When I first entered politics in 2004 one of the biggest hurdles in explaining my roadmap to healthcare reform was to convince people that the system was broken. I tried to accomplish that by telling them of the 47,000,000 Americans – one sixth of our population – were uninsured. Being uninsured meant that those 47 million would therefore seek the most expensive health care in emergency rooms far into the course of their underlying disease. Early treatment before the ravages of the disease progressed, would not only have been better for those people, but would have been far less expensive. Far less expensive does not mean a few dollars, but rather one or two orders of magnitude less expensive, from the tens or hundreds of thousands of dollars to just thousands of dollars. Disappointingly, most voters didn’t really care about those 47 million, not to mention their 108,000 neighbors who reside in our own congressional district without health insurance.

In that short time, even those who were content with the status quo are coming to realize intuitively that our healthcare system is broken. Their employers are no longer providing unlimited access to healthcare and many are not even providing it at all. Under the euphemism of “choice” each year they are having to pay more for less. It turns out that only the very few can avail themselves to all the treatments that the best medicine in the world has to offer. Of course, that doesn’t include the members of congress – they have the best coverage.

Back then, I tried to use statistical measures of health in comparison to other counties to show we did not have a healthcare system, but rather a “sickcare” system. I would present data as if I were presenting a paper to my colleagues. It turns out the voters just weren’t interested. They were not impressed that of the 30 most industrialized countries in the world, we were number 24 in life expectancy1. Neither were they impressed that our premature deaths were the second and fourth worse for females and males2 . They weren’t impressed we were number five in our deaths from heart disease3. They didn’t seem to care that we were number twenty seven in infant mortality with only Mexico, Turkey and the Slovak Republic worse than us4.

For all that, we spend over twice for each person than almost all the other countries5. In fact, you could even say that the Slovak Republic was getting a good deal. They spend six times less than we do and have an infant mortality just slightly higher than ours. Yes, we spent $1.5 TRILLION dollars last year for the best medicine but nearly the worst health care in the world.

So long as someone else paid, i.e. their employers, most voters didn’t care. These were just statistics and if their neighbors ran into trouble, it was just an aberration of the “best medicine in the world,” and it wasn’t going to happen to them. I’ve often wondered what these voters think of the fund raisers to raise money for those non or under insured who need a transplant or treatment for cancer. You see these fund raisers all the time. Is there something not repugnant that the sick have prostrate themselves and go begging for help?

The voters, however, were very impressed with the draconian phrase “socialized medicine.” John McHugh couldn’t say it enough times. A phrase that was used over and over by the American Medical Association to fight prenatal care in the 1920’s and 1930’s, Harry Truman’s healthcare insurance in the 1940’s and Medicare in the 1960’s6,7.

In parroting that, McHugh was selling a fantasy, just at Giuliani, Romney, Thompson, McCain and Ron Paul – yes, Dr. Ron Paul – and every other Republican presidential candidate is selling now. The fantasy is that you have unlimited, unfettered access to American medicine. Those fund raisers that we just talked about – they must be scams – because we all know that everyone has access to all the wonders of modern medicine. What these public “servants” are really saying is that they can avail themselves to all of American medicine – the best medicine in the world – and they want to keep it just that way. So long as you are convinced that you have the choice, freedom and ability to tap all the resources of the best medicine in the world, that is just fine with them. Just keep paying your taxes, provide them with cushy benefits, while they sell you a scam – along with Iraq’s weapons of mass destruction, Iran’s nuclear weapon program, Karl Rove and Scooter Libby having nothing to do with outing a CIA agent, water boarding isn’t torture and …” Walt Disney couldn’t do it any better.

I unsuccessfully tried to persuade the voters to change the way we finance health care, not the way we provide it. John McHugh knew that then, as do the Republican Presidential candidates know that now when they stoop into the linguistic gutter and dredge up “socialize medicine.” If there is any country in the world where “socialized medicine” is an accurate description of a health care system, it is Great Britain. That truly is socialized medicine, where the hospitals are owned by the state, all the health care providers are paid by the state and where you have to register at the local GP’s office for your health care. You don’t have a choice of doctors and there is no incentive for hospitals or doctors to provide care. They are paid a straight salary, regardless of how many patients the see. Hence the long waiting lists. Except for Dennis Kucinich (HR 1200)8, that is not what the other Democratic Presidential candidates are proposing.

The financing of health care to provide everyone with coverage is a far cry from the government owning hospitals, doctors, and telling you where you can go for your health care.

I don’t think the American public needs anymore explanations of how broken our health care system is. They now viscerally know it. They’ve been hit in the gut; their wallets feel it and their loved ones can only look in the window and marvel at the wonders of American medicine.

Next post: Now the we’ve got the hysteria of “socialized medicine” out of the way, we’ll find out where our money goes.

1. Tabulation: Organization for Economic Co-Operation and Development, Life Expectancy at Birth, 2007.
Graph: Organization for Economic Co-Operation and Development, Life Expectancy and Per Capita Spending 2007.
2. Organization For Economic Co-Operation And Development, Premature Mortality, 2007.
3. Organization For Economic Co-Operation and Development, Ischemic Heart Diseae Mortality, 2007.
4. Organization For Economic Co-Operation and Development, Infant Mortality, 2007.
5. Organization For Economic Co-Operation and Development, Health Expenditure Per Capita 2007.
6. David Greenberg, “Who’s Afraid of Socialized Medicine”, Slate Magazine, Oct 8, 2007.
7. NPR Morning Edition 12/06/07 read NPR listen:
8. HR 1200 text HR 1200 Summary