May 21, 2006
Prof. Emanuel Gale
The Collapsing Health Care
Manny Gale is Emeritus Professor of Social Work & Gerontology at CSU Sacramento.
He has long been an advocate of universal health care and is shocked at the expense and consequences of the current American health care "system," saying that America spends more per capita on health care than any other nation and the resulting health indicators are worse than in most other industrialized nations. He claims that the recently enacted drug benefit law is a fraud, since it prohibits importation of drugs and any negotiation of drug prices between the federal government and the drug companies.
Prof. Gale sees much of the problem as resulting from the failure to regard health care as a fundamental human right. There is also the complexity of the system. We have public, community and private hospitals, and a lack of comprehensive community planning. Health care is a labor-intensive industry. The financing consists of a mixture of government payments, health insurance premiums and out of pocket payments by the patients themselves. We have an illness model. Often very expensive curative medicine is provided to patients when much cheaper preventive medicine should have been provided, but was not. This is being penny wise and pound foolish. We have wide differences in coverage and in access to the system between those with different health plans and even wider differences between those with insurance and those without. Mental health coverage is often not available.
Prof. Gale argued that health care should be considered a human right (as it is in all other developed countries--and some not-so-developed countries). In California, Senator Sheila Kuehl has introduced SB 840, which would provide universal coverage. However, it has not passed the Assembly and needs a funding mechanism. Dr. Gale proposed a "progressive" tax increase to pay for it that would include taxes on employers and on tobacco. He would also eliminate private health insurance. He quoted a study by Lewin that claimed that SB 840 would save $346 billion in the next 10 years if enacted.
Prof. Gale also made some comparisons with the health care system in other countries. Surprisingly, Cuba is considered to be one of the best, mainly because of its thoroughgoing attention to the preservation of wellness, rather than America's almost exclusive concentration on the treatment of illness. Expectant mothers in Cuba will typically have about eleven prenatal visits, all at no charge, resulting in much more satisfactory deliveries. In the U.S., many women (or, more often, girls) present themselves at a hospital, prematurely in labor. Heroic efforts, costing hundreds of thousands of dollars, are often needed to save a pathetically underweight baby. It's easy to see how the U.S. ends up with the highest per capita health cost in the world.
Prof. Gale's presentation was followed by a lively question and answer session.
Report prepared by Wayne Luney, Recorder, and Bill Potts