Republicans demonize “socialism.” Democrats do the same for “capitalism” or “privatization.”

Rather than getting apoplectic over labels, we need programs that work.

The U.S. health care system doesn’t. Of the 33 leading industrialized nations, only the U.S. lacks universal health care.

Americans spent $3.65 trillion on health care in 2018 — $11,212 per person. At 18% of the gross domestic product, it’s nearly double the average for industrialized nations.

And what do we get? The U.S. has the lowest health-adjusted life expectancy and one of the highest infant mortality rates for industrialized nations, according to the Organization for Economic Cooperation and Development.

We also have fewer primary care physicians — a case for reduced tuition based on national needs.

The Affordable Care Act isn’t universal health care, but a bastardization (for political reasons) of the Swiss system, which doesn’t have employer-paid insurance. The Swiss spend 12% of GDP on health care. Everyone must have insurance, averaging $300 monthly per adult, but not exceeding 8% of income. Government-regulated health plans offered by 92 insurers are tailored to individual needs.

Universal health care comes in many flavors. In some single-payer systems, the government taxes for coverage, while contracting with private providers (Canada). In others, the government is the primary owner and operator of medical services (United Kingdom).

A multi-payer system is financed with shared costs (Germany, Japan and France). Employees (8.2%) and employers (7.3%) finance Germany’s “sickness fund.” Physician groups negotiate fees with insurers. Strict budgets exist.

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A nonexistent flavor is Sen. Bernie Sanders’ “Medicare for All” — “free” everything without deductibles or co-pays, unlike actual Medicare.

It includes prescription drugs, now purchased in Medicare Part D; vision, dental, and hearing now bought with allowances in the Medicare Advantage option; and very pricey long-term care.

It’s unrealistic, yet many Democrats are buying it, dismissing private options available in many nations, including Canada.

Sanders gets the administrative (and drug) mess right.

The Commonwealth Fund, which rates health care delivery, has the U.S. fifth in quality of care, but last in efficiency and equity, largely because of time spent with administrative issues, duplicative medical testing, and insurance disputes.

We’re also last in healthiness, largely reflecting lifestyle choices. The U.S. obesity rate in 2013 was 35.3%. The OCED average was 19%. Chronic diseases, including diabetes and heart disease, constitute 85% of health care costs. The sickest 5% of Americans devour half of health care costs, the healthiest 50% only 3%. Donald Trump was right in 2000 when he (or someone) wrote in “The America We Deserve,” “We must have universal health care. Just imagine the improved quality of life for our society as a whole.”

The U.S. must get in step with the industrialized world. The crazy-quilt system of employer-based insurance, Obamacare, Medicare, Medicaid, and the Veterans Administration is a mess.

Forget labels. We need a streamlined, less expensive system designed for the common good.

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Saul Shapiro is the retired editor of The Courier, living in Cedar Falls.


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