America's Sick Health Care System

Alone among industrialized nations, the United States lacks a national health insurance system. Forty million Americans lack any form of health insurance; many more face losing their job-linked coverage in company layoffs. Meanwhile, US annual spending for health care totals $4,600 per capita, over twice the average of other industrial countries. Health care expenditure totals a world-leading 14% of GDP stands, for a grand total of $1.3 trillion--and rising.

According to the Organization for Economic Cooperation and Development (OECD), despite this colossal spending, America lags behind Japan and several European countries in standard measures of health: infant mortality, life expectancy at birth, and deaths that could have been prevented by appropriate medical care. The US spends more and gets less, and all indications suggest that the perverse economics of American health care will continue more or less unchanged indefinitely.

The reason is that the losers in this system tend to be poor, politically unorganized, and inarticulate, while their more fortunate fellow citizens are insured for the costs of treatment and reap the benefits of the high-tech excellence for which American medicine is renowned.

Starting with the President, continuing through the ranks of Congress and the federal bureaucracy, and extending to the nation's many millions of steadily, safely employed executives and workers, ample health insurance is a guaranteed benefit. Also safely insured, under the federal Medicare program, are 40 million elderly and disabled citizens.