When Senate Minority Leader Mitch McConnell (R-KY) appeared on Fox News Sunday earlier this month to advocate repealing the Affordable Care Act, host Chris Wallace wanted to know how his party would address the fact that 30 million Americans have no health insurance. After twice refusing to answer the question, he finally said that providing universal coverage to those uninsured people was “not the issue.” He then went on to assert that US already has “the finest health-care system in the world.”
“Let me tell you what we’re not gonna do,” he continued, “We’re not gonna turn the American healthcare system into a Western European system. That’s exactly what is at the heart of Obamacare.”
Much has been made already of Sen. McConnell’s seeming disregard for the issue of those 30 million uninsured Americans. But what about this contention that the Affordable Care Act is a “Western European system?”
The term “Western European system” is a bit misleading since there are well over a dozen countries in Western Europe, and each system is unique. It’s true that most have some form of “universal” health insurance or health care, but there is still a lot of variation on how these systems are financed and implemented.
But even if we were to carelessly lump all Western European systems together, the fact is that the Affordable Care Act goes nowhere near such systems: there’s no public option, no Medicare-for-all, no single payer. Universal public healthcare is just not on the table under the reforms that were passed. Even with the Medicaid expansion, most newly insured Americans will be covered by the private insurance market.
Now how about this idea that the American healthcare system is already “the finest” in the world? How do we stack up against good old Western Europe?
Sorry, Sen. McConnell, but the facts are not on your side. Take a look at the World Health Organization’s hefty compilation of 2012 World Health Statistics. With a little basic number crunching, you can easily see how “Western Europe”* (on average) stacks up against “the finest” system in the world:
Life Expectancy? Western Europe: 80.6 years. United States: 79. Europe wins, if even by only a year and a half.
Neonatal Mortality (Deaths per 1,000 live births)? Western Europe: 2.1; United States: 4. Almost twice as many neonatal deaths here in the US. That can’t be good.
Maternal Mortality (Deaths per 100,000 live births)? Western Europe: 7.4. United States: 21. Yikes! Almost three times as many maternal deaths.
Hospital Beds (per 10,000 residents)? Western Europe: 50. United States: 30. The capacity of Western European hospitals is clearly greater.
Teen Pregnancy (pregnancies per 1,000 girls age 15-19)? Western Europe: 10.9.
United States: 40. But who needs comprehensive sex ed and expanded access to family planning services, right?
Total Expenditure on Healthcare as a Percentage of Gross Domestic Product?
Western Europe: 10.3 percent. United States: 17.6 percent. And they spend relatively less money overall.
Government Expenditure on Healthcare as a Percentage of Total Health Care Spending? Western Europe: 76.6 percent. United States: 47.7 percent. Hmm….Seems like government spending is proportionately higher in these countries that are beating us on so many levels. I’ll let you draw your own conclusions there.
I’d like to also point out that Western Europe doesn’t only surpass us on average. In fact, every single country across the pond is doing better than we are in almost every area.**
Since neither our current system, nor the system we’ll have when the Affordable Care Act is fully implemented will approximate anything they have in Western Europe, we’re not likely to see Western European results like those outlined above.
But the very good news is that the ACA is a tremendous step in the right direction that will result in better outcomes across the board, starting with the measures that are already (or soon to be) in place: extended eligibility for young people covered by their parent’s insurance, preventive health services without co-pays, an end to higher premiums for women, no more pre-existing conditions, and so on.
Sen. McConnell can talk all he wants about repealing these benefits, but the more they are understood by the American public, the less popular such talk will be. In the wake of the Supreme Court smack-down on repealers’ dreams of going back to the same-old-same-old, a majority of Americans say it’s time to move on and focus on jobs and the economy — you know, the issues that people were so fired up about when they voted to shake up congress in 2010. If the only the GOP had spent the last two years working on those issues instead of waging a war on birth control.
*For our purposes, Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, and the United Kingdom.
**Here are the exceptions: Portugal has the same average life expectancy as we do. Luxembourg’s maternal mortality is almost as high (20 vs our 21). Sweden has fewer hospital beds per 10,000 residents (28 vs our 30).