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Health Care in the United States

In Health Care, The United States, Uncategorized on August 30, 2017 at 10:22 am

Somewhere in my social network world I saw a post from CNN in March comparing the US health care system with that of other European countries, focusing on the UK. Bouncing off of Monday’s post on how severe natural disasters displace the poor the most, and poverty rates increase by 1%, and the fact that having health insurance is still an issue in the United States, I wanted to use this Wednesday’s post to talk about health care. Ok. Here we go.

Let’s make something clear here. Health care systems around the world are far from perfect. Each system has its flaws, its challenges, but also has its own distinct advantages. One of the biggest frustrations I experienced when following the debate on the Affordable Care Act (Obamacare) as well as the recent attempts by Republicans to reform or replace the ACA, was watching how those opposing health care would find the most terrible examples in other countries, whether true or not, and use that as an excuse to not fix the current system. Look, if you want to find something bad or a nightmare scenario about a health care system in a particular country, you’re going to find it.

When we look at the US, the biggest disadvantage of health care is that it’s expensive. Very expensive. In fact, among ‘western’ countries, it’s the most expensive. According to a OECD report, the US spends two-and-a-half times more than the OECD average per person. In recent dollars that’s going to be about $9,523 per person. There are a few reasons why it’s so expensive.

The biggest expense seems to go back and forth between two factors so I’ll start with one that surprised me the most. Administrative costs. The US health care system is complicated because there are many parties involved in reimbursement such as government and insurance companies, or in short, there is no single payer scheme. Instead of having a single payer scheme, there are public payments and private payments. So when you get sick and you need to go to the hospital, the stay in the hospital could be covered by a government entity while your medicine is covered by your private insurance company. Having a single payer system, such as they do in Europe, significantly helps to reduce these costs.

The other large expense is the increased costs of health care goods and services. This includes the price for procedures, new drugs, development of said drugs and its marketing, which is passed on to the consumer. In short, Pharmaceutical companies, hospital conglomerates and physician groups get together and decide to charge whatever they want in order to gain the maximum profit. I personally believe this sounds too much like a conspiracy theory and I’ll point to other related issues such as overuse of specialty care, physician fees and malpractice costs or what is termed as “Defensive costs” as contributing more to those costs than a draconian cartel. These costs exist because doctors and hospitals do not want to get sued if something goes wrong.

Despite administrative costs and health care expenses the elephant (pun intended) in the room is simply the general health of Americans. We’re fat and obese. We eat a lot shit, drive everywhere even if it’s 10 feet away, and well, we just eat a lot of shit food. This to me is the main reason why health care costs haven’t decreased substantially like Obamacare promised. And this is a hard thing to do and even if we all decided to become healthier overnight, it would still take quite a few years before we could notice any substantial change. The main issues that Obamacare addressed were that people were no longer able to walk around without insurance and we were able to put more money in the general pot. The other issue it solved was that health insurance companies can no longer deny insurance to people with pre-existing conditions. Thank god.

Now for the opinion part.

If we want to have true health care reform in the States there are two main points that we, Americans, have to accept:

  1. We do not buy health insurance for ourselves. It’s not money that’s put in a bank for a rainy day when we accidentally get hit by a car. It’s money for those who were born with pre-existing conditions, handicaps, those who have chronic illness and anyone who needs medical help a lot or most of the time. But it’s also indeed useful if you get hit by a car. This is a very hard concept for Americans to swallow. We have the feeling that if we have to pay a tax we should directly see the benefit. Unfortunately health care doesn’t work that way and you will now scream that I’m a socialist
  2. We need to get healthy. When I mention the above examples, I’m not putting Dave who decided to become obese and now has type 2 diabetes in there. This is an oversimplification I know and obesity in many cases also has a lot to do with mental health. But for a general society who likes to eat a lot of calories each day, moves very little, and continues to put a lot of bad stuff in their bodies like high fructose corn syrup, guess what? This also puts a strain on the health care system. Preventive health is the key. Stop drinking so much, eat some vegetables every now and then and see what the inside of a gym looks like.

Obamacare is not perfect and no health care system is. For further reading, this is a pretty damn good article from March in Forbes that talks about Healthcare Reform in America. This is a pretty damn good study comparing health care systems in the US, Germany and Canada.


The Times They Are a-Changin’

In Uncategorized on April 4, 2012 at 10:12 am

It is really no surprise that if you stop writing a blog about politics for almost three years the world will change. Even with the posts on the front page before this one was published, I could see a list of my favorite podcasts. Now some of those podcasts, particularly from CNN, you have to pay for. I wonder how many people stopped listening? 

Apparently the last post was the debate regarding Barack Obama’s Nobel Peace Prize. Wow, I had forgotten he won the thing.

Today we have the Arab Spring, the upcoming Presidential Election, the current Republican Primary, Iran’s resolve in obtaining a nuclear weapon, North Korea, European Migration, the crisis in the EU (which I think some posts were pretty much right on the money, despite me being typically anti-EU), the resolution in Myanmar (Burma), to name a few.

In fact, when those posts were last posted, I believe I was watching Gadaffi’s crazy stint in New York City. Now he no longer exists. Tunisia has changed, Egypt is changing, Yemen, Syria, even the confidence of Europe and the United States is shaken. Were the times in 2009, despite the “Great Recession,” a more stable time? Do we have even more uncertainty now than we did back then? Even when I look at my own life, do I have more or less confidence for the future?

2009 to 2012, three years, but boy, what those three years have been. Many probably see them as feeling like a decade, some probably see 2009 as yesterday. Regardless, we are in a different world now, and who knows what the next three years will turn into.

It is an exciting time for those interested in politics, international relations, and global economics. There are a lot of things to discuss, debate, and really just sit back in wonderment as events, some horrific and some not, literally take place before our eyes. 

In the next few posts you can expect my thoughts on the Republican Primary, the upcoming Presidential Election and other issues related to Europe. As I am currently based in the Netherlands I will also try to throw in some Dutch politics for good measure, which is also quite colorful thanks to a Mr. Wilders. 

For those who check this thing from time to time (if you are still there) thanks for hanging in there with me.

For those who are new, welcome, and lets get the debates started again.

Just bad timing

In Foreign Policy, Russia, The United States, Uncategorized on September 17, 2009 at 11:34 am

The big news of the day is that that United States abandoned its plans for establishing a missile defense shield in Europe. The change was expected but the timing was not. Obama is facing a lot of criticism at home for moving to the left, especially regarding health care reform. He has made concessions with the public option, but the Republicans are in full swing and are not shy about rallying the general public and portraying him in a very evil light. We’ve all seen the news footage of the townhall meetings and people screaming at their politicians, even of posters depicting Obama as a Nazi. This will undoubtedly add more fuel to this fire.

Regardless, the abandonment is not entirely a bad idea. Obama has made very clear that his adminsitration has three distinct foreign policy goals. The first is to increase U.S. activity in Afghanistan, as he believes, rightly, that Afghanistan directly threatens U.S. national security. The second is Iran and its nuclear program and the third is the Israeli/Palestinian conflict. We have established on this forum that the last two are directly linked. Apathy against the United States in the Middle East has more to do with the U.S. failure in pushing Israel to acknowledge an independent Palestinian state than the war in Iraq. If this can be resolved, he can put influential countries, such as Syria, Jordan and Egypt firmly on his side and put more regional pressure on Iran. Regarding Iran, the major stumbling block is of course Russia, who has been very adamant in viewing any attempts by the U.S. to start a Missile Defense program in Europe as a direct threat to its natural security. Therefore, the move to forgo any plans at such a shield has more to do with woing Russia than believing that such a system cannot work.

On the other side of the debate is the belief that in forgoing such a system is to alienate further our key Central European allies, Poland and the Czech Republic, in the face of an aggressive Russia. Admittedly, public support for such a system in these countries has been extremely low, and the European Union has always been very weary at any attempts by the U.S. in having such an influence in these countries, as their relations with Russia would be in jeopardy, a vital source for their vital energy resources.

This is a very bold move by the Obama administration considering the timing. Public support has been waning due to health care reform, and Democrats are putting up a fight concerning Obama’s plans in Afghanistan. It’s the right move to be sure, but it’s just very bad timing.

And the wheel goes round and round

In Foreign Policy, Israel, Middle East, Palestinians, The United States, Uncategorized on September 8, 2009 at 5:12 am

Despite pressure from the Obama administration Israel is still planning to build 455 new housing units in the West Bank, according to this report. This move by defense minister Ehud Barak is seen as a slap in the face to Obama’s new hardline approach to the Middle East. Obama rightly believes that the U.S. image in the Middle East, as well as the difficulties the U.S. is facing in deterring Iran from acquiring nuclear weapons, are directly linked to the Palestinian/Israeli conflict. If he can finally secure a two state solution, so it is believed, then many influential states in the Middle East, such as Syria, Jordan, and Egypt, could put more regional pressure on Iran in ending its nuclear ambitions. Unfortunately, as can be referenced in our “Et tu Brute?” post, Obama’s political struggles at home has an additional consequence of undermining his influence abroad.

Ever since its establishment in 1948, Israel has always took a realist approach to its foreign policy, especially regarding the occupied territories. Attacks on Israeli civilians by militant Palestinians has always been returned with a heavy handed response by Israeli troops. Just this past year in fact, after missiles originating from Gaza met Israeli soil, Israeli troops reentered the region, leveling houses one by one. Even the first successful act of peace brokered by Jimmy Carter at Camp David between then Israel’s Prime Minister Menachem Begin and Egyptian President Anwar El Sadat was only made possible after Sadat initiated the Yom Kippur War in 1973 and gained considerable amount of territory, before finally being pushed back out of the Sinai by Israeli troops, as a consequence of an Egyptian deal with Syria to push further and leaving their surface-to-air missile umbrella.

Therefore it should be no surprise that Israel is taking advantage of Obama focusing his attention on pushing health care reform through Congress and losing political clout whilst doing it. Indeed, Israel may not be as strategically important to the U.S. as it was during the Cold War, it nevertheless knows politics and how to play the grand game of international relations.

The Obama administration should not tolerate this blatant maneuver to jeopardize the peace process. Though one could argue that failures in ending the Palestinian/Israeli conflict can be contributed to both the Israelis and Palestinians, the United States nevertheless has a substantial opportunity of having a President who was willing to put the conflict on his agenda in the beginning of his Presidency, clearly illustrating the need to end the conflict. But if history has taught us one thing, it is that the prospects of peace usually disintegrates when it is almost achieved. Obama needs to stay focused and use harsh language to criticize any Israeli settlements in the Palestinian territories, despite any trouble that he is experiencing at home.