Health Care Excuses

By PAUL KRUGMAN
New York Times

The United States spends far more on health care per person than any other nation. Yet we have lower life expectancy than most other rich countries. Furthermore, every other advanced country provides all its citizens with health insurance; only in America is a large fraction of the population uninsured or underinsured.

You might think that these facts would make the case for major reform of America’s health care system — reform that would involve, among other things, learning from other countries’ experience — irrefutable. Instead, however, apologists for the status quo offer a barrage of excuses for our system’s miserable performance.

So I thought it would be useful to offer a catalog of the most commonly heard apologies for American health care, and the reasons they won’t wash.

Excuse No. 1: No insurance, no problem.

“I mean, people have access to health care in America,” said President Bush a few months ago. “After all, you just go to an emergency room.” He was widely mocked for his cluelessness, yet many apologists for the health care system in the United States seem almost equally clueless.

We’re told, for example, that there really aren’t that many uninsured American citizens, because some of the uninsured are illegal immigrants, while some of the rest are actually entitled to Medicaid. This misses the point that the 47 million people in this country without insurance are an ever-changing group, so that the experience of being without insurance extends to a much broader group — in fact, more than one in every three people in America under the age of 65 was uninsured at some point in 2006 or 2007.

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