As President Obama issued his call for reform of American healthcare, he must have been gratified to hear so many professions of good faith and civility from the political and commercial interests that have always opposed change. The health insurance lobbyists as well as the politicians who serve them all promised that this time would be different.
But amid all the reassuring blather, certain fundamental questions were not asked, as usual, because merely posing them might discomfort those same special interests and political leaders. Why do we spend so much more on healthcare, per capita, than other developed countries? Why do we achieve worse outcomes on several important measures than countries that spend far less? Why do we spend up to twice as much per person as countries that provide universal coverage while leaving as many as 50 million Americans without insurance?
The salience of those questions has grown over the past several decades, ever since President Truman first sought to create a universal health benefit program that resembled systems in Europe. Last month, the Paris-based Organization for Economic Cooperation and Development issued the latest in a long series of reports on our wasteful and cruel practices that ought to awaken a sense of national embarrassment. This highly topical study carried a deceptively bland title: “Healthcare Reform in the United States.” Naturally, the mainstream media and punditry ignored its findings (although OECD reports promoting free trade often receive wide coverage).