{The following column will appear in the Anahim-Nimpo Lake Messenger in December}
On November 6, I breathed a sigh of relief when
Barack Obama was re-elected for a second term as the President of the United
States. Although his victory carries no
guarantee of either world peace or fiscal sanity, intransigent conservatives in
Congress were at least not rewarded for their worst behavior.
Most importantly, the election means that the Patient Protection and Affordable Care Act —“Obamacare”—is here to stay. This legislation addresses both of
the most serious flaws in the American health care system: the huge number of
uninsured (46 million people) and under-insured (25 million); and runaway costs (two-thirds of personal
bankruptcies in 2007 were due to illness or medical bills). In recent years, these twin issues of coverage and cost have reinforced
each other in a vicious downward spiral. Coverage has declined because premiums
and co-payments are rising; premiums and co-payments keep rising because of the
lack of effective cost containment.
A recent report comparing health prices said it all.
A routine doctor’s visit costs
approximately $30 in Canada, $22 in
Germany and ranges between $59 and $148 in the U.S. , with the Medicare rate
for seniors set at $72. A bottle of Lipitor
costs $31 in Canada, $78 in Germany, and an average of $134 in the U.S. MRI scans cost $304 in Canada, $632 in
Germany, and an average of $1009 in the U.S.
A normal childbirth in a hospital?
$3200 in Canada, $2200 in Germany, and a whopping average of $9280 in the
U.S.
Increasingly,
it was not just poor people who could not afford to pay these inflated prices. The push for reform was partly driven by the growing
plight of middle-class Americans. And the rising unemployment rates that
accompanied the recession that began in 2008 meant that even more individuals
lost affordable coverage. Something had to be done.
Will Obamacare succeed? The criticism has been made that the Affordable
Care Act does not sufficiently attack
the power of special interests—insurance lobbies, drug companies, and
the corporate health sector—who have a financial stake in the existing
system. It is true that the government had
to jettison the ‘public option’ (offering public insurance at lower premiums
for a standard care package) in order to get the Ac t through the Senate. And to gain the cooperation of doctors and
pharmaceutical companies, the government had to agree not to control the prices
paid for products and services.
But much has been achieved. When fully implemented,
95 percent of U.S. citizens will have the same basic health security that
Canadians have. And the Affordable Care Act contains several payment and
delivery options that will foster higher
value, lower cost and patient-centred primary care . In the not too distant future, Americans may
even have a thing or two to teach us about how to do health care.
Mark
Crawford is an Assistant Professor at Athabasca University. He can be reached
at markcrawf@gmail.com .
