Sunday, September 05, 2004

The Germ Theory of Government

In Plagues and Peoples, William H. McNeill demonstrates that societies suffer from (and learn to tolerate) both macro- and micro-parasites. The syphilis spirochete is a micro-parasite. Dick Cheney is a macro-parasite.

The government, elected or hereditary (or both, as in the Bush dynasty), is supposed to loot and pillage only in a polite and restrained manner, just enough to maintain the resources needed to fight off the impolite and unrestrained incursions of barbarian hordes, drought years, crop failures, and the other hazards of life.

In other words, they're supposed to be insurance. And what happens when your annual premiums cost more than the car is worth? You call Geico. Or you storm the Bastille, dismember the Princess de Lamballe, and guillotine the aristobastards

At crisis points, the parasites are doing more harm than good, or some external factor upsets a previously tolerable balance. This is also true of the various micro-parasites. Germs that rapidly kill their hosts are not successful in the long run

The Bush administration is using the well-worn historical tactic of creating or exploiting panic over an epidemic parasite (terrorists) in order to justify their far more destructive endemic parasitism. Moreover, they are increasing their parasitic demands while decreasing the protections and services offered to the host population. Universal health care, for example, is a highly desirable protection for the body politic. We'll never get that under the Bush administration.

A la lanterne Lysol!

Six times as many people die every year from lack of health insurance as died on September 11.

Some useful statistics:
Currently 43,000,000 Americans are uninsured, and lack of health insurance causes 18,000 unnecessary deaths each year in the U.S. Eighty percent of the uninsured are members of working families -- but a quarter of U.S. workers are not offered health insurance at all, and few Americans can afford to buy the expensive individual policies.

On January 14 the Institute of Medicine (IOM), a Congressionally chartered but independent organization created in 1970 "to serve as adviser to the nation to improve health," released a report and fact sheets asking the president and Congress to act so that everyone living in the U.S. has health insurance by 2010.

Uninsured children and adults are sicker and die more often, as cancer and other diseases are diagnosed too late. Uninsured persons injured in an automobile accident get less services in hospitals and have a 37% higher death rate than those with health coverage. Lack of health insurance causes 18,000 unnecessary deaths every year in the U.S. Currently, 43,000,000 Americans are uninsured.

The cost of the employee's share of health insurance increased 350% (in constant dollars) from 1977 to 1998, while the median income only increased 17%.

Four out of five uninsured Americans are members of working families. A quarter of U.S. workers are not offered health insurance at all by their employer. If they buy their own policy it usually costs much more than the same insurance purchased by a group, especially if they have a chronic health condition. If they do not have insurance and get sick, they usually have to pay much more for the same medical services, since insurance companies can negotiate discounts with doctors, hospitals, pharmacies, and others.

Four out of five without health insurance in the U.S. are U.S. citizens -- although immigrants are more likely than others to be uninsured.

Of the 7.8 million uninsured children in the U.S. today, half are actually eligible for insurance under SCHIP (State Children's Health Insurance Program) or Medicaid. Often they are kept out by complex enrollment or re-enrollment procedures.

It would almost certainly cost less to provide insurance to everyone than to continue the current system. The cost of covering all the uninsured has been estimated as between 3% and 5.6% of total U.S. healthcare cost.

The U.S. spends more per person on health care than any other nation -- 14% of gross its domestic product -- but is 25th in male life expectancy and 19th in female life expectancy among 29 developed countries.

The report recommends five key principles for evaluating health insurance -- that it be universal, continuous, affordable to individuals and families, affordable and sustainable for society, and should "enhance health and well-being by promoting access to high-quality care that is effective, efficient, safe, timely, patient-centered, and equitable." It does not recommend a particular reform strategy, but evaluates four of them, including single payer, on how well they meet these recommendations.

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