The Best System on Earth
(if You Can Afford it)

by Jan Baughman

July 10, 2000


Note from the Editor:  Jan Baughman presents a few facts that speak loud and clear as to the real conditions in the United States of America today. Chances are that you won't hear those facts from the respective 2000 Gore and Bush campaigns... This should not particularly surprise you. After all, both Bush and Gore are the candidates of the status quo; they are the two faces of the same coin, favoring corpocracy and having long forgotten the aspirations of our less fortunate human siblings. Is the status quo your cup of tea?


"While there is a lower class, I am in it; while there is a criminal element, I am of it; while there is a soul in prison, I am not free."
-- Eugene Victor Debs


Another Fourth of July is behind us and Americans are still basking in the afterglow of patriotism. The unemployment rate keeps dropping, hourly wages just increased by a nickel and the stock market is holding. We have so many things to feel good about. That is, if we can afford to feel good.

The United States spends more for health care than any other country - 13.7% of GDP (compared to 9.8% in France, 10.5% in Germany and 5.8% in the UK). Yet we spend only 3% of our health care dollars on prevention and public health, the more reasonable and cost-effective approach to medicine. Forty-four million Americans have no health insurance -- that is one out of six of us. But we have the greatest health care system in the world, right? Not according to the World Health Report 2000.

On June 21, the World Health Organization issued this report in which they rated the health care of 191 nations using five performance indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system's financial burden within the population (who pays the costs). The United States, which ranked Number 1 on one factor -- per-capita expenditure -- ranked 37th in overall health system performance, just behind Costa Rica and ahead of Slovenia and Cuba. In most industrial countries, out-of-pocket health expenses average only about 25 percent because of universal health coverage. In the United States, that average is 56%.

As Dr Julio Frenk, Executive Director for Evidence and Information for Policy at WHO, said, "the poor pay a higher percentage of their income on health care than the rich."

One person who has the courage to discuss the human failings of our great economic and political system is Ralph Nader, presidential candidate for the Green Party. The following is an excerpt from his candidacy announcement on February 21, 2000:

"Consider the economy, which business commentators say could scarcely be better. If, instead of corporate yardsticks, we use human yardsticks to measure the performance of the economy and go beyond the quantitative indices of annual economic growth, structural deficiencies become readily evident. The complete dominion of traditional yardsticks for measuring economic prosperity masks not only these failures but also the inability of a weakened democracy to address how and why a majority of Americans are not benefiting from this prosperity in their daily lives. Despite record economic growth, corporate profits, and stock market highs year after year, a stunning array of deplorable conditions still prevails year after year. For example:

A majority of workers are making less now, inflation adjusted, than in 1979

Over 20% of children were growing up in poverty during the past decade, by far the highest among comparable western countries

The minimum wage is lower today, inflation-adjusted, than in 1979

The number of Americans without health insurance grows every year

There have been twenty-five straight years of growing foreign trade deficits ($270 billion in 1999)

Consumer debt is at an all time high, totaling over $6 trillion

Personal bankruptcies are at a record level

Personal savings are dropping to record lows and personal assets are so low that Bill Gates' net worth is equal to that of the net assets of the poorest 120 million Americans combined

The tiny federal budgets for the public's health and safety continue to be grossly inadequate

Wealth inequality is greater than at any time since WWII. The top one percent of the wealthiest people have more financial wealth than the bottom 90% of Americans combined, the worst inequality among large western nations"

In the meantime, another one of our $100,000,000 missile defense tests failed. One hundred million dollars were spent in thirty minutes to test an uncertain system designed to protect us from uncertain enemies and to help us decide whether we should spend $60 billion more on this system for our national security. Imagine the number of children worldwide who could be fed and vaccinated with this money, with a tangible and successful outcome! Imagine if, one day, the United States spent the lowest on health care per capita, and the quality and distribution of health care ranked up there with the top five countries identified by the World Health Organization -- France, Italy, San Marino, Andorra, and Malta! Imagine taking access to medical insurance for granted!

It's hard to imagine, isn't it? At least we can all sleep better knowing we have the Number 1 military in the world. National security against imagined enemies or affordable health care for all... Have we lost wisdom on our way to the best system in the world?


The World Health Report 2000: http://www.who.int/whr/2000/en/report.htm
Ralph Nader Election 2000: http://www.votenader.org


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