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The First Class American Health System

By now you should have read the report: More U.S. women dying in childbirth. The report notes: “The rate was 12 per 100,000 live births in 2003 — the first time the maternal death rate rose above 10 since 1977.”

We are heading in the wrong direction in health care. In the US the maternal mortality rate rose to 13 deaths per 100,000 live births and the infant mortality rate was 679 per 100,000 live births in 2004. The Canadian rates, with their “terrible socialized system” were 8 and 475, and the Canadians are alarmed that the numbers are so high. Where’s the alarm in the US?

When people talk about rationing and waiting for service, remember there are 45 million Americans who are barred from the system because they don’t have insurance.


1 whig { 08.25.07 at 9:00 pm }

What are malpractice insurance rates for obstetrics and gynecology?

2 Bryan { 08.25.07 at 11:40 pm }

The market tanked so they’ll go up again. The stock market determines insurance rates, not malpractice claims.

The basic problem is a lack of pre-natal care. We have a major shortage of pre-natal clinics down here because the whackos have a habit of blowing them up, even if there is no association with abortion.

3 Badtux { 08.26.07 at 12:01 am }

The other argument the tighty righties use to defend our current medical system in the face of those awful statistics is one that is blatantly racist if you examine it closely. They say, “well of course Canada has better numbers, they have a homogenous society without a permanent underclass.” Now, forget the fact that this is not true (Canada has received an *enormous* number of immigrants over the past twenty years, today over 15% of Canada’s population is mostly-brown-skinned immigrants), but if you read between the lines what the tighty righties are really saying is, “it’s those niggers and wetbacks driving down our numbers.”

Now, there may be some data to support the notion that minorities are the ones with the worst statistics for pre-natal care etc. here in the United States. But they are also largely locked out of the health care system, especially recent non-citizen immigrants who are not allowed to participate in Medicaid or other government-funded health care programs. On the other hand, I guess for the tighty righties that’s a feature, not a flaw… it’s no different from when I was a kid and Police Commissioner George D’Artois would send his horseback-mounted police officers galloping down the aisles of black churches “nigger-knocking” when the black community got too mouthy about that “civil rights” stuff (“I ain’t gonna have that nigger Martin Luther King Junior preachin’ his commie nonsense in my city!”). Them darkies gotta be kept “in their place”. Feh. The more things change, the more they don’t.

– Badtux the Racist-sniffin’ Penguin

4 Bryan { 08.26.07 at 11:49 am }

Racism is definitely part of the mix, but the thing that gets lost is that the majority of the poor are rural whites, not urban blacks and the majority of people who lack access to health insurance are working whites – too much money for Medicare and not enough to afford health insurance.

Quebec has a significant North African population and the Pacific Coast of Canada is definitely part of the Pacific Rim. Canada was also the terminus of the Underground Railroad, so a lot of blacks have lived there for a very long time, not simply immigrants from the former British colonies in the Caribbean and Africa.

5 Badtux { 08.27.07 at 11:16 am }

Not only that, but it’s hurting innovation and preventing bright people from going off and starting new businesses, because health care coverage has basically become Unobtainium for small businessmen. One reason why you can’t start a new business with less than $10M in venture funding here in the Silicon Valley is because you must hire enough employees (roughly 40) to qualify for group coverage because the insurers won’t insure groups smaller than that for any amount of money that is reasonable… and god forbid if the majority of those employees are above age 40, because then the health insurance rates double.

Now, traditionally this has been okay with big companies, because it reduces competition. But now the big companies are starting to hurt because the insurance companies now are refusing to negotiate. Look at General Motors’ health care woes for an example. The health insurance companies have decided that GM needs them more than they need GM, and are ripping GM a new bunghole every time the insurance contract comes up for renewal. It’s unsustainable, and something has to be done. I just fear it’s going to be something that’s good for GM, but bad for the rest of us…

– Badtux the Healthcare Penguin

6 Bryan { 08.27.07 at 1:06 pm }

Hell, most people are unaware that German and Japanese workers make higher wages that American workers, the difference is in healthcare costs: zero for a company in Germany or Japan.

California was part of the problem when I tried to expand back in the 1980s. It seemed like every time I hired someone a new level of bureaucracy kicked in, so if you weren’t ready to go to 50 employees, you couldn’t easily expand. Going with independent contractors was the only way you could survive.

Health insurance was cheap when I worked in Rochester, New York because the big employers, like GM’s Rochester Products, Kodak, Xerox, etc. beat the crap out of Blue Cross/Blue Shield and essentially created universal coverage in the county. Everyone, including individuals, could get the same rate, and everyone had it. Even colleges provided BS/BS coverage through their fees. You kept your coverage when you changed jobs in the county.

It was certainly a shock when I moved to San Diego and encountered Kaiser, and a bigger shock when Rochester reverted to the same corrupt system as every where else after manufacturing started to leave.

We need universal coverage if we are to compete, because the competition has it and it undercuts our cost structure.

7 Badtux { 08.27.07 at 8:04 pm }

Actually, health insurance is funded via a payroll tax in both nations, so it’s not “free” to the company, any more than the Social Security payroll tax is “free” to the company. On the other hand, the percentage of worker costs dedicated to health care in those countries is roughly half that of here in the United States, and by all indications they are receiving better-quality care.

There is no such thing as a free lunch, but there is definitely a difference between a cheap lunch for a high price, and a good-quality lunch for a good price. The U.S. system is the former. The system used by the other industrialized nations is the latter. ‘Nuff said.

-Badtux the Health Penguin

8 Bryan { 08.27.07 at 9:03 pm }

Sorry about that, I should have been more careful with phrasing, nothing is free. It was my experience that payroll taxes were so far down on the list of problems when I was trying to expand back in the 1980s, they were a fairly fixed and predictable expense, not the shock that Kaiser used to unload on us at renewal time.

You can’t budget when you don’t have a clue what a major expense is going to be.

9 child health care { 09.14.07 at 7:34 pm }

child health care…

I stumbled upon your blog by accident a month or so ago and have found myself coming back to it at least a few times every week. You have become my favorite….