"As to diseases, make a habit of two things - to help, or at least, to do no harm."
Hippocrates (460-277 BC), ancient Greek physician
"In a country well governed, poverty is something to be ashamed of. In a country badly governed, wealth is something to be ashamed of."
The U.S. Congress is presently debating a most important piece of legislation that would profoundly reform the U.S. healthcare system. This is without a doubt the most important domestic proposal advanced by the Obama administration.
To understand what is at stake here, one should know that in the U.S., there are three industries that operate in a political and economic environment such that they can literally write their own ticket: the tentacular defense industry, the large financial and banking industry and the pivotal health industry. Together, these industries account for more than forty percent of the U.S. economy. Their common characteristic is that suppliers can more or less create their own demand and fix prices accordingly. The potential for gouging is enormous. Needless to say, these industries are among the most profitable ones... for those who can enter them.
This may partially explain why since 1970, American health costs have grown at an average annual rate of 9.6 percent per year. That is close to twice the pace of the increase of the overall economy. For example in 2010, health costs in the U.S. are expected to increase four times faster than the annual increase in the average hourly wage of American workers. This is clearly unsustainable, less it bankrupts the entire U.S. economy.
Since medical treatment is in many cases not a choice but a necessity, people have very little leeway in economizing on such consumption within their normal budget constraints. If one requires urgent treatment, one must willy-nilly enter the medical system and pay to the hilt. An example observed recently would illustrate the fundamentals. A friend visiting Florida recently had a case of severe indigestion during the night. He was driven to the emergency room of a local hospital, where he spent two hours. The total cost was in excess of $3,000, half of it for simply crossing the door of the ER room and the rest for two simple blood and urine tests. Maybe Walmart should take over the administration of U.S. hospitals!
To protect against unforeseen medical outlays that can seriously perturb their financial position, most people rely on one form or another of health insurance. This could be private insurance, group coverage insurance, cooperative insurance or collective or public insurance.
For example, members of Congress are covered by a public health insurance plan. Military personnel and military veterans are insured through a public plan, either through the U.S. Department of Defense Military Health System or through the Veterans Health Administration (VHA).
Americans who are over 65 years old are covered by a public single-payer health care system, called Medicare. Such a public American health program has been in existence since 1965. This is a large public health plan that presently covers more than 43 million Americans. It now provides comprehensive hospital, medical and drug coverage for those lucky enough to qualify because of age and residency.
One can therefore understand why the issue of comprehensive health care insurance is so politically contentious in the United States. Those who are already covered by a generous public health care program--by such public programs such as Medicare, i.e. the insiders, possibly a third of the U.S. population--do not see an urgent need to change a situation that benefits them. Those who rake in tremendous profits in the private health industry are also fighting to maintain their privileged position. Being already covered, they are less persuaded that there is such a thing as a fundamental right to health care.
The victims, the outsiders whose health insurance is tied to their job or who are not covered at all, do not have the same political clout nor the same access that the insiders have to the media or to members of Congress. Generally speaking, the Republican party and its allies in the far right media side with the insiders, and vigorously oppose most attempts for health care reform and an extension of their privileged position to others. Generally speaking again, the Democratic party and its progressive allies tend to side with the outsiders and have been pushing for reform for many years.