Thank you for an interesting exchange of views.

No one has advocated that private health care should be banned. People are advocating for a public health care option to coincide with private health insurance. That way people have a choice.

If you look at the economics of health care in this country you have health insurance corporations that increase their profits by doing two things: denying coverage to high risk people, and denying claims of high cost procedures. Essentially, they profit from denying people medical care. They have financial incentive to deny medical care to people who need it. They are also exempt from anti-trust laws that every other corporation in the United States is governed by.

Even those insured in the US have to pull teeth to get the health insurers just to deliver on what they are required to. I’ve had surgery before and had the health insurer try to get out of paying the claims — leaving me on the hook for $13k. They contended that I didn’t get proper referrals through each of the steps to surgery — although I did. They pretended to never get the claims that my doctors, hospital, etc. sent them, faxed them, and fed ex’d them.

This went on for two years, and before long collection agencies were coming after me threatening me on behalf of the hospitals, doctors, etc. And eventually — after two years — the insurer finally paid them. I’d been paying the insurer over $5k per year in premiums, and the minute they had to deliver, they tried to weasel out of it. This is a common scenario in the US. And I wondered how many old people would probably have just sent the check themselves (if they had the money) just to get the collection agencies off their backs.

No one has ever proposed that private health care facilities should be taken over by the state. In fact, that’s never been propositioned by anyone. The only changes that anyone has proposed in the US is to offer a public health insurance option to compete with the private ‘for profit’ ones that exists, and to impose fairer legal restrictions on pharmaceutical companies (ones that limit their excessive monopolies — in the form of patents which often exists for many many years, ensuring millions of people cannot afford essential medicines that are affordable in every other country outside of the US). So essentially you would still have private hospitals, private doctor’s offices, with both private and public insurers.

In America we pay twice what every other industrialized nation pays for health care, and in study after study our health care gets lower ratings across the board, not to mention the quality of service itself even gets low ratings from patients. AND then consider we have 50 million uninsured who are forced to go to the ER for everything — common colds, etc. — which costs a fortune, and thereby ensures their costs get passed on to everyone else who needs to go to ER for legitimate reasons.

So, it is definitely a broken, corrupt system we have — which results in tens of thousands of unnecessary deaths each year. I applaud Amnesty International for bringing that into the public light.

I oppose Amnesty International involving itself in what seems to me a political issue. The direction they’re argument’s heading in is that someone’s human rights are being denied if they do not get equal access to medical care as the most privileged. Therefore private health care should be banned. This is a reasonable, socialist, position. A lot of people in Europe support this sort of view. But it’s also valid to argue that people should be allowed to set up private health facilities if they want to even if only the rich can afford them. That’s the American way. Maybe the American way doesn’t work well for health care. Maybe it can be made to work well. Maybe there are advantages to the American way of doing things that make it worth putting up with bad health care for the poor. For example the US hasn’t become a dictatorship at any point in its history, whereas as most of the “better” countries have.

There is a fundamentalist view around that a more equal society is unequivocally a better one, that there can be no argument about this and that any policies that aren’t in line with this are actually against international law! Amnesty International appears to be using this sort of argument. It may be calling for a ban on Capitalism soon. Capitalism creates inequality. The poor have inferior health in all countries. Therefore Capitalism denies the fundamental human rights of the poor.

As far as the US is concerned, I’m going to assume that Amnesty’s in-depth report probably correctly underscores the WHY with regards to its soaring maternal mortality rate — (as usual, with US health care it’s all about the lack of access).

As far as the WHY with regards to Ireland being at the top and Bosnia being second, I would only be speculating since the WHO didn’t summarize their findings with explanations for each country’s numbers. Here are just a few guesses as to the WHY:

1. They both offer Universal Health Insurance coverage.

2. They are small in population, so perhaps they are better equipped to provide superior health care (at least for certain types of care).

3. Ireland is predominantly Catholic, and therefore pro-life. I’m going out on a limb here, but maybe they prioritize maternal care more so than other countries.

4. Despite Bosnia having experienced horrible human rights violations between Bosnian Serbs and Muslims and Croatians during the 1990s, ones engaged in genocide/ethnic cleansing are not necessarily derelict from providing superior health care to their own.

There was a study on Bosnian immigrants who came to the United States to escape the Balkan wars and here’s a brief summary into their impressions of US health care:

During the 1990s, approximately 300,000 Bosnian immigrants came to the United States as a result of the Balkan wars. In contrast to immigrants from less developed countries, Bosnian refugees were typically older, had experienced significant war related trauma, and were accustomed to universal health insurance coverage. There is little information about Bosnian immigrants’ transition to the U.S. health care system.

As part of a related project, 12 Bosnian immigrants were interviewed about their perceptions of the U.S. health care system and their experiences as patients. Participants were universally critical of the U.S. system and described several core issues: confusion about insurance coverage, personalized quality of care, access to primary and specialty care; and a perception of U.S. health care as bureaucratic. Participants compared their experience with prewar Bosnian health care along these dimensions. Implications of the findings and suggestions for improving care to the Bosnian immigrant population are provided.

So, anyways, I’m just throwing some ideas around. Perhaps other groups have conducted studies into some of these countries’ maternal care to better identify what they are doing right versus what others are doing wrong. I suspect Amnesty did some of that in their attempt to identify what the US needs to do to improve their numbers.

I took a second look at the Amnesty report to compare individual states, I just arbitrarily selected Maine (the best) versus Georgia (the worst), and one difference between the two is the existence of a Maternal Mortality Review Board. Maine has one, Georgia doesn’t. But then I noticed Vermont (the second best state) doesn’t have one either.

If you compare the number of uninsured, you find that Georgia has 1,682,400 uninsured versus Maine’s 126,000 uninsured. Maine is a far smaller state.

Another HUGE discrepancy between the two states is that the Medicaid eligibility level for working parents in dollars (for a family of three) is $36,276 for residents of Maine versus $9,072 for comparable residents in Georgia. So Maine makes its Medicaid (government insurance for poor) available to its residents making as much as $36,276. That ensures better access to many more people who otherwise couldn’t afford insurance on their own.

Accessibility to health care, as you see, differs from state to state. But to throw yet another monkey wrench into that “reason,” Washington, DC — which has a worse ranking than Georgia — allows families of three making $36,396 to qualify for Medicaid.

This might be a good study for the Freakonomics guys. They love dissecting piles of raw data to unearth overlooked patterns/consistencies.

Is there a wonderful respect for human rights in Maine (and Bosnia)? Is that really what it’s all about?

It’s disgraceful what our health care system has become — one of the greediest and most immoral industries on the planet.