Two weeks ago, in our January 12 issue, South Boston Online published an editorial against the 5%/7% payroll tax on businesses, which would be used to fund health insurance coverage for all Massachusetts residents. 

     One key reason we came out against it was the wildly scattered estimates of the money that tax would raise – at first, the Legislature told us it would raise $650 million.  Three other estimates by various groups followed - $365 million, $175 million, and $15 million.  More recently, yet another study said that most businesses, instead of paying out, would actually benefit by $145 million (or more).  Believe us when we tell you that all of those estimates contain some very, very questionable assumptions.

     At this time, we haven’t any idea which one is right.  All we know is that four out of five of those estimates must be wrong – very wrong.

     Another reason we were against the proposal was the generally poor record our lawmakers have, when it comes to health care legislation.  At the federal level, just think of the new Plan D and its complexities.  It makes a sick person want to take an aspirin, brew a cup of herbal tea, and hope for the best.  And at the state level, has anyone ever explained what happened to the tobacco funds that were supposed to be used for smoking cessation?  Our elected officials cut them by 90%.  Where did they go?

     But there is a more fundamental problem:  our entire health care system in America is broken.

     We spend 15% of our Gross Domestic Product (GDP) on health care.  That’s more than $1 out of every $7 we earn.  Other developed nations spend under 10%.  That’s equivalent to less than $1 out of every $10 they earn.  France, Germany, Sweden, and Switzerland, all of whom have excellent health systems, are in the 10% of GDP range in health care spending. 

     Furthermore, even though we spend much more per capita in the U.S., we do not have good health care and we are generally an unhealthy nation.  Some 40 million U.S. citizens are uninsured.  The availability of comprehensive care is spotty – you can readily get an MRI (in fact, they are advertised), but just try to find a family practitioner (a “GP”) or an obstetrician in certain areas of our state.

     Consider that Japan spends about half as much as we do on health care (only 8% of GDP), yet the Japanese live five years longer.  Infant mortality in America is worse than any other rich nation.  Were you aware that our health statistics are no better than countries that were once behind the Iron Curtain?  Did you know that our good neighbors in Cuba live about as long as we do, and have healthier babies?  Something is clearly wrong.

     Recently, the major drug firms were criticized for their excess profits; many people attempted to get their medicines from Canada.  But prescription costs account for only 12% of our total medical spending.  Even if drug companies began giving away their products completely for free, that would only drop total medical spending back to what it was in 2003.  Prescription costs are important, but they aren’t the major cause of overall health care cost increases.

     Health costs have risen by three times the inflation rate since the 1980s.  Hospital and doctor fees now take well over half of health spending.  America has highly advanced health technology but little day-to-day preventive medicine.  We waste a lot of money on administrative systems to no avail (did you ever try to figure out a medical bill?).  Both diagnostic costs and the cost of medical malpractice insurance are soaring.  Unfortunately, the medical profession has transformed itself from a patient-care basis to a dollars-and-cents basis.

     And as individuals, we aren’t taking care of ourselves either.  Obesity and its effects, such as Type II diabetes, have become epidemics.  We don’t exercise enough.  Non-smoking rates haven’t improved in many years.  It appears that alcohol and substance abuse are increasing.  A large part of the health problems in America is our own behavior.

     South Boston Online has no good solution to America’s health crisis, but we think our readers should know where the U.S. health care system is headed.  It’s a train wreck waiting to happen.  And simply throwing more money at it won’t make the problems go away.