U.S. Health Care System: American Taxpayers Paying A Lot, Getting Little In Return--A German-American Perspective

U.S. public officials often argue that the U.S.A. has the best health care system in the world and therefore are resisting change in view of President Obama's health care reform efforts. The American health care system certainly has many advantages, particularly for the more fortunate citizens. Shorter wait times, sound facilities, clearly identified processes, uniform procedures, and easy access to medicine illustrate the strength of the system. However, besides other serious flaws such as being heavily symptom- instead of cause-oriented, Americans are paying exorbitant amounts for their health care and getting relatively little in return. Even individuals with health insurances in the U.S.A. are not protected from incurring financially debilitating bills due to the high deductibles that they may be required to pay.

Among the Organisation for Economic Co-Operation and Development (OECD) nations, the U.S.A. is one of the highest spenders on health care, in private, as well as public spending. U.S. private spending on health care is the highest among all OECD nations. Public spending is also very high. However, in spite of the money spent, the U.S.A. has one of the fewest acute care hospital beds per 1,000 populations: 2.5; Japan has 7.9, and Germany 5.3. The money that Americans are spending is not translating into a healthier population, either. In mortality from cancer, the U.S.A. ranks 25 out of 34, more than one-third (36.5 percent) of adults are obese. The USA also lags behind other developed nations in infant mortality, and well above the OECD average (6.9) in prevalence of diabetes (9.6), and the list goes on.

The U.S. health care system is a highly profit-oriented business. American companies are able to do in the United States what they often cannot do in other countries, not only morally, but also legally. For example, they can charge U.S. consumers more than customers abroad, even for drugs that were developed with U.S. tax money, of which the EpiPen is only one example among many. Care generally addresses the symptoms, instead of the underlying causes: Physicians are extremely prone to prescribing pills for which they receive kickbacks from pharmaceutical companies. Extensive reliance on pills keeps patients coming back for more of the same, and additional pills, to counteract the side-effects of the pills that they are already taking.

This explains why natural approaches to health are detached from the mainstream approach as much as it is the case in the U.S.A. A health system that does not see a holistic approach as a foundation of care, not consider using the body's own healing powers in the healing process, and not include natural healing methods, does not have the best interest of patients in mind. In comparison, in Germany, for example, alternative medicine is a lot more integrated into the mainstream health care system. Main stream physicians in Germany are very well-versed on natural medicines and can officially recommend ("prescribe") them, in which case, some insurances even cover the cost. Retreating to spas that health insurance pays for is also a given component of their health care system. Such retreats include massages, natural baths, and dancing. Americans pay a lot, but don't come nearly close to receiving the same services.

However, the status-quo of the U.S. health care system should not come as a surprise. In 2013 the highest average profit margin achieved by a U.S. company was by the Pfizer corporation (42 percent), substantially more than banks (29 percent) and oil and gas companies (24 percent). Excessive profits and money also means power and control. Pharmaceutical companies exert those in various ways. For example, medical schools in the U.S.A. receive funds by the pharmaceutical and other health-industry sources. Subsequently, the companies can control the curriculum. Moreover, they can influence research, and also outcomes. Universities are hired to conduct crucial research for the companies, as they have the necessary credentials and enjoy the public's trust as a place of intellectual integrity.

For the cost of health care, some like to conveniently blame the "Mexicans" and other minorities, or undocumented individuals, for exploiting the social services systems. Some people, of course, may "exploit" the system. However, that is a given in any system that involves humans. But the exploitation of the system by patients is not the cause of why Americans are spending a lot and are receiving relatively little in return, neither is the size of the country--an argument that is often used when comparing U.S. public services performance with other developed nations. The disconnection is caused by the lack of legal and moral limitations, such as on how much American patients can be charged and an undifferentiated "business over public services" ideology that turns even the most basic services into a money-making machine--a highly exploitative health care system, in this case.

We could go on and on about health care in the U.S.A. However, in a nutshell, the American health care system has serious moral and practical flaws that need to be fixed. At the same time, suspicion toward the current health care reform is well-granted. Given the predominantly undifferentiated mindset toward business over public services and the indifference regarding excessive profits in this country, any system, regardless how perfect, will turn into an exploitative system that does little but extort money from citizens. Until the indifference toward exploitative business practices changes, there is little use to change the health care, or any other system in the United States, because without ethics and limitations to profit-making, most every system we create is going to fail our country's ordinary citizens in the long-run.

Ms. Dudek is a German-American researcher, analyst, and writer. She regularly contributes to U.S. and German sources such Migazin and the Hill.