USA: Road to healthcare paved with good intentions -

I was in Greece some years ago, sat at the bottom of the Acropolis, minding my own business as I largely do when two grizzled old American geezers started talking about the “home of democracy”.

One said to the other: “They’ve got free healthcare here.” The other said: “That’s because they are socialists here.”  The first replied: “The whole of Europe is socialist. They’re all communists in Europe.”

I was reminded of this exchange because at the Silicon Valley comes to Oxford event, just round the corner, the prime keynoter was one Gary Lauer, the CEO of Ehealth, and an ex-executive at IBM and at Silicon Graphics too. His company is, as far as we understand it, a shopping front where people can choose their own health insurance.

Lauer was at pains to describe what he called the US “health landscape” and to do that he had to talk American politics.

As we European communists know, the majority of US citizens have to have health insurance – often funded as part of a job package by employers or by  governmental agencies. There are about 330 million people living in the USA but around 55 million can’t get healthcare and there is no safety net.

Lauer said: “The cost of healthcare compared to GDP has been rising steadily. Healthcare is a double digit percentage of GDP – thirteen to fourteen percent.”

The silicon and software sectors are dwarved by healthcare, he said and the US population is growing older and life expectancy is growing too. But, he added, the 50 million uninsured people poses a moral and polical dilemma.

The US president Barack Obama wanted healthcare reform, like Bill Clinton before him, and managed to push through the Affordable Care Act (ACA) – better known as Obamacare.  And since the act came into effect, the matter has been highly politicised.

Basically, the Act provides for guaranteed healthcare, and mandated that everyone in the USA must have health insurance coverage. The Act also provides subsidies for lower income people – and they are generous subsidies, said Lauer – as much as 400 percent above the federal poverty level.

Each of the 50 states had to implement an online marketing space – a sort of health exchange. But of those 50 states, 36 have not bothered to implement the Act at all. The 14 states who have gone for it have had their problems, for example, he said, Oregon hasn’t managed to enrol one person so far. And the healthcare products compliant with Obamacare are more expensive than the existing offerings. Obama said that if you liked your existing healthcare you could keep it. However an unexpected consequence of Obamacare is that millions of people in the USA have had their insurance cancelled.

The target for the first six months was to enrol seven million people, but the actuality is that so far only 103,000 people are “somewhat enrolled”.

The legislation, said Lauer, stands or falls on enrolment – the system needs people between the age of 18 and 34 to enrol to subsidise the old codgers and the poor and the unfortunate.

Lauer concluded by saying that insurance could become “prohibitively expensive” and that seven senator are up for re-election next year in traditionally Republican states – he talked to them last week and they’re all quaking in their boots about their franchise.

I was in Greece some years ago, sat at the bottom of the Acropolis, minding my own business as I largely do when two grizzled old American geezers started talking about the “home of democracy”.

One said to the other: “They’ve got free healthcare here.” The other said: “That’s because they are socialists here.”  The first replied: “The whole of Europe is socialist. They’re all communists in Europe.”

* According to the CIA World Factbook, life expectancy in Cuba is 78.05 years. The same source gives life expectancy in the USA at 78.62 years. For "communist" Greece it's 80.18 years and for "communist" Great Britain it's 80.29 years.