Amerikas kranke Gesundheitsfürsorge

Als einzige unter den Industrienationen fehlt den Vereinigten Staaten ein System der allgemeinen Krankenversicherung. Vierzig Millionen Amerikaner haben überhaupt keine Krankenkasse; noch viel mehr stehen davor, mit ihrem Arbeitsplatz auch die an diesen gebundene Betriebskrankenversicherung zu verlieren. Inzwischen werden in den USA 4,600 Dollar pro Kopf in das Gesundheitswesen bezahlt. Das ist mehr als das Doppelte dessen, was im Durchschnitt andere Industriestaaten dafür ausgeben. Mit Aufwendungen für die Gesundheitsfürsorge, die einen Anteil von 14 % am Brutto Inlandprodukt (BIP) erreichen und sich auf jährlich insgesamt 1,3 Billionen $ belaufen, stehen die USA an der Weltspitze.

Trotz dieser riesigen Ausgaben hinkt Amerika nach Angaben der Organisation für Wirtschaftliche Zusammenarbeit und Entwicklung (OECD) hinter Japan und einigen europäischen Länder hinsichtlich der üblichen Kennzahlen für die Volksgesundheit her, und zwar in Bezug auf die Kindersterblichkeit, die Lebenserwartung bei Geburt und auf Todesfälle, die bei der entsprechenden medizinischen Versorgung hätten vermieden werden können.

Im Hinblick auf die Gesundheitsfürsorge gibt Amerika also unwahrscheinlich mehr aus als es dafür bekommt. Das ist ein Zustand, der offensichtlich so nicht fortbestehen sollte. Und doch tut er das. Tatsächlich gibt es diese perverse Wirtschaft der Gesundheitsfürsorge amerikanischem Stils schon seit Jahrzehnten. Alles deutet daraufhin, dass sie so mehr oder weniger unverändert bis in unbestimmte Zukunft weiterbestehen wird.

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