Here, America, Let Me Help You

As everyone knows, America’s Republicans are striving to find ways to reduce spending so as to dish out yet more tax savings for the very rich. Those tax savings, in turn, will make their country stronger and wealthier, they say, because of the “trickle down effect”. This assumes that what trickles down from the outhouses of the superwealthy at the top of the hill is beneficial.

One area of angst in their budgeting struggles is to carve back Medicaid and Medicare, which, to be fair, eat up an awful lot of tax dollars. But oddly enough, Republicans, the purported party of business, can’t seem to approach the issue in a businesslike way.

One of the oddities of health care among first world nations is that Americans pay the most (about twice the average of advanced countries) and get the least. Their life expectancy and overall health are lowest of the G7 nations, yet the per capita cost is highest. Now, if you were a business consultant, wouldn’t you want to sort that out?

A fairly quick breakdown shows that 15-20% of their overall health care budget goes to “administrative costs, marketing, and profit”.

Marketing? Seriously? Hospitals and doctors need to advertise? Give me a break. Profit? Since when are essential public services run at a profit? Does your police department show a profit? Fire department? The Navy? The White House, at least during business hours?

OK, “administrative costs” are a fair line item, but at 8% are completely out of line with the average of OECD countries at 1-3%. So much for American efficiency.

How about drug and prescription costs in the US? Let’s compare the prices in US dollars of epipens: United States, $600. Japan,$98. Germany, $85. Canada, $80. France, $76. Australia, $65. UK, $61. (Hint for the American consumer: none of the rest of us are doing this at a loss. These are all at fair market value in our countries. Yours?)

So, let’s say you’re a business consultant called in to help save a failing enterprise, and you tell them that the best way to do that is to cut the number of on-target customers they handle. You’d be shot, and you’d deserve it.

No, as a business consultant you’re going to put the failing business through a SWOT analysis, that is, look at Strengths, Weaknesses, Opportunities, and Threats. Strengths? Without doubt, America has many, many world class hospitals, doctors, nurses, and medical managers, and they develop their fair share of pharmaceuticals. Weaknesses? Well, we’ve covered most of them, but just to add to the misery, consider all the hidden costs of an unhealthy population or the fiscal disaster of taxpayers going bankrupt to pay hospital bills. Not pretty. Opportunities? Just look around the OECD. Threats? Americans aren’t getting any younger or any healthier, and it’s only going to get worse. Sorry, America, there’s no good news if you persist in your present course.

Does “socialized medicine” work? Just ask any conservative politician in Canada, Australia, or the UK how they’d like their electoral chances if they opposed national healthcare. Even the far right UKIP and Canada’s pathetic Peoples’ Party dare not fiddle with medicare, nor do any of Australia’s right wing wierdos. It’s settled, it works. On to more important things like girls’ bathrooms and trans football.

Happy to go down to America and help you sort this out. For a cut of the savings, of course. 8% shall we say?

(Since writing this, I see that American professor Scott Galloway has made similar and more trenchant comments. See them here. (https://mail.google.com/mail/u/0/#inbox/FMfcgzQbfLSWRtWmZPXSCDtsXxZNmnfh) )