examples of efficiency and compassion
as so heralded. If so, then why do so many Canadians
cross the border for medical care they can’t get
north of the border.
Healthcare will only become affordable when the
government butts out and the market is allowed to
bring true competition to lower costs and increase
availability for all Americans. Oh, by the way, illegal
aliens will have to for their own as well!

Posted by Steve Miller | Report as abusive

Where I work my company screws up occasionally and we get sued when we do. The amounts are not small either, we pay insurance to cover those suits, and you know what I think most businesses are in the same boat. So why are doctors soooo special they need some roof on lawsuits when they screw up? That’s just a bunch of nonsense, don’t want to get sued, don’t screw up. You’re rates would be lower too.

I am all for private enterprise taking care of stuff and competition ruling who is on top, BUT healthcare makes a bad business model. To work properly, we’d have to break the tie to our place of employment (which creates competition because right now we have none), restrict them so that they had to accept pre-existing conditions, and regulate their rates (both to keep them honest because like I said healthcare is a bad business model for making a profit). They’d complain the whole way.

Think about it a different way, to get the cost of healthcare down you need as many healthy people paying into it as possible, what better way than one system everyone pays into? If you wanted additional care, like mental health you could buy some supplimental private insurance.

I pay over $7000 annually for health insurance I never use and I can tell you right now having seen both what kind of care my father had in a VA hospital and how well Mecicare worked for my mother, I’d prefer either over what I have now.

Posted by William | Report as abusive

Mr. Pitts totally contradicted himself between Statements #1 and #2….

In #1, he told us we had numerous other reasons for LOWER LIFE EXPECTANCY…

in #3, he told us we should stop whining for being forced to PAY for HIGHER LIFE EXPECTANCY.

Foreign countries with HIGHER LIFE EXPECTANCY must either have these same toys at a lower cost or better standards of medical education and intervention.

Either way, Mr Pitts, the representative of Big Pharma has condescendingly told us we are mistaken, so we should just go back in our holes and wait to be gouged once more…

Ever try paying all the hidden expenses that comes from people you have never heard of before after a “routine” procedure or minor operation?

Posted by Todd | Report as abusive

1/3 of all testing, visits, and procedures are done to avoid a possible lawsuit. THAT is a huge factor in the increase in cost over the years. Most debates are ignoring tort reform.

In America we try to save every infant that makes it to 20 weeks gestation. This increases infant mortality statistics.

If one removes gang related homicides, the rates of homicide are equal in the USA and Canada.

Those in socialized medicine do not get whatever they want or demand. Most americans do.

Healthcare reform is so much more involved than, “we are the only civiled nation that doesn’t have socialized healthcare.” (We’re supposed to be capitalist, not socialist.)

Posted by Alan | Report as abusive

I would be thrilled to spend only 5% of our income on healthcare. We have the same insurance that members of congress have – Federal Employees Health Insurance – with a choice of about 6 different insurance companies to choose from. Our doctors are wonderful, the coverage is great but – our premiums alone are 24% of our income and they increased 40% over 2008 but our COLA was less than 2%. Our cost for just premiums and one or two checkup visits (no prescription drugs since we are healthy, barring any unforeseen illness will be $13000, almost half of our $28,000 income. And, very little of that actually goes to pay for health care.

Posted by Patricia Gould | Report as abusive

First Google link that comes up;


Hmmmmmmmmm. Do you think that there may be a bit of bias in his interpretation of the issue?

people like him and Lieberman and Bachus are sticking up for the blood-sucking insurance industry. I don’t know how they sleep at night.

Other than on really expensive sheets.

Posted by mike | Report as abusive

The United States does NOT care to treat the medical needs of lower income citizens!! This is a fact. It is a fact that lower income/no income citizens have a higher incidence of chronic disease which may be the cause of their lower incomes!!! The wealthy do NOT wish to treat the medical needs of the lower income citizens because then there will be even more competition for the higher-paying professional jobs, positions in Universities and colleges, and there will be less people to fill the ignorant day laborer-positions!! Wake up America!!!

Posted by morekare | Report as abusive

It is unfortunate that the medical “industry” cannot find a way to show itself actually apple-for-apple, orange-for-orange better than what other nations have in their health care, and instead has to resort to such pathetic attempts to sway opinion away from reality. Huxley’s admonition would be well addressed by doing a real analysis of our current situation.

Nevertheless, the industry finds itself in a battle of anecdotes, where everybody on both sides can claim that something happened to support their own side or deny the other’s. Doesn’t anybody else see the weakness of their case?

Hmmm. More of us die because of accidental injuries and homicides than in Canada…and that somehow accounts for the numbers for life expectancy? Did you also mention the number of young American men and women that die in wars compared to Canadians? Maybe that, too, should be noted. I guess your implication is that Americans are far more daring and interesting compared to Canadians, and that, too, is because they have “socialized medicine.” Right?

But did your broad generalizations also work for Britain, France, Germany, and Scandinavia? How about Japan? Are you prepared to trot out your simplistic notions against ALL of the nations that have government-sponsored health care, or just cherry pick where the numbers appear to be in your favor?

Your arguments about the 47 million uninsured somehow doesn’t add up. Did you notice? Your actual numbers, as specious as they are, only account for 22 million “uninsured.” Those 1/4 offered but who can’t afford the premiums somehow in your mind’s eye don’t qualify as properly “uninsured” don’t reduce the number. (Ref. Huxley above). And your Medicaid group is an even viler reference. You apparently choose to ignore the circumstances that one must be in to qualify for Medicaid. One has to be completely destitute to get Medicaid, and few people can quickly appear to be living on the streets if they have to qualify for Medicaid support.

This again is the kind of choice offered by our current system. People who are rich have few worries, nor do people who are destitute, but neither group contributes much to the economy, whereas the employed and their employers currently shoulder the burden of private, insurance-based medical coverage, including that received by military personnel and government workers.

Yeah, it’s an equity issue, but far broader than you’re willing to address.

Bottom line: the problem is fundamental. Our current medical coverage is based on an insurance model, which is built on limiting risk. Our medical care needs to be pay-as-you-go and single payer, multi-tiered with multiple providers, all with tight regulations but with freedom granted to care providers to do what is right for each individual.

Those who oppose this ideal do so strictly for financial reasons, and to protect the status quo. They have nothing else to argue about. Don’t fall into their seductively simplistic reasoning.

Posted by Uncle Ludwig | Report as abusive

Here in Washington state we have been spending about thirty percent of our income on health insurance, to the point where our health insurance tops our mortgage.
we have a small business, it so saddens me that we can no longer provide health insurance to our employees.
In part because of the low cost of competing illegal immigrant labor force that took over the home building market.
Thanks to other small businesses that chose to hire illegal’s to remain competitive.
The illegal’s are welcome to free medical and educational services. Don’t get me wrong it is the American businessman and the governments welfare system, the entitlement attitude of many of the American public that causes this situation. For many years I have felt that healthcare and education are the two standards that Americans must share equally. No one should go uncovered.

Posted by Evelyn F Fuchser | Report as abusive

Susy, How much should a doctor make? Do you know what is required to become a doctor? Do you know how much it costs to run a medical office? Did you know that the average doctor makes the same as the average plumber?

Posted by Alan | Report as abusive

Thinking that the immortality rate is lower than we are told does not makes everything better. I civlized society should make health care and treatment available to everyone. If you are the one dying and in need of medical intervention and can’t get it, would you really say that you don’t mind dying because the immortality rate is lower immortality than you thought?

Medicating that our rising cost of health care is ok, even though it exceeds cpi by 400%, is not ok. Insurers are for profit. Our current health care is driven by someone’s financial success and decisions on life or death by one person should not be determined by another person’s greed, lack of critical thinking, or lack of emotional intelligence.

Posted by Rich | Report as abusive

The answer to this particular problem is not socialized care nor can it be left as it is. There has to be some kind of middle ground. I don’t have the answers, I am not so well versed in all of the politics. I do know that I am a 29 yr old single mother who receives no govt assistance (other than thankfully paying for school). The only way I am surviving is that my parents are willing to assist me until my degree is complete, I work a full time job, and have to get additional school loans. I currently have insurance but was without for 8 years previously.
It is obvious that there is no easy or clear cut answer to the Health Care issue but to me there is one thing that bothers me the most. I Do Not Want the Govt to Have Any More Control Than They Already Do! (over this or anything else) The Govt has long been irresponsible with taxpayers money, ignoring the wishes and needs of it’s people and thinking that their position is unassailable.

Posted by Jenn | Report as abusive

1.So how do you explain the infant mortality? To many infants drinkin, driving, and carrying on?
2.According to government statistics, 15% of USA citizens do not have any healthcare coverage. Lets see,15% of 300 million, gosh, 45 million American citizens. Now add the illegals and you have a real problem.
3.So high-tech healthcare is the reason for the higher cost. So why doesn’t high-tech make costs lower and productivity higher like it does in all other industries?Mr. Pitts, you are full of BS.

Posted by DragonMist | Report as abusive

I live in Canada and although our health care system is not perfect, it is better than the American one. Like my dad raise 6 kids on a tight income, so when we needed medical services, good thing it was free. Or now my dad is in his retirement, living on a fixed income, he could not afford such insurance as in the US or to pay for procedure. So when he had a surgery for his prostate, he didn’t pay. Or when I got appendicitis, I did not pay for the surgery or the many followup visits. If you are healthy (and have a good job) or rich the American system is perfect, but for everyone else must be hard to get coverage, to afford it. I hear alot of stories of insurance companies only covering “some” procedures, depending on the quality of coverage you have. I have to admit I’m happy I live in Canada.

Posted by JR | Report as abusive

I agree with Glen’s post — “Healthcare will only become affordable when the government butts out and the market is allowed to bring true competition to lower costs and increase availability for all Americans.” It’s time to allow the free market system to work.

Posted by Deborah | Report as abusive

Rich, please divulge your wonderful source of knowledge. Who in this country is denied health care when they need it? Illegal immigrants can go to a hospital and get care, criminals and ex-cons are all provided care when needed; no one is denied care. Health care needs reform but you can’t provide everything for everyone all the time, don’t allow your soft heart to soften your head.

The expansions and improvements of our medical knowledge are a direct result of individuals wanting to succeed and make life better for everyone and themselves. Part of that drive for success includes making a profit, what a novel concept! Profit is greed though eh? There was a time when I had to suffer through my professor chatter the same thing.

Posted by Joshua | Report as abusive

There is 100% coverage in the US, however it is provided in the most expensive and inefficient way possible:

1. If you’re insured you pay through the nose for a health insurance policy – which can be cancelled and backdated to prior to a treatment even if the insurer already approved it and there is nothing you can do.
1a. If you’re insured a large amount of your tax $$’s cover medicaid, medicare, charity care etc. for the people who aren’t insured.

2. If you’re uninsured, you can go to the Dr, but probably think twice as you will likely be charged 4 times as much as the insured patient. Ironic, as most uninsured are that way because they can’t afford it.
2a. So you don’t go to the Dr’s and get treated for minor ailments and get regular checkups.
2b. You wait, until you are too sick not to seek treatment and head for the place where you can’t be turned away – the Emergency room.
2c. The emergency room provides good care, but can’t give you any medications to take away, only a prescription that you can’t afford to fill, but at least you got an injection of broad spectrum anti-biotics – it doesn’t completely kill the infection, but you feel better for a while.
3. The hospital you visited sends a multi-thousand dollar bill for your care. You can’t pay it.
3a. The infection wasn’t really cured and instead the injection has helped to breed more resistance to anti-biotics into the germs that made you sick in the first place.
4. You apply for medicaid, or charity care or whatever is available to pay your bill.
4a. The hospital passes your delinquent account to a collection agency who begin to harass you.
5. You are turned down for any help with the bill.
5a. The collection agency sues you.
6. The hospital never gets paid for your treatment and has to apply for state aid (see the taxes being paid above).
6a. You have a judgement against you for the hospital bill, but you can’t pay it, as you can’t get a job because you are still sick and your credit is shot and employers won’t touch you.
7 But you did get to see a Dr. Lots of people were employed and paid to try and get you to pay, but you don’t have any money, so I pay them all through taxes, through increased health insurance.

Meanwhile, if we were all covered, a $50 Dr’s visit and a $25 prescription would have resolved the problem, instead the person is still sick, yet the treatment and repercussions from it have cost thousands, all of which is being paid for, by us, still.

Can you get excellent medical care in the US? Yes. In the UK? Yes. In Canada? Yes. Are any of them perfect? No. But anyone who trots out the BS about healthcare horror stories in other countries need only pick up a US newspaper to read the same things happen here – it’s called human error.

Posted by Giles | Report as abusive

Average Doctor income seems to be about $150,000 a year. Average Plumber income seems to be about $50,000 a year. The same? No.

Posted by marnues | Report as abusive

No matter the facts behind the urban myths-we are a nation of overweight, homicidal maniacs with libidos out of control, health care in America still needs reform as it is still too costly and unavailable for everyone.

Posted by Amy | Report as abusive

My daughter works for a very small company,in a very small town. She is single,in good health and NOT an illegal immigrant. It is very insulting to suggest that if she were it would be different. She has no health care. Her employer offers it,but the cost is out of sight. If she took it she would not buy food or pay her rent.She is not on welfare,jst has a low paying job.For the area we live in she is lucky she has a job at all. Most of them have gone to China. This country needs to start taking care of her people and really doing it. Not just saying”gosh we need to take care of our people.” I know a lot of people who want to retire,but can’t because a family member needs medical care they could not afford if they left their job.

Posted by Sharon Crawford | Report as abusive

This entire article is crap. The last line states that we shouldn’t be overhauling healthcare based on sound-bites. But there’s no science here. No research. No interest in finding the underlying problems of the system. This is just sound-bites to counter the sound-bites Mr. Pitts doesn’t like.

Posted by marnues | Report as abusive

This is a horrible article; my thoughts resound with the post of uncle ludwig on the first page.

Your statements are as ridiculous and unbased as the facts you perceive to be wrong.

Posted by Lyndon J | Report as abusive

Thanks for a very fact filled and straight forward article. I know there are ways that health care could be improved but rushing a bill through Congress is probably not one of them.

Posted by Leah | Report as abusive

I don’t know where you get the 16% share on healthcare – last year our total health care expenses amounted to over 50% of our income. That was for self-employed premiums, normal visits, and one visit to the emergency room for stitches. I wonder each year how much longer we’ll be able to “do the responsible thing” and insure ourselves.

Posted by Laura | Report as abusive

Mr. Pitts’s statement about being able to get a $98 health insurance policy in Iowa is hog-wash. It doesn’t pass the giggle test. It is worthless like the rest of his comments.

Posted by Malcolm Brown | Report as abusive

Healthcare reform is not what’s needed. PAYING for healthcare is what we’re talking about. The entire concept of insurance has screwed up the concept of individual responsibility and destroyed competiton for my healthcare dollar. REMOVE insurance and watch what happens to the cost of healthcare. So long as we continue to talk about “insurance” as if it is an endless pot of “free money”, this issue will NEVER go away. When you rob Peter to pay Paul, you’ll always have support from Paul.

Healthcare is a privilege, not a right. Why? Because rights cannot be paid for with money. They are beyond value.

So why should I have to pay for someone elses privilege? This is a rhetorical question since Peter agrees with me and Paul does not.

Posted by Dave | Report as abusive

My wife and I lived for two years in England, and the NHS service was terrific. They accepted us without question into the system even before the minimal paperwork was completed. I can’t imagine them turning down “illegal” immigrants. The birth of my son cost not a penny. A nurse visited us every day for over a month to make sure he was doing well.

Now we are back in the US. My employer has to pay a lot of money for our insurance. But that is not enough, I have to supplement it as well. And most of our medical expenses only get applied to our deductible (are we patients or cars?) The insurance company stands between me an my choice of doctor. When accidents or real medical problems occur, I get numerous bills from various doctors and related medical services.

Why is a simple tax not easier than all of the ways the US “private” systems skins me every year? If the US medical system cannot meet the need, then a National system is the only way out.

Posted by Wendel | Report as abusive

Excellent article! Some things to consider:
Health care costs money. Money doesn’t fall from the sky.Somebody’s got to pay for it and somebody’s got to make sure it is spent wisely. Bloated bureaucracies do not spend money wisely. (Anecdotal evidence suggests that the SSA employees who met face to face at a resort spent about $700,000 for the meeting. This could be accomplished much more cheaply via tele/videoconference. Insurance companies are very good at controlling health claims costs – because they are focused on delivering a profit to their shareholders. They do the resort thing too with premium dollars because they deliver that profit. Their executives are extremely well paid.Thye have to motivate their sales teams and grab market share via favorable lobbying.

Lifestyle choices affect health care costs. How do you make behavioral changes in a person who’s made some poor choices in life. Behavioral changes take time to make. The teenager who is hooked on drugs (including alcohol) is not likely to change behavior within a 12 month window. These changes take time. The provider (Dr.) has no incentive to make sure these changes occur. Health insurance is a 12 month product, usually from the employer. Unenlightened employers do not see the value in encouraging healthful changes in behavior.

Today’s health care is very much different from the health care of the 50’s or the 60’s. In the 60’s if you presented at a hospital with a heart attack, you had a 60% chance of survival. Today it is 80%. The technology also has improved. Things that were not possible before is fairly routine now – liver transplants and the like.

Avoiding health care costs should be the primary focus of health care reform. Four chronic conditions eat up most of the health care dollars. If these chronic conditions can be avoided or at least mitigated the dollars spent on them would be greatly reduced.

Where are the trial lawyers on this? Waiting to pounce on their prey for “malpractice”! They’re watching and licking their lips because suing the government is a very remunerative activity especially since the government can print money.

There is a lot of support for “health care reform” – whatever that is. If you asked people if they would like a nice lunch and not have to pay for it, that proposal would also get a lot of support.

Posted by Seakay | Report as abusive

“The [one and only] reason” health care costs have escalated is “not waste fraud and abuse but advances in medical technology and growth in incomes.”

“The” makes this a whitewash. “Growth in income” gives it away–whose? MD’s? Insurance companies? Get off it–if there were one and only reason it would be the unregulated medical system which allows waste, fraud and abuse and is as unaccountable as unregulated banks. Hitech med
helps too, no doubt. But until regulation and accountability we’ll never know the percentages.

Posted by Michael Kubara | Report as abusive

OK. I’ve seen BS on both sides of this argument. What is it exactly we are trying to fix? I could go on with endless anecdotes about health care delivery, but that doesn’t answer the question. If it’s coverage, easy enough..allow those looking for coverage to get it where it’s cheapest, whether inside or outside of their own state (that would be regulatory reform of insurance). If it’s cost of coverage, let’s figure out what the cost elements for the insurance pool are that is driving up cost and go after those (a government offering will not fix this by a susidized, artifically low premium). If it’s the actual cost of health care delivery, let’s look at the cost elements there (including government paperwork, malpractice insurance, and redundant testing).

Posted by wildbiker | Report as abusive

Americans don’t just spend their income on health care, they spend their debt and credit. Pitts give little to no proof of his third point. It is possibly the worst premise I have seen. An LSAT student could see that. Blaming the statistics is not the same as refuting them. Using social problems and stigmas to explain why our health care costs are so high is useless.

Pitts only good point is about the market for insurance coverage. Expanding the market would theoretically be beneficial for health care coverage. However, Pitts would not dare approve of actually regulating the insurance market to the extent needed to cover the remaining 25 million people without coverage. And coverage has no equivalence to low costs.

Posted by PJ | Report as abusive

Too bad Reuters did not identify CMPI or Mr. Pitts as the conservative shills they are. CMPI was born out of a conservative think tank, Pacific Research Institute, and is funded by pharmaceutical companies.

Do you wonder why Mr. Pitts contributes no real data or points to the health care discussion? He has a point of view he is paid to represent, not unlike when he was in a PR firm. Who pays? Check his organization’s web site carefully. You might also look to Don’t be fooled by organization names or mission statements. Remember the dictum: “Follow the money.”

Posted by William | Report as abusive

Our physicians make way more than they do in other countries.
we have far more diagnostic and imaging facilities than other countries. We use our health care, and take way more drugs than they do in other countries. Therefor our cost are much higher.
Our system of employer provided health care is a joke.
Everyone should buy their own coverage and they would
than be aware of the true cost.Than you will see cost come

Posted by pjack | Report as abusive

I firmly believe that moving from the current privatized system to a public health system will not change anything at all. We simply are mving from private insurance to a public plan that is run by the government. Nothing is being done to create the change that is necessary to bring down the cost and increase the availability of care. How about focusing on wellness? There are so many state and federal mandates right now that cause premiums to be higher. There are ways to fix the current system but it’s such a huge cycle that it’s going to take years if it’s properly. All the current government wants to do is stamp their name on this public option. Please, do your research. Don’t believe everything you read and hear on TV. It’s not all fact. Or will you be happy when there is a public plan and you aren’t able to choose your benefits? Don’t worry, someone that just got fired from Wendy’s will make that decision for you.

Posted by Shellie | Report as abusive

“Profits at 10 of the country’s largest publicly traded health insurance companies rose 428 percent from 2000 to 2007, while consumers paid more for less coverage. One of the major reasons, according to a new study, is the growing lack of competition in the private health insurance industry that has led to near monopoly conditions in many markets.”

“Pharmaceuticals again ranked as the most profitable sector in the United States, topping the annual Fortune 500 ranking of America’s top industries, released this month.”

“The single most profitable industry in the United States, the nine largest pharmaceutical companies generated profits of $30.6 billion in 2001. Over the past decade, drug company profits represented an 18.5% return on revenue, some 5.6 times greater that the 3.3% median return of Fortune 500 companies. And according to Fortune magazine, during 2001 — a year in which the Fortune 500 reported the worst financial performance in the magazine’s 48 year history (apart from 1992, which was complicated by a change of accounting rules) — the drug industry ranked first on all three of Fortune’s profitability measures, including return on revenues, return on assets, and return on equity.”

FierceHealthcare reports the following top 10 CEO salaries for 2008.

* Ron Williams – Aetna – Total Compensation: $24,300,112.
* H. Edward Hanway – CIGNA – Total Compensation: $12,236,740.
* Angela Braly – WellPoint – Total Compensation: $9,844,212.
* Dale Wolf – Coventry Health Care – Total Compensation: $9,047,469.
* Michael Neidorff – Centene – Total Compensation: $8,774,483.
* James Carlson – AMERIGROUP – Total Compensation: $5,292,546.
* Michael McCallister – Humana – Total Compensation: $4,764,309.
* Jay Gellert – Health Net – Total Compensation: $4,425,355.
* Richard Barasch – Universal American – Total Compensation: $3,503,702.
* Stephen Hemsley – UnitedHealth Group – Total Compensation: $3,241,042.
Revenue $M %change Profit $M %chan
1 UnitedHealth Group
21 71,542 58 4,159 26
2 Wellpoint
35 56,953 26 3,095 26
3 Aetna
85 25,569 12 1,702 4
4 Humana
110 21,417 49 487 58

My God People! Wake up and smell the coffee. We are being taken to the cleaners by the insurance companies, the pharmaceutical companies, and the Care givers! To tell you the truth what is happening in Congress is not going to solve these Capitalistic abuses. Health care should not be a for profit industry left to itself and unregulated. The government needs to get a grip on these industries and manage their gouging of the American people. A government insurance option is not going to cut it! It is obvious that the Free Market is not working in these industries. Whether it’s due to not enough providers in the market (Oligopoly) or the fact that we are at their mercy or die or a combination of both it does not matter. It is not working! There are hundreds of billions these leaches are skimming off the sick and injured of this nation.

My solution is to capitalize it all.

I have been to Military Hospitals most of my life. While Triage is a pain, the rest is petty damn good. Good Dr. and nurses and a managed health system that is totally controlled by the government and it is a not-for-profit activity that is successful treating our men and women in uniform and their families. Next, stop giving drug companies exclusive rights to their drugs for so long. And Stop this crap of calling it a new drug because you added some Tylenol to it and renewing the patent. And let’s face it, if they want to sell their drugs they will have to sell them to the government so the hospital/pharmacy will dispense.

This is not as radical as it seems. If the government we so piss poor at running a hospital or pharmacy then they would not be doing it for our military. If it was cheaper and better for our boys and girls to get their treatment on the “Free Market” it would be happening. Get real people! The Government is already running hospitals and pharmacies across this nation. The model works! So stop listening to the spin Dr’s trying to make you believe the government can’t do anything right. The Department of Defense has been running hospitals and taking care of the sick and injured for more years than I have been alive.

Posted by B.Free | Report as abusive

it is obscene when someone can horde billions, more than hundreds of people could spend in a lifetime, when others barely get to afford the cost of their own lives. nobody asked to be here, and to cause suffering so you can horde more money than your entire family could truly use in several lifetimes is a crime against humanity. I’m not against rich, i am against obscenely, greedily rich. people who manipulate our government and our citizenry for such ends. yes, someone should get to put a cap on them, or at least make them pay for socialized health services so the rest of the people at least don’t have to suffer sickness on top of monotonous petty materialism.
Socialism causes apathy by itself.
capitalism causes gross class imbalance alone.
the two need to be mixed.
especially in the medical field.

Posted by jeremy | Report as abusive

When did health insurance pricing get so stupidly expensive? Exit the non profit BC/BS system educators formed so that they could get a health benefit that would not break the municipal budget. It was so wildly successful that it inevitably went to the for profit sector. Less than 10 years down the road (from the change) schools are trying to cut insurance benefits to families. So now what? Single payer SSI run healthcare.
I like it.

Posted by DanO | Report as abusive

1/Each country has affective factors that could as easily be summoned in using this argument.
2/Remove the illegal immigrants and you STILL have too many Americans without healthcare insurance.
3/Fine, spend it on docs and the third homes of the drug company VPs instead of tv’s IF you have the money.

Posted by tom Lennox | Report as abusive

America: A public health system for all is a human right if you are middle or upper class americans why worry you can opt out and go private its still about choice for you. But if your lower class or poverty stricken you need this system as its the only real healthcare for you. I am an Australian and you are falling beind the rest of the world do whats right look after your poor & disabled that is their right from those who have much to those who have not.
Charity can be hard to find certainty is an absolute for the poor, funny how its the rich who are against this the most they dont need to worry or is it a selfish greed not to pay more taxes to help their brothers in need.

Posted by Peter Mitchell | Report as abusive

I live in Canada, our system is great, anything bad you have ever heard about it is a lie.

Posted by Samuel | Report as abusive

Trying to convince people that spending 3 times more on healthcare then 50 years ago is a good thing, just shows scum like this author would sell his own mothers organs if the profit was big enough.

Posted by Moose | Report as abusive

This raises the question I had when Bill Clinton arrogantly declared that 16 percent of GDP (or maybe it was 17 percent then) was too much to spend on healthcare. Who is he to tell me how much of my own money I can spend for any given purpose? Obama should be made to answer the same question.

I’m 70 years old and until this year when I needed my Medicare “A”, no tax payer has ever spent a dime on me except when I was on active duty in the Army. Meanwhile, I keep contributing to Medicare “A” and “B” for others and when I finally need part “B”, I’ll be very angry if the promise is broken.

Posted by Roy | Report as abusive

I tell people who will listen that when my grandfather was alive and working, there was no health insurance. People paid for their health care from their own pocket. If they did not have enough, charity was abundant. When people died it was a tragedy but not a “moral imperative” that government swoop in and pick up the tab. We’ve grown accustom to others paying our bills and the right we declare to health care is but an economic right.

We pay a lot for “health care” today mostly to extend our lives. The length of our lives should not be determined by the amount of money a society can extract from its citizens. Health care reform is not about health at all, but rather who pays the bills – private companies or the government. In either case, the health of someone goes unchanged. We spend tremendous amounts of money treating diseases, many brought upon ourselves because of lifestyle choices. Spending increasing amounts of money to treat self-inflicted disease seems ludicrous at best.

Most of us frown upon stealing from another regardless of the reason and regardless of the wealth of either individual. When a government does it in the name of reform we seem to go numb.

I have a right to life which includes a right to dispose of the fruits of my labor as I see fit. To deny me this right is to deny me the right to support my life. There is no such thing as ‘partially’ destroying a right. You can not create some new medical “right” (which is an actually a declared economic “right” rather than an unalienable one provided in the Constitution) without negating the right to property, and thus the right to life. This is true of any so called economic ‘right.’ If someone receives without working, then someone has worked without receiving. If the “work without receiving” was not voluntary, that man or woman is a slave. This is wrong and needs to be called wrong for the right reasons. It is to bleed dry the life from the healthy and productive in the name of fighting disease. This is true in all economic endeavors that place the so called interests of group or “society” above the actual, self evident, rights of the individual. It is especially ugly to do so in the name of health.

The government has no more business in the health care insurance arena then it does in running banks or car companies. We often forget the words of our founding fathers. James Madison said for example:

“Government is instituted to protect property of every sort…. This being the end of government, that alone is not a just government,…nor is property secure under it, where the property which a man has in his personal safety and personal liberty is violated by arbitrary seizures of one class of citizens for the service of the rest.”

Posted by Jim | Report as abusive

If i’m making enough of a living for myself that I can spend the extra money on health care for myself and my family that i deem acceptable – who do any of you think you are to say i should share my hard earned piece of pie?? If you are too poor to pay for a primary care insurance, you can qualify for state medicaid. If you’re elderly, you have medicaid. If you get fired, you will have a severance package coverage for a period of time that should allot you the time needed to find a new job and insurance. If you can’t qualify for any of that, you need to re-prioritize.
For anyone to tell me that my next door neighbor should get his diabetes meds paid for by me because he drives to mcdonalds 10 times a day to get 10 meals and can’t lift a finger unless it is carrying food to his trap because he’s ‘poor and helpless ‘, you need to do some serious reconsideration.
I am lucky enough to live in Colorado where I have mountains in my backyard and a very active life style. I rarely get sick. The last major medical event in my life involved a basketball game where my leg was fractured. I went to the ER and… brace yourself… paid for everything myself! I didn’t need a handout. I didn’t whine about how other people should pay my bill for me because I chose to play in an aggressive basketball pick up game.
I am in no way, shape or form responsible for illegal immigrants who don’t even pay taxes. I’m not responsible for those too lazy to get a job, or for those who have lost them. I’m financially strapped as a recently graduated college student – I can hardly afford myself, let alone the medical bills of the rest of America.

Posted by IlikeMyRights | Report as abusive

Everyday I drive my father out to the nursing home for a visit with my mother. The most direct route to the “home” takes us through an area that is basically a black area. By 10:00 in the morning there are hundreds of men hanging out on street corners, in front of the party stores and car stereo equipment stores. They are healthy men. Another thing I see on Sundays. After church gets out, they walk the elderly black women home, not leaving them on their own. I see a community. It really hurts me and leaves me wondering…what did we do to our African American brothers and sisters? We took them out of one kind of slavery…but couldn’t wait to put them into another. The liberal left, for generations, has forced them into abject poverty, low self worth and have victimized them for votes. They don’t see it because they’re in it. They have healthy bodies and the potential to have healthy minds. They can’t work their physical bodies to the point of falling into peaceful sleep at night because they haven’t used up the energy their body has stored in their muscles. Are their diets full of fats, sugars, salt, as it appears to be? My heart just cries for them. We’ve made them slaves to a system that they can’t get out of and into a culture of victims. How did we let this happen? Did we vote into office people that we trusted only to find out that they only care about $$$$ instead of raising up a Nation of hard workers, family oriented adults, with a standard of values that will ensure success and prosperity…for votes? It will my life’s commitment to raise up my brothers and sisters regardless of their color and give them the vision of self esteem, victory over emotional and economic slavery and to realize that color is not an obstacle to self fulfillment. In God’s eyes we are all weighty, like gold.

Posted by JanieD | Report as abusive

I can’t believe what I am reading here. Nobody seems to have a solid grasp of the problem so the solution has escaped you.
Read some of the following articles:
How to Make Healthcare Cheaper — ow-to-make-health-care-cheaper.html
Understanding the Healthcare Debate — nderstanding-healthcare-debate.html
Watch a simple video that adds to the discussion Here — hat-does-healthcare-really-cost.html

Healthcare is a big issue that needs careful thought and consideration. It also needs to be adaptable and fitting for the user. Government one size fits all approach isn’t going to cut it. Look over all the real issues and then tell your congressmen to to fix what needs fixing.

Posted by ablur | Report as abusive