U.S.A.! U.S.A.!

The Commonwealth Fund just published a study in the journal Health Affairs, which examines the American health care system versus the experience in other developed countries. The Fund commissioned a Harris interactive poll of nearly 20,000 people in 11 countries between March and June.

Americans still pay more per capita for healthcare than the rest of the developed world, are unhappier with the results and are less healthy than people in other countries.

Some of the findings are eye-opening. A third of Americans say they have gone without medical care or skipped filling a prescription because of cost, compared to 5 percent in the Netherlands, for example. 20 percent of U.S. adults had major problems paying medical bills, compared with 2% in Britain and 9 percent in France, the next costliest country in terms of healthcare. The study found that only in the United States did such a large percentage have trouble paying their health care bills.

"U.S. adults were the most likely to incur high medical expenses, even when insured, and to spend time on insurance paperwork and disputes or to have payments denied," the report says.

About 60 percent or 157 million Americans under 65 get their health insurance through their employers. Roughly 45 million people 65 and older have coverage through the nation's Medicare system.

In the study they claimed that 47 million were without any health insurance. But last week the U.S.Centers for Disease Control and Prevention estimated that 59 million Americans had no insurance for at least some of the beginning of 2010.

The ten other countries in the survey all provide a mix of public and private insurance. Adults in Britain, Switzerland, New Zealand and the Netherlands were the most likely to be able to get to a doctor the same day or next day when they needed to. More than 90percent of Swiss adults said they could see a doctor that fast, compared with 57% of adults in Sweden and the United States and fewer than half in Canada and Norway.

Interestingly, only 70 percent of adults in the United States or Norway said they were confident they would get the most effective treatment if ill, compared with 90 percent of Britons and 89 percent of the Swiss.

I guess Al Qaeda will have to attack the Swiss now because they envy their healthcare. Have you noticed they are planning attacks on Europe more these days? Maybe they don't envy our freedom anymore.

The Lair of the White Worm*

*A Ken Russell movie you can miss.

Heard Howard Dean on the Young Turks. Howard Dean said that the Senate Health bill was basically written by two former employees of Wellpoint and United Health. He still is for it but suggests a Medicare buy-in for people 55 or older, since we are the high price people in health care. He believes the compromise with the Republicans could be to drop the mandates because that is the only part that is unpopular with the American people. On the other hand,that would not satisfy the insurance companies who desparately need these new customers. I think it might be clever if Obama dropped the mandates and forced the Republicans to put them back in the bill because they would have to answer to their insurance funders.

A spokeswoman for the Commonwealth Fund said the full implications of their report are not all the dire cost escalations which I quoted yesterday but rather that Americans, who still had health insurance, would see a rapid deterioration in the care they receive. She said doing nothing would not maintain the status quo as Republicans argue but start the steady decline in the American healthcare system.

Frank Luntz must feel the most important person in Washington today. How would you like to be a writer and everyone in town reads from your script. "Scrap the bill", "Start Over Again","take commonsense measures","the American people only support incremental change" were repeated over and over again from Republicans both in the Health Care Summit and on the television stations all weekend. All of these are verbatim quotes from his memo. I'm waiting for a Republican to suddenly talk for him or herself. Can you imagine being a Senator having to use talking points written by a consultant for everything?

A constituent of John McCain's wrote a letter to an Arizona newspaper questioning where the man's integrity went. The writer pointed to McCain's past support for sensible immigration reform, cap and trade legislation to combat global climate change,a debt commission and health care reform. And all these positions have been dramatically reversed because he faces a primary challenger who is bonkers. The writer asks why the 72-year old McCain doesn't stick to his principles and if he loses, do a Joe Lieberman and run as an independent. Good question because there are no strong Democratic candidates for the seat and John can't very well turn back again once he defeated his rightwing challenger and convince people he really doesn't believe what he says now.

I've noticed that since John McCain appears on the Sunday Talk Shows every week since he lost to President Obama that now no one reports anymore what he says. This is the Orrin Hatch syndrome. Hatch for years appeared on Meet the Press and was so convinced all American knew who he was that he ran for the Republican presidential nomination only to discover no one knew who he was or at least listened to anything he had to say.

Former Freedom House board member Dick Ravitch has assumed the position as the only mature adult in Albany with the David Patterson scandal forcing the Governor to announce he was not running again. Ross Douhot, the new ersatz conservative New York Times columnist, has embraced another former Freedom House board member Mitch Daniels as his candidate for President since Mitt Romney can't make anyone like him. Mitch, the former head of the OMB, has vowed that states must radically reduce spending in the next few years. His message is sour and his personality is perfect for Indiana but nowhere else. Maybe he can get another Freedom House trustee Peggy Noonan to write his speeches for him.

The unemployed are forming a union. One of their first acts is to call for Jim Bunning to be thrown out of the Baseball Hall of Fame for his one-man stunt to block the continuation of unemployment compensation. His stunt also means a layoff today of thousands of transit workers around the country and a cut in doctors' fees for Medicare by over 20%. Nice going Jim. By the way, Sandy Koufax has been acting as spring training pitching coach for the New York Mets.

Pat Robertson said God was even more upset with Chile than Haiti because of the prosecution of Augusto Pincohet. But commentators point out that Chile's good government has mitigated that country's disaster as contrasted with Haiti poor government performance. So good government may be the answer to counter God's wrath. Maybe the United States could learn that. I can see this becoming part of the Good Governance program for USAID. Who knows it may actually persuade some countries.

Republican talking heads say the healthcare bill is unpopular with the American people. Actually, every point on the Obama 11-page plan had a majority support except for mandates. If anything,if you bury deep into the polling data, it shows that the American people do not believe the health reform bills go far enough. The so-called "public option" has overwhelming support in both red and blue states and it's the only element left out of the Senate bill.

MENTAL TEST: Over the next few years, jot down names of Republican talking heads, commentators and op-ed writers for potential names of people who would serve in another Republican administration. As Ronald Reagan said, "Personnel is policy." Just do this and review the list and I am sure you will be horrified.

Whether you agree with Paul Krugman or not, it was embarassing to see him as a guest on one of the Sunday talk shows where all they talked about was the replacement of the White House social secretary. When he interrupted to talk about the growing number of unemployed, Sam Donaldson pipe up,"Welcome to Washington, Paul." This isn't Stoogeland for nothing.

I'm getting a little fed up with the conservatives alleged reverence for Ronald Reagan. Almost every conservative that has been quoted by the press as wanting to go back to the days of the Big Ron were part of the gang of conservatives who turned against him during his second term. Later these same characters turned against George H.W. Bush and went over to Ross Perot. This stuff also applies to conservative attacks on Ron Reagan, Jr. Big Ron's problem with Little Ron was around the issue of ballet. However, the adopted son Michael now dons his father's political mantle and attacks young Ron when Michael only reconciled with his father when he was stricken with Alzheimer. What a bunch of opportunists.