God Bless The USA

by digby

I don't find a whole lot to like these days about my hometown paper The LA Times, but today they did a big story on the state of American health care and the film "Sicko" that I think a lot of their readers will find informative. It breaks no new ground for those of us who follow these issues in the blogosphere, but it's a step in the right direction.

The story features a very handy little chart that you all might find useful in political discussions on the job or at those fun summer bar-b-ques where certain people of the righty persuasion try to pretend that they know what they are talking about:

Healthcare: where the candidates stand

Most 2008 presidential candidates address healthcare on their websites, but the amount of detail varies considerably. Here's some basic information from the sites of candidates — and potential candidates.


Joe Biden
Would "expand health insurance for children and relieve families and businesses of the burden of expensive catastrophic cases."

Hillary Rodham Clinton
"America is ready for universal health care."

Chris Dodd
Would "ensure universal affordable quality coverage by creating a Health Care General Fund (HCGF) to serve all Americans. Then, require employers to either cover their employees or contribute to the fund."

John Edwards
Offers a detailed plan for "universal health care through shared responsibility."

Mike Gravel
"a universal health-care voucher program in which the federal government would issue annual health care vouchers to Americans based on their projected needs."

Dennis Kucinich
Supports "a plan for a universal single payer, not for profit healthcare system.

Barack Obama
Gives a plan for "providing affordable, comprehensive and portable health coverage for every American" and "modernizing the U.S. health care system."

Bill Richardson
Would "open up existing sources of affordable, portable coverage to more Americans."


Sam Brownback
Advocates "increased consumer choice, consumer control and real competition."

Jim Gilmore
Healthcare isn't listed on "The Issues" portion of his site.

Rudy Giuliani
Healthcare isn't listed on the "On the Issues" portion of his site.

Mike Huckabee
The site doesn't have an "issues" component.

Duncan Hunter
Doesn't list healthcare under "Issues."

John McCain
Doesn't list healthcare under "On the Issues."

Ron Paul
Doesn't list healthcare under "Issues."

Mitt Romney
Recommends "extending health insurance to all Americans, not through a government program or new taxes, but through market reforms."

Tom Tancredo
Says "tort reform and immigration enforcement would save the system billions."

Tommy Thompson
Would place "the uninsured in state-by-state insurable pools, allowing private insurers to bid on their coverage."

Obviously Republicans are catering to their true base --- the vastly wealthy --- who don't have to worry about health care any more than the candidates themselves do. That's nice for them.

I wonder if Democrats are missing the boat on something though. There were a couple of other charts included in this story that might just make even some rich Republicans a little bit uneasy. After all, isn't it just considered a given that red-blooded real Americans believe this is the very, very best country in the whole wide world?


Now, the knee-jerk attitude that the U.S. is the best place on earth to be sick, fueled by the reputations of great institutions like the Mayo Clinic and by America's leadership in drug and technology development, is beginning to be challenged by rigorous international comparisons. There is increasing evidence that, despite justified pride in individual institutions and medical breakthroughs, the world's biggest medical spender isn't buying its citizens the longest, healthiest lives in the world.

It's not just moviemakers and comics saying so. The dire message that the U.S. healthcare system is, by some measures, an also-ran on the worldwide stage is being delivered by doctors, researchers — even insurance industry giants.


How we measure up

The United States recently ranked last among six industrialized nations on measures of safe and coordinated care, according to the Commonwealth Fund, although it spent the most per person.

Overall ranking (2007) 3.5 5 2 3.5 1 6
Quality of care 4 6 2.5 2.5 1 5
Access 3 5 1 2 4 6
Efficiency 4 5 3 2 1 6
Equity 2 5 4 3 1 6
Healthy lives 1 3 2 4.5 4.5 6
Health expenditures
per capita (2004) $2,876* $3,165 $3,005* $2,083 $2,546 $6,102

I'm sorry, that's just embarrassing. Perhaps Democrats should (at least sometimes) speak about health care in the language of good old fashioned national competitiveness. A good stump speech might mention this shameful state of affairs and then say that under Democrats the United States will once again be number one --- something about which the Republicans obviously care nothing because they don't even discuss it.

I know it's a little bit shallow and maybe even a bit offensive. But winning elections isn't only about being right on policy. It's making people realize that certain problems exist and finding ways to help them see that it's in their interest to solve those problems. If you can use Americans' knee jerk belief in the innate superiority of the US of A to actually create a superior health care system for Americans, then I'm not sure there's anything wrong with it.

And anyway, with all the money we spend there actually is no excuse that we're not number one.