Old Folks At Home . . . And Abroad

November 22, 2014
Posted by Jay Livingston

“We need to get rid of Obamacare,” says Ed Gillispie in a NYT op-ed yesterday (here). The reason: Obamacare’s “gravitational pull toward a single-payer system that would essentially supplant private insurance with a government program.”

Gillespie, who lays out his credentials at the start of the article – he ran for Senate in Virginia and lost – notes that Obamacare is unpopular. But he omits all mention of a government-run single-payer system that happens to be very popular – Medicare. No Republican dare run on a platform of doing away with it. Gillespie himself accused Obamacare of cutting Medicare, a statement that Politifact found “Mostly False.”

So how are seniors doing? Compared to their pre-Medicare counterparts, they are  probably healthier, and they’re probably shelling out less for health care. But compared to seniors in other countries, not so well. A Commonwealth Fund survey in eleven countries finds that seniors (age 65 and older) in the US are the least healthy – the most likely to suffer from chronic illnesses.*

Over half the the US seniors say that they are taking four or more prescription drugs. (All the other countries were below 50%.)

And despite Medicare, money was a problem. Nearly one in five said that in the past year they “did not visit a doctor, skipped a medical test or treatment that a doctor recommended, or did not fill a prescription or skipped doses because of cost.” A slightly higher percent had been hit with $2000 or more in out-of-pocket expenses.

In those other countries, with their more socialistic health care systems, seniors seem to be doing better, physically and financially.  One reason that American seniors are less healthy is that our universal, socialized medical care doesn’t kick in until age 65. Americans’ health problems may have started long before that. People in those other countries have affordable health care starting in the womb.

Critics of more socialized systems claim that patients must wait longer to see a doctor. The survey found some support for that. Does it take more than four weeks to get to see a specialist? US seniors had the highest percentage of those who waited less than that. But when it came to getting an ordinary doctor’s appointment, the US lagged behind seven of the other ten countries.

There was one bright spot for US seniors. They were the most likely to have developed a treatment plan that they could carry out in daily life. And their doctors  “discussed their main goals and gave instructions on symptoms to watch for” and talked with them about diet and exercise.

Gillespie and many other Republicans want to scrap Obamacare and substitute something else. That’s progress I suppose. Not too long ago, they were quite happy with the pre-Obamacare status quo, even though the US healthcare spending was double that of other countries with little difference in health outcomes.  That didn’t stop George Bush from insisting throughout his years in the White House that “America has the best health care system in the world.”  But at least now, the Republicans want to do something different.  Unfortunately, their Republican ideology precludes them from learning from other countries. As Marco Rubio put it, we must avoid “ideas that threaten to make America more like the rest of the world, instead of helping the world become more like America.”

But maybe Republicans might learn from their own country by taking a second look at Medicare, a program many of them publicly support. They’ll just have to avoid letting anyone know that for nearly a half-century it has done what Gillespie says should not be done: “supplant private insurance with a government program.”

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* Includes hypertension or high blood pressure, heart disease, diabetes, lung problems, mental health problems, cancer, and joint pain/arthritis.