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Health Care in the U.S.A. – We Can Do Better!

June 16, 2005

by Carol Antoniewicz

For the past five years, I’ve supported the efforts of Health Care for All, a coalition of over 1,000 Maryland organizations working to achieve affordable, quality health care for all Marylanders.  It’s been quite a learning experience.  I still believe in the goals of Health Care for All.  It just looks like the whole health care system may have to crash and burn before we voters get riled up enough to demand a better way.

Most of us like to think the U.S. is number one.  Well, we’re not number one in health care, except for spending the most. In many U.S. cities the infant mortality rate rivals that of a developing country.  We’re not even close to #1 in life expectancy.  Our rates of cancer, heart disease, etc. are embarrassing.  Our senior citizens worry about whether to spend limited retirement dollars on food or medicine.

Yet people say we have the best health care system in the world.  I don’t think so.  In fact, I don’t think we have a health care system; we have a DISEASE care system.  A health care system would be devoted to keeping people healthy.  Instead, we wait until folks get sick and then spend lots of money (often making things worse), putting them through tests, treatments, expensive medicines, etc.

When HMOs (health maintenance organizations) got rolling 15 years ago, they were touted as the solution. But because folks are forced to change health plans due to changing employers, the front-end investment to keep people healthy is not a reality in most HMOs.

I believe health care is a basic human right, like food, shelter and education. (Quite honestly we’re not doing so great in those areas either.)  The richest country in the world ought to be able to find a way to provide health care to all its residents.  Did you know that only 3 of the 30 most developed countries do NOT provide health care for all ?  That’s right.  The U. S. stands next to Turkey and Mexico for that dubious distinction.  That’s why the World Health Organization ranked us 37th in health standing worldwide.

Health care has become BIG business.  Insurance companies, Healthcare corporations, Pharmaceutical companies are traded on Wall Street.  Health insurers are not in business to keep people healthy, they’re in business to make money.   They spend our health care dollars on advertising, multi-million dollar salaries for top executives, lobbying and case managers who are trained in how to deny enrollees health services. 

Even the so-called non-profit plans, like CareFirst Blue Cross and Blue Shield, operate like big business.  Do you know what they call the portion of funds they use to pay for your actual health services?  It’s called the “medical loss ratio.”  For plans like Medicare the “medical loss ratio” is 95% - there’s relatively little administrative cost.  For most private insurers, only 75% – 85% is spent on health care.  In a multi-billion dollar industry, that means billions of dollars that could go toward saving lives goes elsewhere.

We’re not getting our money’s worth!

In future articles I hope to share what’s happening in Maryland, including some admirable plans to extend health coverage to working people who cannot afford insurance.  And how you can speak up to let elected officials know that you think “we can do better.”

In the meantime, check out these websites:

Health Care for All (Maryland)

Families USA                     

Who uses Medicaid

The Kaiser Foundation

World Health Organization (WHO)


Editor’s Note:  As an corollary  to today's commentary, I want to point out that there are significant unmet healthcare needs in Frederick County, and that various groups are now working to elevate the issue and perform the necessary background research to demonstrate those needs and to build a broad coalition effort to begin to effect changes, and to meet more of the needs. 

 Many of the uninsured individuals are working adults.  Some are children.  

As a corollary to housing not being affordable for many in the county, there are families where food and healthcare cannot be supported as needed. 

Preventative care is the most efficient and cost effective care, rather than our system of what is often a last chance response to years of neglect. 

Over the next few years, I hope that you will become more aware and will support efforts to build a local response.

It will require a community of partners to accomplish the needed access to healthcare. 

If both Carroll County and Montgomery County can do this, one seen as being rich and urban,  and the other lower income and more rural,  seemingly closer in comparison to Frederick County,  then we can,  and should, do something about it as well.