Stop the non-sense: Save the Children

In a world that enjoys ever increasing wealth, it is often forgotten how many still live in poverty and how high child mortality remains. Fortunately according to a new report from the United Nations Children’s Fund (Unicef), more children are now surviving beyond their 5th birthday. To be specific the number of deaths has fallen from 12.5m in 1990 to 8.8m in 2008, the lowest on record with dramatic falls in Latin America and the former Soviet Union while progress in Africa has been slower. The report notes big improvements in preventing malaria but much more needs to be done to treat the other 2 main causes of deaths: pneumonia and diarrhoea. In a world often obsessed by material wealth or consumed by big political battles about issues such abortion and climate change, it is unacceptable to lose sight of the most urgent issue, saving our children who die from diseases we know how to defeat. This will not be achieved only by offering yet more financial aid to poor nations. The key remains getting the governments of those countries most affected by child mortality to honestly provide decent basic public services to their citizens. This battle requires money and goodwill of different nations working together but this is the war that we should be fighting and winning.

Health Care is Sick in America

American politicians are arguing about health care in another attempt to reform the broken system. America’s health-care system is by far the costliest in the world. Despite health care spending per person is almost double that of other rich countries, millions of Americans are without health insurance and quality of health care is not much better than elsewhere. Beyond the large numbers of uninsured, the problem is that it continues to grow at an unsustainable pace and is starting to have a huge impact on business and employment. The health care industry has been quite good at raising fears of rationing by more government intrusion in the health sector but the reality is that in America federal & state agencies (Medicare, medicaid, etc) already control a large portion of the market. The key to reform, regardless of political affiliation, is that the majority of Americans who have health insurance must come to terms with the fact that the current model of receiving any treatment covered by insurance without incurring some of the costs is a recipe of disaster for everyone. The problem with health care is  that market forces have been paralyzed by overregulation and until health care consumers can shop based on price, America will continue to get sicker and bogged down by its blindfolds in an ever more competitive global economy.

Offshoring and rationing medical care

As economies falter protectionism in on the rise and will hurt everyone. Americans who often are afraid of seeing their jobs offshored have been quite happy to soak up Asian savings and cheap products to raise their standard of living. Now even more of them are discovering the benefits of medical tourism. With 46m Americans lacking health insurance, and millions more facing huge out-of-pocket medical expenses, Americans are increasingly heading overseas to cheaper facilities where many treatments can be done in world-class hospitals abroad for a fractions of the price charged by American hospitals. Recent research shows that American health tourists will rise from 2m in 2009 to 10m by 2012.

People voting with their feet are sending a clear message to the health care industy and the American government which overregulates this sector stifling innovation. Although many in America would love the expansion of government run health care beyond the already huge Medicare system (operated with gargantuan deficits), the reality is that Americans do not want to face up to the trade offs and compromises required to provide health care to all. Those who are well covered by subsidized company plans are keen to protect their privileges until of course they find themselves out of a job and without coverage.

A modern society however should not tolerate having millions of people without basic health coverage because this hurts everyone by lowering productivity and imposing hefty costs on taxpayers. In a world of unlimited demands and scarce resources the clear solution remains rationing care. This is already done by the hated HMOs, and any other system whether run by private entities or governments would continue to face the hard choice of measuring costs versus benefits. The clear challenge is to tackle privileges  and realign services and resources more rationally. Clearly even rich societies cannot afford to provide unlimited medical care to everyone, but they owe it to themselves for financial and ethical reasons to provide at least some basic health care services to all its citizens. It would be too much however to hope that political rhetoric will allow a proper debate about this very sensitive topic so we expect more American to happily travel seeking excellent medical care at a lower cost in foreign facilities far away from the hypocrisy.