16 September, 2011

How to spend a fortune and get nothing.


Twitter is a wonderful beast. Almost real-time updates of any subject you care to think of.  By chance I was able to read running commentaries on what Republicans were saying during a nomination debate.  As an Australian, I don’t hold that much interest in the spectacle that is the lead up race for the White House, except this time the Republican side is led by a comedy troupe of Tea Party candidates.
One candidate in particular, Ron Paul, struck me as the freakiest of carny folk in Republican side show alley.  Yet this isn’t about Paul.  This is about where some of the claims about him has led me; the vaults of official statistics by the OECD.
You see, some people believe that government shouldn’t be in the business of looking after its citizens, specifically their health.  One tweeter, in defending Ron Paul’s decision not to pay the $400,000 medical debt owed by one of his campaign managers - who had died - told me:


Rick Fisk might be on to something.  The Texan Governor Rick Perry signed an executive order to fund a cervical cancer vaccine that targets HPV, a position he has now thinks is poor policy.  Michele Bachmann adds the HPV vaccine caused mild retardation in a young girl and is therefore potentially dangerous.  Paul simply says: “It's not good social policy and therefore I think this is very bad to do this.”  So obviously any government involvement in health is bad.  Obamacare must be bad.
Ever since Jesus played fullback for the Saints*, leading political figures have told us that the private sector is always more efficient that an equivalent government sector.  It’s certainly a mantra of the Tea Party, that and the idea of universal healthcare is inherently toxic.  The arguments can appear convincing, but once stripped of emotion, are they really?  Hence delving into the OECD health statistics.
There are remarkable things to discover.  For example; in 2008, the US spent $7220 per capita on healthcare (all figures in 2011 USD).  This represents 17.4% of GDP.  More than half of that is what Americans are paying privately.  Every woman, man and child in the US forked out more than an average $3610 for private healthcare and almost the same again indirectly through tax.
Second place in the staggering statistics department goes to the Netherlands, who spent $4241 per capita, or 12% GDP.  Unlike the US, the Netherlands has a universal health care system, and only about one-sixth of that is in the private sector. 
In twenty-third place is Australia, possibly the best match for the US in health after Canada.  After all, Australians eat roughly much the same amount of rubbish, watch a similar amount of terrible television and speak (mostly) the same language (but without the weird accents).  Australia’s figures for 2008 are $3445 per capita or 8.7% of GDP, below the OECD average of 9.5% GDP.
Keeping in mind this total is the private and government sectors  combined per capita, and yet it’s less than what the US pays privately per capita.  Despite this, Australians on average live longer and have better health outcomes than Americans.  The OECD data demonstrates Australia’s universal healthcare system is more efficient than the US private fend-for-yourself system and more effective.  Surely that can’t be right?  Believe me, the healthcare system in Australia isn’t exactly a shining beacon of efficiency, no matter how hard or magnificently those at the coal face work.  How can such a sector, two-thirds funded by governments (i.e. Australian tax payers), be better than the equivalent private sector in the US, the land where the consumer rules?  
One explanation is the private US medical system is fraudulent, syphoning off billions of dollars from governments, insurance premiums and individuals when they present themselves for care.  Maybe that’s a little harsh.  Perhaps the private healthcare sector is so grossly incompetent, inefficient and ineffective Americans would be better off without it?  Best not to confuse a mistake for malice, but either way, small wonder President Obama wants reform.
What does it take to convince the fans of the Perrys, Bachmanns and Pauls that they are willing to continue spending a fortune to get very little in return?  I mean people like Fisk who told me that if we pay tax for such things as healthcare, the government should also pay for our car loans (no, I’m not joking and I wish Fisk was).  It’s a serious question I wish the American people would ask of those who aspire to be called, one day, President of the United States.
*Obviously Jesus didn’t play fullback for the Saints; Jesus is a fictional character.


Update: Rick Fisk informs me - which I haven’t verified - that Ron’s Paul’s campaign manager, Ken Snyder, couldn’t be insured because he had a pre-existing condition, and that Snyder died of pneumonia.  Fisk assures me Paul had no moral obligation to help Snyder.  Is Paul seriously wanting to be the Republican Party’s nominee?