Hightower Lowdown

How messed up is America's health-care system? Consider the case of the Leavitts. Anne and her husband Dixie, both in their 70s, got frazzled trying to work their way through the maddening maze of George W's new prescription-drug program, which compels seniors to choose among 1,400 competing drug-insurance schemes offered by 80 corporations. Each plan in this baffling "marketplace" offers different coverage, is frustratingly complex, and is filled with fine print. The Leavitts had to call on their son to help them select a company to cover their meds.

But -- oops! -- even with hands-on help, Anne and Dixie made a bad choice that almost cost them their entire medical coverage. They rushed to drop that plan and were lucky to find another at the last minute to avert a family disaster. What makes the Leavitt's story unique among the millions of seniors who've been similarly discombobulated by Bush's convoluted prescription plan (including 15 million who've been left with no drug coverage) is that their helpful son is none other than Mike Leavitt. Yes, the head honcho of Bush's Health and Human Services Department! One more twist: Dixie Leavitt made his fortune in the insurance business.

If someone who's an insurance professional and is personally advised by the government's top health official still gets flummoxed -- that's a clue that the Powers That Be have saddled us with a truly lousy program.

The health-industrial complex

There's no legitimate excuse for this mess. A program to provide medicines for every single senior could and should be simpler and far less expensive than Bush's $1/2 trillion scam. Medicare, with its extremely low overhead and an efficient payment system already in place, is the logical conduit for such a program. It could negotiate with drug makers on behalf of every senior to get low prices on all medicines, then pay pharmacists directly for the total cost of prescriptions they fill.

Instead, Bush and Congress put the new drug benefit in the hands of the corporate bureaucracies that separate us patients from our medical professionals. All seniors are on their own to purchase one of the confusing myriad of drug cards from HMOs and insurance companies. These middlemen then bill Medicare for whatever medications the seniors get and put no lid on the prices of the drugs.

Thus, rather than being a straightforward benefit for people in need, Bush's program has become a boondoggle benefit for America's bureaucratic, wasteful, fraud-ridden health-industrial complex. Such giants as UnitedHealth, Humana, and WellPoint (which have already scarfed up more than half of the new drug program's market) are given both a new source of monthly premiums and a generous federal subsidy to provide prescription coverage.

Not to be left out of the financial fun, the drug barons have obtained a green light to bloat their profits (already the highest of any industry) with overpriced pills that ultimately are paid for by Medicare dollars taken out of all of our paychecks. WARNING: The following fact could make your eyeballs explode: Bush demanded and got a provision in his new program that specifically prohibits Medicare officials from negotiating with drug corporations to lower the prices they charge. If only this were a bad horror movie! Alas, it's the core reality of America's sick health-care system. Wait, you say. We've got the top technology and medical know-how in the whole freakin' world. America is Number One! We have the healthiest people and we get the best quality health care there is, bar none. USA! USA! USA!

Well, that's the rah-rah myth we're fed by the industry, the media, and most politicians, but it's not true. Still, if you insist that the USA simply must be Number One, it is true that ours is by far the most expensive health-care system on the globe. Go USA! In 2004, spending averaged $6,280 for each man, woman, and child in America -- more than double the average ($2,307 per capita) spent in all other industrial countries.

Over 16% of our economy ($1.9 trillion last year) goes into our corporatized system -- 50% more than Switzerland's universal system, which ranks second in spending per person. Not only does the U.S. drastically outspend everyone else, but it does so while leaving tens of millions of Americans outside the system. In contrast, Canada puts only 10% of its economy into healthcare, Australia 9%, and England 7%, and these countries manage to provide care for every one of their people. [ read more ]