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The Inhuman State of U.S. Health Care Vicente Navarro more on US Politics/Economy3ShareVicente Navarro is Professor of Public Policy, Sociology, and Policy Studies at the Johns Hopkins Bloomberg School of Public Health and Professor of Political and Social Science at Pompeii Fabra University. He is editor-in-chief of the International Journal of Health Services, and author of The Politics of Health Policy (Blackwell, 1994) and Dangerous to Your Health: Capitalism in Health Care (Monthly Review, 1993). This essay was the opening address at a seminar sponsored by the medical and public health students of the Johns Hopkins University, held there in 2003. The health sector of the United States is in profound disarray. Even though the United States spends more on health care (14 percent of its GNP) than any other country, we still have problems that no other developed capitalist country faces. Let me list some of them. The first and most overwhelming problem is that no less than forty-four million of our people have no form of health benefits coverage whatsoever. The majority of them are working people, and their children, who cannot afford to pay the health insurance premium that would enable them to get care in time of need. Many of them work for small companies that cannot or will not pay their part of the health insurance premium. Because these individuals cannot pay for insurance, they do not get needed care, and many die as a consequence. The most credible estimate of the number of people in the United States who have died because of lack of medical care was provided by a study carried out by Professors David Himmelstein and Steffie Woolhandler (New England Journal of Medicine 336, no. 11 <1997>). They concluded that almost 100,000 people died in the United States each year because of lack of needed care—three times the number of people who died of AIDs. It is important to note here that while the media express concern about AIDs, they remain almost silent on the topic of deaths due to lack of medical care. Any decent person should be outraged by this situation. How can we call the United States a civilized nation when it denies the basic human right of access to medical care in time of need? No other major capitalist country faces such a horrendous situation.
But the problem does not end here, with the uninsured. An even larger problem is the underinsured, that is, people whose health benefits coverage is inadequate. Most people find, at a crucial moment in their lives when they really need care, that their health insurance coverage does not include the type of medical problem they have, the type of intervention they need, or the type of tests or pharmaceuticals they require—or, that it covers only a minute portion of what must be paid for the services. We, as Americans, are the citizens with the least amount of health benefits coverage in the western world. Even the federal programs, such as Medicare (which in theory should cover all care for the elderly), are very insufficient. In every European country and in Canada, the elderly do not have to pay for the pharmaceuticals they need. Not so in the United States, where many elderly must cut back on necessities in order to pay for the drugs they need. In the United States, 35 percent of the elderly cut back on their food purchases so they can afford their medications. But where the cruelty of the system reaches its utmost is among those who are dying. Among the terminally ill, 39 percent indicate that they have “moderate to severe problems” in paying their medical bills. No other major capitalist country comes even close to this level of inhumanity
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