Universal health care is a social justice necessity


Please consider the following: The United States is the only wealthy industrialized country without some form of universal health care.

How many Americans are aware that after World War II, under the Marshall Plan, Germany and Japan’s universal health care systems would be completely rebuilt?

A good decision for Germany and Japan? It certainly appears so. In comparing health outcomes, both countries outperform the United States, and do it at approximately half the cost.

A good decision by our representatives not to establish some form of universal health care in this country? Certainly not for those Americans unable to afford our current system. That would include the uninsured and under-insured. The approximate half-million Americans every year who go bankrupt due to health costs, not to forget those who never seek needed treatment because of cost.

The Legatum Institute, a London-based think-tank, publishes an annual prosperity index ranking countries on the ability of their residents to prosper and flourish. One of the contributing factors — or pillars — for individual prosperity is health, defined by the organization as what “measures the extent to which people are healthy and have access to the necessary services to maintain good health, including health outcomes, health systems, illness and risk factors, and mortality rates.”

The Legatum Prosperity Index 2019 rankings for the health pillar are Japan second, Germany 12th, and the United States 59th. Nothing to be proud of.

The Commonwealth Fund is a non-profit health policy group with headquarters in New York City. The group compared the health care systems of 10 other wealthy Organization for Economic Cooperation and Development — or OECD — countries with the United States. The data used in the study came from the OECD.

A publication from the analysis on Jan. 30 concluded that the “U.S. health care system is the most expensive in the world, but Americans continue to live relatively unhealthier and shorter lives than peers in other high-income countries. Efforts to rein in costs, improve affordability and access to needed care — coupled with greater efforts to address risk factors — are required to alleviate the problem.”

An analysis from 2000 by the World Health Organization of the overall efficiency of national health care systems ranked Japan 10th, Germany 25th, and the United States 37th. Other current national health care rankings are similar order-wise.

The transition of countries to some form of universal health care has occurred over the last century. The first attempt to establish universal health care in this country was in the early years of the 20th century. Since then, every attempt has failed.

If the argument for the continuation of our health care system is based on the belief that the market will create a better system, maybe we should ask, “A better system for whom?” Certainly not for the majority of Americans.

A September 2019 report from the House Ways and Means Committee concluded that “Americans pay, on average, nearly four times more for drugs than other countries — in some cases, 67 times more for the same drug.”

How many Americans are aware that direct-to-consumer advertising of prescription drugs is legal only in the United States and New Zealand? Who benefits from advertising prescription drugs on television? We know who pays for the cost of advertising.

In preliminary data from the Centers for Disease Control and Prevention, the number of drug overdose deaths in the United States in 2019 was 70,980, which includes 50,042 deaths involving opioids. This year, that number is expected to increase.



his crisis, which began about 20 years ago, has now taken more than 800,000 lives. The number of deaths per year has increased in proportion with the use of prescription opioid drugs. Assuming this was an avoidable crisis, who would we hold responsible? The doctors? The drug makers? Or those who approved the drugs?

Is it a culture that exploits for profit, agencies established to protect? Is it by coincidence that the former commissioner of the U.S. Food and Drug Administration serves on the board of Pfizer? In New York, should we question when a former majority leader of the state senate who recently resigned from the senate takes a position with Northwell Health?

The chief executive of Northwell Health has previously held a senior management position with a major health insurance company in New York. He also has served in the New York state government. An opponent of a single-payer system, his salary is in the millions.

The COVID-19 pandemic is testing every country. Two major factors in controlling the virus are national leadership and the health care system. The number of lives lost in each country will continue to grow in relationship to the ability of that country to deal with the virus.

In the United States, communities of color have been disproportionately impacted by the pandemic. These groups are also disproportionately underserved by our current health care system.

Where would we be now if our country had adopted some form of universal health care? With a different health care system, could we have avoided the opioid crisis? With universal health care, would we have done a better job of containing COVID-19, thereby saving the lives of thousands of Americans?

The data is available and evolving. Comparisons can be made. We need to pay attention, ask questions, and hold our representatives accountable.

What will future generations think of us for accepting a health care system where profit is prioritized over care? Should we not consider every person of equal value and of equal importance in the future of this country?

Universal health care is a necessity in our march toward social justice.

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David Carlson,