Corporate Greed Vs People's Health in America

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Corporate Greed Vs People's Health in America

Cesar Chelala

As the health care discussion has gathered momentum in the U.S., there is increasing evidence of the role played by corporations and politicians to hinder provision of adequate health care to the majority of Americans. The result is that the U.S. has one of the worst health care systems among industrialized nations.

Studies carried out by the World Health Organization and the Commonwealth Fund in New York show that the U.S. health care system overall performance ranked 37th among the countries included in their analysis.

The Commonwealth Fund study, released in 2007, entitled "Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care," found that not only is the U.S. health care system the most expensive in the world, but comes in dead last in almost any measure of performance.

The Commonwealth study compared the health system in the U.S. and that of Australia, Canada, Germany, New Zealand and the United Kingdom. Although the most evident way in which the United States differs from the other countries is in the absence of universal coverage, the U.S. is also last in terms of access, patient safety, efficiency and equity.

Compared to the other countries studied, the U.S. lags behind in the adoption of information technology and other national policies that promote quality improvement. In countries such as New Zealand, Germany and the United Kingdom, up-to-date information systems enhance physicians' ability to monitor chronic conditions and medication use. At the same time, the U.S. pays a higher percentage of health dollars for administration than any other nation.

The U.S. is behind all industrialized nations in terms of health coverage. Almost 47 million Americans lack health insurance coverage, which represents more people than the entire population of Canada. As pointed out by Wendell Potter, a former health insurance executive, if this number includes all those that are underinsured, that represents more people than those living in the United Kingdom. According to the Children's Health Fund, 9 million children are uninsured in the U.S., while another 23.7 million -nearly 30 percent of the nation's children- lack regular access to health care.

There are several ways corporations pressure politicians not to support health care plans that benefit the majority of the population. As Wendell Potter stated during an interview with Bill Moyers, "By running ads, commercials in your home district when you are running for reelection, not contributing to your campaigns again, or contributing to your competitor..."

In addition, Potter described how a Republican strategist suggested the use of phrases such as "government takeover," "delayed care is denied care," "consequences of rationing," "bureaucrats, not doctors prescribing medicine," which despite being evidently untruthful were faithfully parroted by politicians opposing health care for all.

Through several mechanisms insurance companies deny coverage to people so as to increase their profits. As Potter explained in a testimony to the U.S. Senate Committee on Commerce, Science and Transportation last June, among those mechanisms are ‘rescission' and ‘dumping'. If a sick policy holder omits a minor illness or a pre-existing condition when applying for coverage the insurance company use this as a justification to cancel (rescind) the policy.

In addition, insurance companies dump those businesses whose employees' medical claims exceed what insurance underwriters estimated. What makes the situation particularly serious is that once an insurer dumps a business, that business has no other viable options because of widespread industry consolidation.

Lack of coverage seriously affects the health of the uninsured because they receive less preventive care, are diagnosed at a later disease stage, tend to receive less quality care and have higher mortality rates than those insured.

This is a crucial moment to solve one of the most savage inequities conspiring against people's health and well being in America. Both individuals and businesses, particularly small businesses, are at the mercy of powerful corporations' interests. Unless those interests are curbed, people's health will continue to be a victim of corporations' predatory appetite.

Cesar Chelala, MD, PhD, is a public health consultant for several international agencies.

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