Only social change can reform US healthcare
I met Mary Elswick at the Free Clinic in Cleveland, Ohio. Too poor to afford health insurance, she has to rely on charity to treat her gout, neck and leg pains, and a myriad of other complaints, yet she doesn’t like the sound of President Obama’s healthcare reform.
“I don’t know about the government controlling it… That’s a little scary to me as far as socialism and stuff,” she said. I pointed out that the plan for a government health insurance scheme might mean she too could be insured. She was unconvinced.
“I dunno if it’s from watching the news or what, but I just feel like we wanna keep our individual freedoms,” she said.
All through the summer, Americans have been bombarded with TV ads and talk shows telling them that the healthcare reform proposed by President Obama would mean turning their private system into something like the NHS, which is “socialised medicine”.
Sarah Palin (remember her?) says it’s the first slip on the slope to compulsory euthanasia or “pulling the plug on Grandma”. To someone like me, born in the NHS, such fears seem strange, and yet it is true that America has the best healthcare in the world – provided you have insurance.
Go to the Cleveland Clinic and you’ll see higher technology than anything we have in the NHS. All records are kept electronically (whatever happened to the NHS computer??). People come from all over the world to be treated here.
So what gives? Dr Steve Nissen, the top cardiologist at the Cleveland Clinic, says it’s possible to insure more people while retaining high technology. “We waste more on healthcare than most countries spend,” he told me. With 17 per cent of GDP devoted to health, it should be possible to square the circle. Part of the problem is that 29 per cent of healthcare costs – according to Dr Nissen – go on private insurance administration.
What strikes me most is how the system as it stands encourages doctors to perform multiple procedures by paying them per treatment, rather than giving them a salary or rewarding positive outcomes. And it doesn’t cover most preventive measures.
But then real prevention in America and everywhere else means changing what people eat, stopping them smoking, making them exercise and eradicating poverty. Which means social change. Which isn’t going to happen through President Obama’s healthcare plan. Or the NHS.