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By LEE BIRD
Bawahaaaock New* Contributing Writer
It is with some trepidation that I venture to express my thoughts on health care reform in the light of all the opinions published in the newspaper during the past few weeks. ; The subject is of great complexity, exacerbated by widespread disinformation circulated by powerful, monied special interests and by political ideologues alike. The result Has been not only to arouse a primordial fear of change in the minds of many, but also to obscure facts that would be helpful in arriving at sound conclusions.
The selected facts on which I base the following discussion are set forth more folly in The National Health Program Chartbook, by David U. Himmelstein, M.D. and Stefi fie Woolhandler, M.D. M.P.H., Harvard Medcial School/Cambridge Hospital, Cambridge, Mass. To my knowledge, these facts have not been challenged since their publication in 1992.
Sen. Robert Dole recently said, in debate, “We have the best health care system in the world.” He repeated the statement three times for emphasis. But do we?
Fact: While at least 35 million . Americans have no health insurance, an additional 50 to 70 million with insurance have such inadequate coverage that a major illness would cause them to be ruined financially.
Fact: The one-third of Americans who are under-insured are1 often denied care, they are sicker and die younger. At the same time, about 300,000 hospital beds lie empty, there is a growing surplus of physicians, and a large number of unnecessary procedures and tests are performed.
Comment: Rationing in the face of a shortage of resources might be a tragic necessity, but in the context of an oversupply of resources it can hardly be justified and is morally re-' pugnant.
Fact: Between 1970 and 1984, ithe number of health care administrators in the U.S. increased almost six fold while the number of physicians and clinical personnel merely doubled. In 1987, per capita health costs in the U.S. were about 40 percent higher than in Canada. More than half this difference, or about $80 billion, was accounted for by the excess bureaucracy in the present U.S. system. • Fact: in 1990, Blue Cross/Blue Shield of Massachusetts employed more than 6,600 people (to administer insurance to 2.5 million New England residents. By contrast, British Columbia’s provincial plan, covering 3.1 million residents, was administered by 435 people. More people work for Blue Cross/Blue Shield of Mass, than work administering Canada’s entire National Health Program, covering 26 million people.
Fact: In 1987, U.S. administrative costs were $341 more per capita than Canada’s. If U.S. administrative costs were reduced to the Canadian level, the savings would amount to $80 billion (according to a 11991 GAO study), which would be sufficient to fond comprehensive coverage for all of the uninsured and to improve coverage for the underinsured.
Fact: High tech care is readily available in Canada. Thus, as compared to Americans, Canadians have higher rates of heart and/or lung and liver transplants, and comparable rates of bone marrow and kidney
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