Health care in the United States
aspect of American society
Health care in the United States is provided by many distinct organizations, made up of insurance companies, healthcare providers, hospital systems, and independent providers. In 2016, 58% of community hospitals in the United States were non-profit, 21% government-owned, and 21% for-profit. According to the World Health Organization (WHO), in 2018 Total health expenditure per capita in 2018 PPP international U.S. dollars were: United States $10,624, Canada $5,200, Australia $5,005, United Kingdom $4,620, Spain $3,576, Cuba $2,519, Russia $1,488, and China $935. The United States does not have a universal healthcare program, unlike most other developed countries.
QuotesEdit
Physicians’ and pharmacists’ first and foremost ethical obligation in situations of epidemic, disaster or terrorism is to provide urgent medical care and ensure availability and appropriate use of necessary medications. ~ American Medical Association
Homer Simpson: America's health care system is second only to Japan … Canada, Sweden, Great Britain … well, all of Europe. ~ Gary Apple and Michael Carrington
The head of Indianapolis-based insurance company OneAmerica said the death rate is up a stunning 40% from pre-pandemic levels among working-age people. “We are seeing, right now, the highest death rates we have seen in the history of this business – not just at OneAmerica,” the company’s CEO Scott Davison said during an online news conference this week. “The data is consistent across every player in that business.” ~ Margaret Menge
The U.S.'s privatized for-profit health care system had long been an international scandal, with twice the per capita expenses of other developed societies and some of the worst outcomes. ~ Noam Chomsky
It has been a rotting corpse for decades, with heinous medical experiments carried out throughout our modern history. The administration of LSD to prepubescent children by the intelligence services in the 1950s; the widespread use of psychiatric drugs, lobotomies, electric shock, and involuntary commitments in the decades after; and the deliberate butchery of over 60 million infants in America since 1971. We are only now paying a bill that was racked up over several generations. We tolerated medical injustice because most of us did not know any better. More of us know more now, but the truth is withheld from the masses under the COVID-19 censorship regime. ~ Benjamin Braddock
- Physicians’ and pharmacists’ first and foremost ethical obligation in situations of epidemic , disaster or terrorism is to provide urgent medical care and ensure availability and appropriate use of necessary medications. This requires close coordination with the entire health care team to help ensure patients receive the testing, treatments, follow-up care and medications they need. We applaud the innumerable selfless acts by health care professionals across the nation who are putting themselves in harm’s way to provide care to America’s patients.
- Homer Simpson: America's health care system is second only to Japan … Canada, Sweden, Great Britain … well, all of Europe. But you can thank your lucky stars we don't live in Paraguay !
- Gary Apple and Michael Carrington, The Simpsons, Season 4, episode 11: "Homer's Triple Bypass", (Dec 17, 1992)
- It doesn’t say rest on your laurels, but to keep on pushing. In this work, sometimes you get heavy criticism. People do say ugly things, ‘You just want money.’ I just want other people to have health care. You know, Jesus healed everybody and never charged a co-pay.
- With its broad sweep, the COVID-19 pandemic has forced us into an unprecedented national emergency. This emergency, however, results from a deeper and much longer term crisis — that of poverty and inequality, and of a society that ignores the needs of 140 million people who are poor or a $400 emergency away from being poor. [...] We cannot return to normal. Addressing the depth of the crises that have been revealed in this pandemic means enacting universal health care. [...] Before COVID-19, nearly 700 people died everyday because of poverty and inequality in this country. The frontlines of this pandemic will be the poor and dispossessed - those who do not have access to healthcare [...] - and those who are continuing to work in this crisis, meeting our health care and other needs. It should not have taken a pandemic to raise these resources.
- William Barber II and Liz Theoharis, letter to President Donald Trump, Vice President Mike Pence and Members of the 116th Congress, Poverty Amidst Pandemic: A Moral Response to COVID-19 (March 19, 2020), Poor People's Campaign: A National Call for a Moral Revival.
- In June 2019, we presented a Poor People’s Moral Budget to the House Budget Committee, showing that we can meet these needs for this entire country. If you had taken up this Moral Budget, we would have already moved towards infusing more than $1.2 trillion into the economy to invest in health care, good jobs, living wages, housing, water and sanitation services and more. This is not the time for trickle-down solutions. We know that when you lift from the bottom, everybody rises. There are concrete solutions to this immediate crisis and the longer term illnesses we have been battling for months, years and decades before. We will continue to organize and build power until you meet these demands. Many millions of us have been hurting for far too long. We will not be silent anymore.
- William Barber II and Liz Theoharis, letter to President Donald Trump, Vice President Mike Pence and Members of the 116th Congress, Poverty Amidst Pandemic: A Moral Response to COVID-19 (March 19, 2020), Poor People's Campaign: A National Call for a Moral Revival.
- While the virus itself does not discriminate, it is the poor and disenfranchised who will experience the most suffering and death. They’re the ones who are least likely to have health care. [...] We need health care to be understood as a human right for all of us.
- William Barber II, The Real Epidemic is Poverty (March 30, 2020), The Progressive
- It has been a rotting corpse for decades, with heinous medical experiments carried out throughout our modern history. The administration of LSD to prepubescent children by the intelligence services in the 1950s; the widespread use of psychiatric drugs, lobotomies, electric shock, and involuntary commitments in the decades after; and the deliberate butchery of over 60 million infants in America since 1971. We are only now paying a bill that was racked up over several generations. We tolerated medical injustice because most of us did not know any better. More of us know more now, but the truth is withheld from the masses under the COVID-19 censorship regime.
- Benjamin Braddock, An Open Letter on Justice and Medical Tyranny, Countere, 30 March 2022
- When Susan Finley developed flu-like symptoms, she didn’t go to the doctor because she was frightened about the cost. Finley’s grandparents later found her dead in her apartment. She was 53. Finley did not die as a result of Covid-19. She died in 2016 as a result of America’s healthcare system – a system that led her to avoid treatment for the common flu in order to avoid debt. It is that same system that is currently creaking under the pressure of a pandemic that experts warned was coming but governments failed to prepare for.
- It [America’s healthcare system] is a system that does not qualify for the term “developed”. [...] There are 2.9 hospital beds for every 1,000 people in the United States. That’s fewer than Turkmenistan (7.4 beds per 1,000), Mongolia (7.0), Argentina (5.0) and Libya (3.7). In fact, the US ranks 69th out of 182 countries analyzed by the World Health Organization. This lack of hospital beds is forcing doctors across the country to ration care under Covid-19, pushing up the number of preventable deaths. America’s numbers are similarly unimpressive when it comes to medical doctors. The United States has 2.6 doctors per 1,000 people, placing it behind Trinidad & Tobago (2.7), and Russia (4.0 doctors per 1,000, for a country that is described as being “in transition”). Life expectancies at birth are lower in the US than they are in Chile or China. The US has a higher maternal mortality rate than Iran or Saudi Arabia.
- The facts are as exhaustive as they are exhausting. There’s one simple conclusion from all of this. We’ve been tricked. We’ve been told that America, like most other majority-white countries, deserves the title “developed economy”. It does not. You cannot charge a woman $39.95 to hold the baby that she has just given birth to. You cannot constantly operate hospitals at close to capacity in order to maximize profits. The pursuit of private money in systems built for public good has not worked ethically or practically.
- I don't think I know enough to say, well, here's the plan. It's not my specialty.... But I don't think there's any way not to have that debate about how much we're going to spend on health care.... In finding our way forward, we've got to be able to find ways to deliver the quality care that everyone expects and that we're capable of providing to the maximum number of people.
- Dick Cheney, "The Weekend Interview: The Story of Dick Cheney's Heart", The Wall Street Journal, July 9, 2011.
- The U.S.'s privatized for-profit health care system had long been an international scandal, with twice the per capita expenses of other developed societies and some of the worst outcomes. Neoliberal doctrine struck another blow, introducing business measures of efficiency: just-on-time service with no fat in the system. Any disruption and the system collapses. This is the world that Trump inherited, the target of his battering ram.
- Noam Chomsky, in an interview with C.J. Polychroniou, Chomsky: Ventilator Shortage Exposes the Cruelty of Neoliberal Capitalism (April 1, 2020), Truthout
- If Americans are to have the courage to change in a difficult time, we must first be secure in our most basic needs. Tonight I want to talk to you about the most critical thing we can do to build that security. This health care system of ours is badly broken, and it is time to fix it. Despite the dedication of literally millions of talented health care professionals, our health care is too uncertain and too expensive, too bureaucratic and too wasteful. It has too much fraud and too much greed.
- Bill Clinton, Address to a Joint Session of the Congress on Health Care Reform, (22 September 1993)
- In the wake of slavery’s end, skilled Black midwives represented both real competition for white men who sought to enter the practice of child delivery, and a threat to how obstetricians viewed themselves. Male gynecologists claimed midwifery was a degrading means of obstetrical care. They viewed themselves as elite members of a trained profession with tools such as forceps and other technologies, and the modern convenience of hospitals, which excluded Black and Indigenous women from practice within their institutions.
- Michele Goodwin, “The Racist History of Abortion and Midwifery Bans”, ACLU, (July 1, 2020)
- To better understand racial injustice in the anti-abortion movement, remember that American hospitals barred the admission of African Americans both in terms of practice and as patients.
- Michele Goodwin, “The Racist History of Abortion and Midwifery Bans”, ACLU, (July 1, 2020)
- Sarah Kliff spent the last year looking at over 1000 ER bills and has found outrageous facility fees, high costs for OTC drugs, and charges for simply sitting in the waiting room. Medicare for All would take these excess costs out of the equation...
- Ro Khanna in a Twitter post (28 December 2018)
- Our demand for Medicare for All must be stronger than Big Pharma lobbyists.
- Ro Khanna in a Twitter post (28 December 2018)
- Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.
- Martin Luther King, Jr., Speech to the Second National Convention of the Medical Committee for Human Rights – Chicago (25 March 1966), as quoted in Dan Munro, "America's Forgotten Civil Right - Healthcare", Forbes (28 August 2013). See also: Amanda Moore, "Tracking Down Martin Luther King, Jr.'s Words on Health Care", Huffington Post (18 August 2013)
- Un pre-ACA days, a bout with a virus might not have been considered a preexisting condition. That's because many people tend to recover quickly from viruses.
But in a blog post last week, researchers at the Rand Corp. suggested that COVID-19 could be seen differently by insurers. "Given the chronic problems [which can include organ damage, fatigue and confusion] associated with some COVID-19 cases, it is possible that some insurers would place restrictions on anyone who had a confirmed case of COVID-19," wrote Carter C. Price, Rand's senior mathematician, and Raffaele Vardavas, a mathematician at Rand who specializes in infectious disease models.- Fran Kritz, ”Coronavirus FAQ: Could COVID-19 Ever Be Considered A Preexisting Condition?”, Goats and Soda, NPR, (November 9, 2020)
- Twenty years ago, Kaiser surveyed health insurance underwriters and asked about a similar situation: a hypothetical applicant in perfect health except for "situational depression" following the death of a spouse. According to the survey, "in 60 applications for coverage, this applicant was denied a quarter of the time, and offered coverage with a surcharged premium and/or benefit exclusions 60% of the time."
So both experts and consumers are concerned that invalidating the Affordable Care Act could mean that once again, individuals with preexisting conditions might not be covered — and such conditions could include COVID-19.- Fran Kritz, ”Coronavirus FAQ: Could COVID-19 Ever Be Considered A Preexisting Condition?”, Goats and Soda, NPR, (November 9, 2020)
- Modern observers accustomed to thinking of the medical profession as prestigious technically effective and highly paid are sometimes shocked to learn that it was none of those things in the nineteenth century. On the contrary, much of its history during that century was an uphill struggle to attain jut those attributes. Whereas European physicians entered the modern era with at least the legacy of well-defined guild structure-structures that took responsibility for teaching, maintained the right to determine who could practice, and exercised some control over the conduct an craft of the profession-American physicians did not. Because of its history as a colony, the United States attracted few guild-trained physicians, and consequently a formal guild structure never developed. Healing in this country started out primarily as a domestic rather than a professional skill (women and slaves often developed considerable local reputations as healers), and therefore anyone who claimed medical talent could practice-and for the most part could practice outside of any institutional controls of the sort that existed in Europe.
It is true that some early colonies did establish different fee structures for “trained” as opposed to “folk” doctors, but these regulations were not supported by “enabling” legislation. “Trained” physicians had the right to charge more, but there were no regulatory mechanisms by which they could enforce their higher fees or, ore importantly, deny others the right to practice medicine. From the earliest days of the medical profession in this country, therefore, physicians wanted effective licensing laws that would do for them what the guild structures had done for their European colleagues, namely, restrict the competition.- Kristen Luker, ”Abortion and the Politics of Motherhood” University of California Press, pp. 16-17
- In the early part of the nineteenth century, the fate of trained physicians became even worse. What few regulations had existed in the colonial period were swept away in the era of Jacksonian democracy, and medical practice became one vast free market. Moreover, during the second quarter of the century, deep doctrinal divisions appeared within the rank of trained physicians themselves. For the first third of the century, physicians had depended on a model of illness that called upon the use of drastic medical treatments such as bleeding or the administration of harsh laxatives and emetics. By the 1850, a new group of physician (including such luminaries as Oliver Wendell Holmes) rejected the use of this “heroic armamentarium” and earned for themselves the sobriquet of “therapeutic nihilists” inasmuch as they seemed to argue that anything a physician could do was probably ineffective and might be dangerous as well.
Two other developments during the course of the century kept the social and professional status of medicine low. First, as the effectiveness of “heroic” medicine was called into question by some physicians themselves, there was a proliferation of healers who advocated new models of treatment. Thomosonians, botanics, and homeopath among others all developed “sets” of healing and claimed the title of doctor for themselves. These nineteenth-century sectarians flourished, perhaps in part because they tended to support relatively mild forms of treatment (bath, natural diets) instead of the “heroic” measures used by many doctors. Thu, regular physicians (those who had some semblance of formal training and who subscribed to the dominant medial model) found themselves in increasing competition with the sectarians, whom they considered quacks.- Kristen Luker, ”Abortion and the Politics of Motherhood” University of California Press, pp.16-17
- Concurrent with the emergence of the sectarian, there was an explosion of new medical schools: an estimated four hundred new ones opened during the course of the century. Unlike modern-day medical schools, whose strict admission standards are legendary, the majority of these schools were proprietary. Like modern-day vocational schools, they were open to all who could pay their fees, and precisely because they depended upon fees to survive, they were reluctant to fail anyone who could be counted on to pay tuition regularly.
Members of the regular medical profession were therefore caught in a dilemma. In order to upgrade the profession’s status, they had to upgrade not only the standards of practice but also the education and qualifications of those who wished to practice. However, the prerequisite to such an upgrading-the restriction of the title of “doctor” to only the bet and the best-trained physicians-was difficult to meet because of the lack of licensing laws. Physicians faced the paradox that they could not obtain licensing laws until they were “better” than the competition, but becoming “better” depended on having licensing laws. The way in which physicians solved this problem was to bring them to the center of the abortion debate in America.- Kristen Luker, ”Abortion and the Politics of Motherhood” University of California Press, p.18
- We are the richest country in the world. We spend more on health care than any other country. Yet we have the worst health care in the Western world. Come on. We can do better than this.
- Michael Moore as quoted in Corliss, Richard (19 May 2007). "Sicko is Socko". Time.
- The head of Indianapolis-based insurance company OneAmerica said the death rate is up a stunning 40% from pre-pandemic levels among working-age people. “We are seeing, right now, the highest death rates we have seen in the history of this business – not just at OneAmerica,” the company’s CEO Scott Davison said during an online news conference this week. “The data is consistent across every player in that business.”
- Margaret Menge, Indiana life insurance CEO says deaths are up 40% among people ages 18-64, The Center Square, 1 January 2022
- Sanders is still fighting the battle for single payer, Medicare-like coverage for all, even as fellow Democrats capitulated to the siren songs of the health and insurance industries. President Obama, himself a one-time advocate of single payer coverage, buckled to the insurance companies and its lobbyists and minions in Congress and agreed to health care legislation (the Affordable Care Act) that would continue to treat healing the sick as a profit center instead of a basic human right.
- Bill Moyers & Michael Winship, Tell the Truth about Bernie’s Health Care Stand, Common Dreams, (16 January 2016)
- So if you believe in guaranteed high-quality universal healthcare, because you have seen the cost and the consequence of millions of our fellow Americans who have no healthcare or do not have enough healthcare, then let us come together around a policy that begins by prioritizing affordability in prescription medications that ensures that we bring down the cost of our premiums and our deductibles. And in a country, and in a country where too many of our fellow Americans are dying of diabetes in the year 2019, dying of the flu, dying of curable cancers, in a community, in a state, in a country where one of the largest providers of mental healthcare services is the county jail system, and in a nation that is in the midst of a maternal mortality crisis three times as deadly for women of color, then let us ensure that universal healthcare means all of us can see a primary care provider, all of us can get mental healthcare help, and that universal care means every woman makes her own decisions about her own body. We can give every American, every business in this country the choice to enroll in Medicare without eliminating plans that many Americans like for their families because those plans work for their families. Everyone able to see a doctor. Everyone able to afford their prescription. Everyone able to take their child to a therapist. No one left behind. No one priced out. We must get to universal guaranteed high-quality healthcare as soon as surely as we possibly can.
- The New York State Department of Health appeared to announce this week that non-white New Yorkers would receive priority over whites in receiving “extremely limited” Covid-19 therapies for people at risk.
- Russia Today, Non-whites to receive priority for limited Covid pill, 31 December 2021
- D.C. Women's Liberation succeeded for the first time in making informed consent a national issue. In the aftermath of the hearings, the U.S. government would require the pharmaceutical industry to include a patient information sheet with complete information on side effects in every package of birth control pills sold. The growing women's movement was prompting women to assert control over their bodies, and in doing so it changed forever the way Americans take prescription medications.
- Criticism should not be focused on Nazi Germany alone but extend beyond to include physicians in democratic countries, as well. Physicians outside Germany before the war, in the United States in particular were well aware of the evolving racist thrust of the health care system. They chose to remain silent.
- William E. Seidelman (1992). Quoted in, The War Against Children of Color: Psychiatry Targets Inner-City Youth (1998), Peter R. Breggin, M.D., Common Courage Press, Monroe, Maine, ISBN 1567511279 ISBN 1567511260 ( 2002 ed., ISBN 1567511260 ISBN 9781567511260 ch. 7, Condemned by Science: The Role of Psychiatry in the Holocaust, p. 124. [1]
- We're going to ask the wealthiest people and the largest corporations to start paying their fair share of taxes. We're going to take on the pharmaceutical industry and have Medicare negotiate prices. We're going to finally deal with child care and pre-K. Can you imagine in this country where you have free pre-K for every working family in America? We're going to have — end the disgrace of the United States being the only major country on Earth not to have paid family and medical leave. We're going to expand Medicare to cover dental, hearing aids and eyeglasses. We are going to got home health care... We're going to have — end the disgrace of the United States being the only major country on Earth not to have paid family and medical leave. We're going to expand Medicare to cover dental, hearing aids and eyeglasses. We are going to got home health care.
- Bernie Sanders, Sanders: GOP ‘nervous’ about ‘overdue’ progressive policies in budget, infrastructure bill", PBS Newshour, (20 July 2021)
- Let Mr. Barrasso go to the folks in Wyoming and ask them whether they think it's a good idea that they should be paying a third of their income in child care. Ask elderly people who don't have any teeth in their mouth whether they should be able to get dentures through Medicare. Ask the scientific community whether the time is now in a big way to deal with climate. Ask the ordinary American consumer whether we should take on the greed of the pharmaceutical industry, which charges us the highest prices in the world for prescription drugs.
- Bernie Sanders, Sanders: GOP ‘nervous’ about ‘overdue’ progressive policies in budget, infrastructure bill", PBS Newshour, (20 July 2021)
- The crisis of public healthcare systems has long been a widespread demand in several countries, particularly in the U.S. Surveys showed that even before this crisis, healthcare was among the main concerns of the U.S. population because of the debt it generates for families and because 27.5 million people do not have any kind of coverage. Bernie Sanders has been attacked, not only by Trump but also by the Democrats and Biden, because he calls for Medicare for All. All healthcare systems are organized around the profits of big corporations.
- Trotskyist Fraction – Fourth International, Coronavirus and the Healthcare Crisis: Our Lives Are Worth More than Their Profits!, Left Voice, (March 14, 2020).
- Obamacare's going to be repealed and replaced. Obamacare is a disaster if you look at what's going on with premiums where they're up 45, 50, 55 percent... They [the uninsured] are going to be taken care of. I would make a deal with existing hospitals to take care of people.
- Donald Trump, "Trump gets down to business on 60 Minutes" aired September 27, 2015
- For historical purposes remember, I was able to get rid of the INDIVIDUAL MANDATE, the most unpopular and expensive part of ObamaCare. You are no longer forced to pay a fortune for the “privilege” of NOT getting bad healthcare. This ended ObamaCare as we knew it. Thank you!
- Donald Trump via Twitter tweet posted January 2, 2020
- Access to medical care has long bedeviled swaths of rural America — since 2005, 181 rural hospitals have closed. A 2020 KHN analysis found that more than half of U.S. counties, many of them largely rural, don’t have a hospital with intensive care unit beds.
Pre-pandemic, rural Americans had 20 percent higher overall death rates than those who live in urban areas, due to their lower rates of insurance, higher rates of poverty and more limited access to health care, according to the Centers for Disease Control and Prevention’s 2019 National Center for Health Statistics.- Lauren Weber, “Covid Is killing rural Americans at twice the rate of people in urban areas”, “NBC News”, (Sept. 30, 2021)