Conclusions

Above, the US has not been compared to countries such as India, where the infant mortality rate is around 60 per thousand and the life expectancy is 62.5 years for men; 64.3 for women. In Kenya, the infant mortality is a little better than India's, and the life expectancy decidedly worse - less than 50 for both men and women - because of traditional tropical diseases combined with AIDS and compounded with poverty. These countries do not have anything like the resources of the US, so we can't learn much from that comparison.

The US, while the wealthiest country in the study, has been compared with similar countries (except for Cuba), to illustrate what is possible here in the US.

By now, if the examples haven't convinced you that the United States is wasting about half the money it puts into health care, nothing will. People who try to claim that "free-market competition" is the best way to control health care costs just don't know the facts. The fact is, the US Medicare program has overhead administrative costs of less than 5%, while the private insurance companies have overhead costs in the 20-25% range. This clearly demonstrates that the efficiency of the marketplace is in this case just a myth.

However, simple inefficiency in administration is inadequate to explain how so much money is wasted in American health care. First off, let's define "waste" in this context. If you don't need to spend money in some particular manner to get good health care, then money so spent is wasted.

Private insurance companies, in addition to overhead expenses, must have profits, so some of the money paid for health care goes to these profits. They also have executive salaries and perks that would not be tolerated in a government agency, salaries and perks that are not needed (as we see in the example of numerous other countries) for purposes of delivering health care, and so this money is also wasted.

But it is not just profits and perks. Private insurance insists on reviewing every procedure, and contesting a great many of them. This takes time, personnel, and money, and is a way of delaying health care, not delivering it. Doctor's offices and hospitals are compelled to carry a matching staff to fill out forms, make and return phone calls. Doctors and nurses find much of their time consumed in the same process. All of this costs money, and this money is wasted, as the administrative conflict is almost entirely unnecessary.

Medicare has no money in its budget to lobby Congress or pay for TV ads during election campaigns. The private health insurance industry uses millions this way. If it does not pay for health care, it is wasted money.

The other big institutional offender is the drug industry. Americans pay the highest prices in the world for drugs. Drug companies use the money for advertising, lobbying, campaign funds for pet politicians, executive salaries and perks, and still have enough left over to report a high rate of profit. This rate of profit is either splendid or obscene, depending on your view of stock profits and prices; it is certainly not necessary to pay the costs of developing and producing drugs. All of the extras above the cost of producing drugs and a reasonable rate of profit is wasted, compared to the practices of most other countries.

It is no secret that when a national health system which buys all the drugs from all the manufacturers for even a small country negotiates prices with drug manufacturers, the result is reasonable drug prices. It is also no secret that when drug companies deal with dozens or hundreds of insurance companies and with the millions of atomized individuals paying out of pocket, ridiculously high drug prices result. That's why Americans increasingly buy drugs from Canada.

The drug companies and the insurance companies are tied together by the laws of this country and the politicians who make the laws. The companies see a stream of money, in the Social Security and Medicare programs, which they wish to turn into profits and perks for themselves. They are literally paying politicians to make this happen, and running commercials to enhance the myth of "competition in a free market" to get us to accept it.

The collusion among insurance companies, drug companies, and politicians to put their profits above our health care is vulnerable on the political side of this triangle, if we refuse to let them buy our votes.

If we vote against every incumbent who takes money from these industries, we have a beginning. If we decide to organize to vote against every incumbent who is not vigorously in favor of universal health care, we have a path to follow. This may sometimes mean voting out a half-decent candidate and getting a worse one in, and having to vote that one out in the next election cycle. It's not a smooth path or a perfect outcome, but we have to demand universal health care in a language politicians understand.

Once they understand they have to give us universal health care or they are out, we win. If we settle for expressions of sympathy and gestures of support without real action, we lose. The choices are ours.