Amongst a backdrop of record spending, the United States faces three great policy challenges: (1) managing and absorbing the swelling costs of the past and present occupation of Iraq and Afghanistan; (2) providing healthcare for all Americans or healthcare reform to tackle rising costs; and (3) considering the costs of merely doing nothing, implementing legislation tackling climate change and greenhouse gas emissions.

Although the Obama Administration has inherited these problems and must work to remedy them, I have no hesitations blaming the Bush II Administration for allowing these three issues to fester. No doubt, a very costly mistake of the Bush II Administration was the Iraq invasion and subsequent occupation of Iraq. Nonetheless, 75% of Americans originally supported the invasion of Iraq. Proudly, I did not support the invasion of Iraq.

Unfortunately, what we all received—whether we supported the Iraq invasion or not—was a future potential price tag of $2 trillion dollars. In addition to Democratic support for the invasion of Iraq, the aggressive Republican push and support for this costly war is contrary to that party’s philosophy. Nonetheless, Republicans point the finger at Democrats for perpetuating big spending thus big government. However, Republicans under Bush II managed to produce record deficits, which arguably, did not promote the general welfare of our country.

Basically, we’ve received nothing for these huge policy mistakes. Accordingly, that’s why I support spending measures like healthcare reform from the Obama Administration, because these new policies are needed to alleviate inefficiencies contributing to record deficits, and these new policies reflect spending for the general welfare of our country.

Currently, Congress is debating healthcare reform, but the political will to remedy our nation’s healthcare woes has slowed down due to worries over costs. However, these worries either reflect ignorance of the issues or a desire to ignore them. Too bad we didn’t bottle up any of that American support leading up to the Iraq Invasion for healthcare reform, because we could use some of that aggressive American support for healthcare reform, education reform, and meaningful measures to tackle climate change and pollution.  Ultimately, I believe the arguments against healthcare reform are as weak as the arguments made to invade Iraq.

Here are some interesting numbers I’ve found online regarding the three issues mentioned in the first paragraph.  Furthermore, I will continue to update this post, and please fill free to contribute.

WAR

1. % of Americans supporting the 2003 invasion of Iraq: 75%.
2. Cost of the Iraq War earlier today: $667,415,039,641 and rising substantially by the second
3. Cost of Iraq War per second: $5,000 – $6,300 or more
4. Total projected cost of former President George W. Bush’s Iraq War: $2,000,000,000,000 (or $2 trillion dollars) or more
5. Projected cost of the Iraq War in 2003: Under $50,000,000,000 (that’s billions)

Well, the Office of Management and Budget, has come up come up with a number that’s something under $50 billion for the cost. How much of that would be the U.S. burden, and how much would be other countries, is an open question. I think the way to put it into perspective is that the estimates as to what September 11th cost the United States of America ranges high up into the hundreds of billions of dollars. Now, another event in the United States that was like September 11th, and which cost thousands of lives, but one that involved a — for example, a biological weapon, would be — have a cost in human life, as well as in billions, hundreds of billions of dollars, that would be vastly greater.

—former Defense Secretary Donald H. Rumsfeld

HEALTHCARE

Canada spends more than a third less per capita on health than the United States and still covers everyone, whereas the U.S. system leaves 46 million people without insurance.

Via

1. Cost of current House healthcare plan: $1.042 trillion over 10 years

According to a report “submitted to Congress by the Congressional Budget Office and the Joint Committee on Taxation,” healthcare reform as it stands now would cost “$1.042 trillion over 10 years . . . [but] that cost would be partially offset by program savings of $219 billion over five years and added revenues totaling $583 billion.”

2. % increase of employer health insurance premiums in 2008: “5.0 percent – two times the rate of inflation.”
3. Even though no national healthcare plan currently exists, the total national health expenditure as % of U.S. gross domestic product in 2008 and 2018: “The health share of GDP is projected to reach 16.6 percent in 2008 and 20.3 percent by 2018.”
4. U.S. obesity-attributable medical expenditures in 2003: $75,000,000,000 (yes, that’s in billions). More data can be found here and here.
5. Research suggesting % of Americans that could be overweight or obese by 2030: 86%
6. % of Americans under the age of 65 without health insurance in 2007 (including me): 18%
7. Despite not having some type of universal coverage, how does the U.S. rank in overall healthcare expenditures? #1: “The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care.” (from a 1999 source)

Discussion of Michael Moore’s Sicko—“Bill Moyers interviews former health insurance industry executive Wendell Potter, who left the field after almost 20 years to become a health reform advocate.”

Via AMERICAblog News, these folks share their experiences with foreign healthcare and healthcare in the United States:

Comment 1

I’m a Canadian. two years ago my sister walked into our local hospital, dropped dead with a heart attack, they worked on her for 15 minutes and got her heart started again. She was moved to ICU and put on life support with a nurse by her bed 24 hours a day. A few days later she was air lifted to a bigger hospital an hour away. She remained in ICU for another two weeks on life support and again with a nurse 24/7. They even at one point were talking about a heart transplant. She finally recovered without the transplant and was realeased from hospital. The total bill for the entire 3 weeks…..$O.00. So what if i have to wait a few months for knee surgery, BTW that wouldn’t cost anything either.

Comment 2

So what if some poor French farmer or Factory worker is paying for someone else’s medical bills? Have you not considered that maybe – JUST MAYBE – they, too, will one day require medical attention? At which point those who have already been to the hospital / clinic will be paying for THEM, so its a fair system. Everyone gives some and everyone takes some.

Sure, some take more than others given biology and a few unwise lifestyle choices, but who has really lived a problem-free life?! The medical attention is there when YOU need it — not when your needs have been cleared through your insurance company and are able to pay for it.

Comment 3

I have a very good example of why our healthcare costs are so inflated. I live in NYC, and in my experience, the insurance my employer provides is quite good. I know it costs nearly $15,000 per employee per year, which luckily, my employer pays in full.

I recently wanted to get a new pair of glasses, and needed to see the eye doctor to make sure my prescription hadn’t changed since my last exam some years earlier. The way my insurance works, I have to go through my primary care doctor for a referral to any “specialists”, or my insurance will not cover it. When I called my doctor’s office to ask them to put in the referral with my insurance, they refused. They would only give me a referral to see an eye doctor if I came in for an exam with my primary care doctor first. So I had to wait 2 weeks to see my primary doc, who charges almost $400 per visit (paid by my insurance) just to be told I was in fine health. And only then did they clear me to see my eye doc.

My primary care doc essentially held me hostage with insurance.

Comment 4

I had triple bypass open heart surgery in 1995 at a local private hospital in my PPO, which was part of the health coverage provided by my employer. I’d gone to the ER late one night and went directly from there to the OR at noon the next day (thanks to a cancellation in the top cardiac surgeon’s schedule). The surgery was a such a success that I didn’t need any patchwork done until just a few weeks ago. I was in the hospital for 6 days only because I had a relatively minor setback on the morning of day 4, when the insurance company wanted me to be sent home. The total hospital bill was over $100,000, not including the doctors’ fees.

The insurer paid their share of everything but the room, claiming that it alone hadn’t been preauthorized. Remember, I was not involved in any of the arrangements; it all took place between the hospital and the insurer. The room charge for 6 days in the CCU was approximately $20,000 (nearly 15 years ago!). When I began getting monthly bills from the hospital, I started contacting both the insurer and the hospital, all to no avail. They all recognized the absurdity of paying for the surgery and the meds and the staff time, etc., but not the room. Yet no-one chose to resolve it. I couldn’t and didn’t pay.

Eventually, the matter was turned over to a collection agency. Finally, I overheard in the pharmacy line that the hospital had a dispute-resolution office. Why I hadn’t been told of its existence, I can’t imagine. Fortunately, though it took the better part of 6 months, the hospital was able to persuade the insurer to reverse its decision not to pay for the room. Except for the deductible, I was off the hook.

Besides the stress to me, think of all the time, effort and expense devoted to this idiotic dispute. Nor was this a rare experience; many of my coworkers and friends and family had similar experiences. For example, when my father was dying of a brain tumor in the mid-’80s, my mother was confused and distressed by Medicare’s apparently random rejection of about 10% of her legitimate claims.

During one of Dad’s several hospitalizations, Mom overheard in the lounge a conversation among other spouses about the same problem. The solution, as described by 2 of those involved, was simply to resubmit the claims exactly as before. From then on, every time Mom resubmitted a rejected claim, the claims were paid.

After my father passed away, we read in the papers of a major investigation of this practice. Medicare contracted out its claims determinations to big insurance companies on a regional basis, which I imagine is still the practice. When the government decreed that Medicare had to reduce its expenditures by a certain percentage (maybe 5 to 10%, but I don’t recall the details), the feds ordered the claims-administering insurers to tighten up the screening of claims.

In some cases, they took a closer look at pending claims to find more that could legitimately be declined; in other cases, they randomly rejected one of every 10 or 15 or 20, whatever was necessary. Prudential was the “guilty party” for the region that included Northern New Jersey; apparently, they were among the random rejectors, which explains how identical claims could be accepted on the second or third attempts after one or more rejections.

In contrast, when I was on vacation in London in the early-’70s, my friends and I were having lunch in our hotel dining room. Just as the meal was being served, I had a moderately severe asthma attack, my first in many years. After being whisked to a nearby hospital by ambulance, I was treated in the emergency clinic and kept overnight for observation. The total cost was zero/nil/nada, including meds. The only negative was that the hotel insisted I pay for the meal I’d been unable to eat!

Comment 5:

Given the supposed superiority of the free-market system we think we have for healthcare, shouldn’t our costs be dramatically less than those socialists across the pond?

France spends only around 10% of its GDP on healthcare. With no one denied care or coverage.

The US spends 17% of GDP on healthcare. Millions are uninsured.

So in reality, the President is right; we should be able to ensure access to healthcare without spending a single dime more.

Comment 6:

I have a severe genetic disorder that causes my insides to painfully swell. In the states, I have to import medication to treat the disorder at a cost of around $1,000 a treatment. While in France studying abroad, I became sick on the train from Lyons to Paris. After standing in the bathroom of the train throwing up for over two hours, I somehow stumbled to a cab and asked to be taken to the nearest hospital.

Upon arriving, I continued throwing up in the waiting area. The nurse kindly took down my information and led me to the back. After about 10 minutes of trying to explain my disorder, the doctor suddenly realized what I was asking for, left the office, and came back with three vials of my treatment medication. He treated me, gave me plenty o painkillers, and sent me on my way.

As for payment? The nurse asked for my address and I wrote it on her hand. About a month later, a bill for 40 euros arrived at my home in Nebraska.

Comment 7:

We were visiting my in-laws in Auckland, New Zealand and before the trip, I called my healthcare provider here in the Pennsylvania area – Highmark Blue Cross – about coverage abroad. They sent me a link of primary care physicians. Understand that I pay extra for PPO care, so theoretically, I should be able to pick anyone from their list and just set up an appointment.
My daughter had an ear infection and I called the doctors on Highmark’s list. Out of 10 doctors, 7 doctors have changed practices and are no longer at these medical practices or out of business. The other 3 were surgeons. Obviously Highmark did their homework.
My mother-in-law suggested we take our daughter to their primary care physician at the local mall. I am expecting having to pay 200-800 USD for office visit and possible prescription(s). We get to the local doctors office, and it was not crowded at all. Prices for care were listed: $20 NZ Dollars for local residents, $30 NZ Dollars for international guests/visitors.
$30 NZ Dollars which at the time was approximately $20 US Dollars. For uninsured, non-resident treatment.
We were prescribed an antibiotic and I was expecting to pay $80 USD, but the pharmacy (which is attached to the doctors office) did not charge us stating it is part of the primary bill of $30 NZ Dollars.
Considering I pay in excess of $12K per year for PPO health maintenance and still have the potential to have treatments rejected, the “choice” option here in the US really is no choice. Although the base tax rate for NZ residents is slightly higher than in the US for individuals earning less than 120K, add the “tax” of healthcare and mandatory auto insurance, plus additionals like dental insurance and eyecare, plus term and whole life insurance, home owners insurance, and state, local and residential property tax in addition to a local wage tax, and my overall “tax” burden exceeds 60% of my income. Whereas, if I were to move to Auckland, NZ, with same medical coverage, life insurance, home owners and local taxes, my tax burden is only 45%.

More personal stories that make a strong case for national healthcare can be found here.

CLIMATE CHANGE (incomplete)

Via NRDC

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War on the Net:

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Healthcare on the Net:

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Climate change on the Net:

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Photo source for attribution here, here, here, here, here, here, and here. The authors or licensors of these images do not endorse my work or me and their images are protected under an attribution license.

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