Cape Cod Times

You've heard it and read it many times. The U.S. spends more money on health care than any other industrialized nation — and each year the number of uninsured increases. It's now at 46 million and counting. Meanwhile, the countries with whom we compete globally continue to provide universal health care to all of their citizens at less than half our cost per capita. Even worse, a Commonwealth Fund study on preventable mortality found that in 2003 the U.S. had 110 preventable deaths per 100,000 people and was in last place among the 19 nations evaluated. France placed first with the best record at 65 deaths per 100,000 people.

Looking ahead, the economic prospect is even more bleak. In 2007 we spent $2.4 trillion on health care, or $7,900 per capita, and are projected to reach $3.1 trillion in 2012 and $4.3 trillion in 2017, or 20 percent of our gross domestic product.

Dollars wasted only reflect the dysfunctional health care system's monetary cost to our society. The worst consequence is the waste of human life and potential that is inevitable when a society does not believe that access to comprehensive, affordable health care is a human right.

Our current system rations health care by income. It is a system that not only affects the health and well-being of citizens, it jeopardizes their financial viability. The health insurance plans affordable to many low- to middle-income individuals and families often do not provide the comprehensive coverage we all require but only the financially comfortable can afford.

The Kaiser Family Foundation has just reported that premiums for employer-sponsored family health insurance rose 5 percent to $13,375 annually in 2009, with employees on average paying $3,515 and employers $9,860. In contrast, workers' wages increased just 3.1 percent during the same period. Since 1999, premiums have gone up a total of 131 percent while workers' wages have risen only 38 percent and inflation 28 percent during the same period. It's also important to note that in addition to that $3,515 premium, the family also pays the deductible, co-payments, coinsurance, costs of out-of-network care, and costs of products and services not covered by the plan

The system also stifles entrepreneurial initiative. As insurance costs increase, the self-employed face the daunting task of trying to buy a policy in the individual market, where insurers are highly risk averse and the premiums are exorbitant. For someone considering starting a business, finding affordable health insurance in this market becomes a considerable negative in reaching that decision.

Probably the most devastating indictment of our health care system is the recently released statistic on bankruptcy — over 60 percent of the bankruptcies in the U.S. are caused by medical bills. Unfortunately, Congress is now considering plans that mandate coverage, requiring uninsured individuals and families to purchase plans, often with inadequate benefits, that they may not be able to afford, and that will not protect them from bankruptcy.

Looking back at the evolution of our mixed private/public system, it's interesting to note that private insurers were the last to enter the group health care insurance market, having initially considered it too risky. However, noting the success of nonprofit, community-rated Blue Cross and Blue Shield in the 1930s, they took the plunge and by 1958 almost 75 percent of U.S. citizens were covered by some form of private insurance, primarily provided by employers.

Because private group insurance coverage has grown more expensive and less comprehensive, its share of the market has now fallen to about 60 percent. Over the years, that gap has been filled by government programs like Medicare, Medicaid and the V.A. — yet 15 percent of our population remains uninsured.

When protesters talk about keeping the government out of health care, they clearly don't understand the major role government already plays in our health care system. In fact, it provides coverage for the most vulnerable among us: seniors, veterans, children, the poor and the disabled. By doing so, it relieves private insurance companies of the risks they have always sought to avoid"¦and the bill is paid by the taxpayer. Meanwhile, private, employer-provided health insurance continues to provide less and less coverage in exchange for ever-increasing premiums for which employees pay a higher and higher percentage of the cost.

In 1993, the membership of the League of Women Voters concluded an intensive study of the U.S. health care system and reached the following consensus:

"The LWVUS believes that quality, affordable health care should be available to all U.S. residents. Other U.S. policy goals should include the equitable distribution of services, efficient and economical delivery of care, advancement of medical research and technology, and a reasonable total national expenditure level for health care. Furthermore, the League believes that all Americans should have access to a basic level of care that includes the prevention of disease, health promotion and education, primary care, acute care, long-term care and mental health care."

Rhondda Tewes of South Dennis is chairman of the health care committee of the League of Women Voters of the Cape Cod Area.

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