Forget about Spy, Mother Jones, Rolling Stone, Nation, or even the
Daily Worker. If you're looking for something really subversive, try
Consumer Reports. They're the people who tell us when we're buying a lemon,
even if it's made in the U.S.A.
Is that un-American or what?
If you still believe that we make the best cars in the world, that our insurance
companies really have the best interests of their clients as their guiding principle, that the
invisible hand of our free market always works to the advantage of all concerned, then you
probably shouldn't read Consumer Reports. It will only upset you.
And if you still believe that we have the best health care system in the world, you
should close your eyes and whistle "Zip a Dee Do Dah" every time you approach a
newstand. Even a passing glance at a Consumer Reports cover may cause
trauma so severe that you have to make a claim to your health insurance.
Earlier this month Hillary Rodham Clinton told an audience of health care
professionals that while "we have the finest physicians and hospitals in the world…we have
the stupidest financing system for health care in the world. The financing system is
becoming the tail that wags the dog."
She probably reads Consumer Reports.
The problem with the people at CR is that, like the capitalist enterprises they
critique, they're obsessed with the bottom line. The difference is that they're obsessed with
the consumers' bottom line. And in the last couple of years, that obsession has
focused on medical care.
In three consecutive issues (July, August, September) in 1992, they took a long
hard look at American health care. It wasn't a pretty picture. Bottom line: We waste at
least $200 billion a year "on overpriced, useless, even harmful treatments, and on a bloated
bureaucracy. That's enough to extend high-quality medical care to every American now
uninsured. . . ."
And they didn't just let it go at that. In the current issue, Senior Editor Trudy
Lieberman reports some of her findings about Japanese health care. All Japanese are
covered for just about anything that goes wrong—and by "a system that spends a far
smaller proportion of Gross National Product on medical care than we do." Their biggest
complaint is about hospital food.
Think of that.
Their coverage comes either from employer-sponsored health-insurance societies
or from the National Health Insurance program—with premiums "based largely on
income."
The big difference between our medical insurance and theirs is that "in the U.S., a
good chunk of each premium goes for insurance-company overhead, administrative
expenses, and the cost of evaluating risks—a cost associated with keeping people out of
the system. In Japan, a portion of the premium subsidizes groups with high medical
expenses, such as the elderly —a cost that keeps people in the system."
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The Truth, Mainly
The Japanese choose their own doctors, there's no rationing of service, and there's
a strictly observed fee schedule determined every two years by representatives of
physicians, hospitals, pharmaceutical companies and employers.
The result is that a chest X-ray costs $8 , an endoscopy $105, and an MRI $210—
about one-fifth of what they cost Americans.
The NY Times this month explained why our MRIs cost upwards of $1,000. If
you think in supply-and-demand terms, you'll be puzzled here. The higher cost isn't
because there are too few MRI machines, but because there are too many. "Since many
MRI machines are busy only half the day, they must charge high rates in order to cover
their overhead."
Did you catch that? The larger the supply and the smaller the demand, the higher
the price. As a non-judgmental English major, I probably wouldn't call it the "stupidest"
financing system in the world, but it does seem fraught with voodoo.
Here's a final example of Consumer Reports' fanatical devotion to the
bottom line. Remember the Congressional Budget Office which drew all the Republican
praise a couple of weeks ago for pointing out that Clinton's health plan would put us even
deeper in debt? CR had the effrontery to report that the very same office had
earlier estimated that a single-payer plan would save us "at least $110 billion a year by
2003." And everybody knows that a single payer plan is socialized medicine.
Those subversive rascals at CR just have no respect for our national
institutions. Next thing you know, they'll be telling us that apple pie has too much lard in
the crust.
And any time now, I expect them to come up with an un-American proposal to
head off a trade war with the Japanese by a compromise: We'll buy their cars if they'll
manage our health care.
Satterfield is a college professor and writes as a means of discovery.
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