NY Times poll: Americans DO WANT government-run health care program; overview of national health care programs

A front page June 21, 2009 "New York Times" story by Kevin Sack and Marjorie Connelly, "Poll Finds Wide Support for Idea Of Government-Run Health Plan" reports that "The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector."
"85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt."
Inside this "Times" issue, on page 20, appears a chart with more results from the survey. 72 percent of respondents, said "favor" to this question: "Would you favor or oppose the government's offering everyone a government administered health insurance plan like Medicare that would compete with private health insurance plans?"

65 percent of respondents answered, "Providing for the uninsured," to the question, "Which is a more serious problem right now: keeping health care costs down or providing health insurance for Americans who do not have any?" 26 percent answered, "Keeping costs down."

The leading source of family bankruptcy in the United States is out-of-pocket costs for health emergencies. Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem. Increasing percentages of Americans are uninsured --despite being employed. Employers often devise schemes, such as hiring people only part-time, so as to prevent employees from qualifying for health care. The United States spends six times more per capita on the administration of the health care system than its peer Western European nations.

Some thing is wrong with this system.

* * *

The media and far too many politicians invoke the same argument against health care, often citing only the British health care program. Yet, they ignore the fact that every other industrialized country (European or comparable Asian country, e.g., Japan or South Korea) has a national health care plan.
Indeed, some developing countries have national health care systems, see this wikipedia article citing the systems in Colombia and Ghana.
The British system is unique in that the doctors are employees of the national government. This is not the only possible path to a national health care system.

See the wikipedia article, "Health care system," at the section on "health care by country." In particular, see the section on France. France has a mix of public and private health care. Most doctors are in private practices; there are public and private hospitals. The nation's social security system has organizations that fund public and private health care providers. As the article states, "It generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments." The World Health Organization in a 2000 study of health care internationally, rated France's national health system as being the best system. (See this WHO report, "World Health Organization Assesses the World's Health Systems.")
"The World Health Organization has carried out the first ever analysis of the world's health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan. . . . . In Europe, health systems in Mediterranean countries such as France, Italy and Spain are rated higher than others in the continent."

The American system is a failure by the financial fairness measure. The WHO report described the issue thusly,

Fairness of financial contribution: When WHO measured the fairness of financial contribution to health systems, countries lined up differently. The measurement is based on the fraction of a household's capacity to spend (income minus food expenditure) that goes on health care (including tax payments, social insurance, private insurance and out of pocket payments). Colombia was the top-rated country in this category, followed by Luxembourg, Belgium, Djibouti, Denmark, Ireland, Germany, Norway, Japan and Finland.

And note the following WHO comparison of a few North American systems, and the United States' place in this comparison:

In North America, Canada rates as the country with the fairest mechanism for health system finance – ranked at 17-19, while the United States is at 54-55. Cuba is the highest among Latin American and Caribbean nations at 23-25

Interested in greater detail from the WHO health care system study?:
"Copies of the Report can be ordered from bookorders@who.ch."

We cannot afford national health care? Looks like we already cannot afford the system we currently have. Compare the health care costs; and note the costs for the United States.
"In 2005, France spent 11.2% of GDP on health care, or US$3,926 per capita. Of that, approximately 80% was government expenditure."
"In 2005, Italy spent 8.9% of GDP on health care, or US$2,714 per capita. Of that, approximately 76% was government expenditure."
"In 2005, the Netherlands spent 9.2% of GDP on health care, or US$3,560 per capita. Of that, approximately 65% was government expenditure."
"In 2005, Sweden spent 9.2% of GDP on health care, or US$3,727 per capita. Of that, approximately 82% was government expenditure."
"In 2005, the United States spent 15.2% of GDP on health care, or US$6,347 per capita. Of that, approximately 45% was government expenditure."
(These data are from the wikipedia article, "Health care system," retrieved July 13, 2009.)

Potential Agriculture Secretary, Michael Pollan, great writer, thinkier on food policy

A crucial person for Secretary of Agriculture would be Michael Pollan. He is someone that makes the connections between the economy and healthfulness of certain diets (diets in the sense of eating regimens).
He was interviewed yesterday on WNYC's Brian Lehrer Show.


Here is an open letter that he wrote to the next president, published in October, in "The New York Times Magazine." As in the Lehrer Show interview, in the Times article, he connected the policy of cheap --but unhealthy-- food and bad diets.
He cites the connection of pesticide use, food growing with fossil fuel burning and climate change:

Complicating matters is the fact that the price and abundance of food are not the only problems we face; if they were, you could simply follow Nixon’s example, appoint a latter-day Earl Butz as your secretary of agriculture and instruct him or her to do whatever it takes to boost production. But there are reasons to think that the old approach won’t work this time around; for one thing, it depends on cheap energy that we can no longer count on. For another, expanding production of industrial agriculture today would require you to sacrifice important values on which you did campaign. Which brings me to the deeper reason you will need not simply to address food prices but to make the reform of the entire food system one of the highest priorities of your administration: unless you do, you will not be able to make significant progress on the health care crisis, energy independence or climate change. Unlike food, these are issues you did campaign on — but as you try to address them you will quickly discover that the way we currently grow, process and eat food in America goes to the heart of all three problems and will have to change if we hope to solve them. Let me explain.

After cars, the food system uses more fossil fuel than any other sector of the economy — 19 percent. And while the experts disagree about the exact amount, the way we feed ourselves contributes more greenhouse gases to the atmosphere than anything else we do — as much as 37 percent, according to one study. Whenever farmers clear land for crops and till the soil, large quantities of carbon are released into the air. But the 20th-century industrialization of agriculture has increased the amount of greenhouse gases emitted by the food system by an order of magnitude; chemical fertilizers (made from natural gas), pesticides (made from petroleum), farm machinery, modern food processing and packaging and transportation have together transformed a system that in 1940 produced 2.3 calories of food energy for every calorie of fossil-fuel energy it used into one that now takes 10 calories of fossil-fuel energy to produce a single calorie of modern supermarket food. Put another way, when we eat from the industrial-food system, we are eating oil and spewing greenhouse gases. This state of affairs appears all the more absurd when you recall that every calorie we eat is ultimately the product of photosynthesis — a process based on making food energy from sunshine. There is hope and possibility in that simple fact.

Food prices, the governmental endorsement of the growing of certain foods arise:

It may surprise you to learn that among the issues that will occupy much of your time in the coming years is one you barely mentioned during the campaign: food. Food policy is not something American presidents have had to give much thought to, at least since the Nixon administration — the last time high food prices presented a serious political peril. Since then, federal policies to promote maximum production of the commodity crops (corn, soybeans, wheat and rice) from which most of our supermarket foods are derived have succeeded impressively in keeping prices low and food more or less off the national political agenda. But with a suddenness that has taken us all by surprise, the era of cheap and abundant food appears to be drawing to a close. What this means is that you, like so many other leaders through history, will find yourself confronting the fact — so easy to overlook these past few years — that the health of a nation’s food system is a critical issue of national security. Food is about to demand your attention.

The bad and the good news, in the connection to food policy:

It may surprise you to learn that among the issues that will occupy much of your time in the coming years is one you barely mentioned during the campaign: food. Food policy is not something American presidents have had to give much thought to, at least since the Nixon administration — the last time high food prices presented a serious political peril. Since then, federal policies to promote maximum production of the commodity crops (corn, soybeans, wheat and rice) from which most of our supermarket foods are derived have succeeded impressively in keeping prices low and food more or less off the national political agenda. But with a suddenness that has taken us all by surprise, the era of cheap and abundant food appears to be drawing to a close. What this means is that you, like so many other leaders through history, will find yourself confronting the fact — so easy to overlook these past few years — that the health of a nation’s food system is a critical issue of national security. Food is about to demand your attention.

This, in brief, is the bad news: the food and agriculture policies you’ve inherited — designed to maximize production at all costs and relying on cheap energy to do so — are in shambles, and the need to address the problems they have caused is acute. The good news is that the twinned crises in food and energy are creating a political environment in which real reform of the food system may actually be possible for the first time in a generation. The American people are paying more attention to food today than they have in decades, worrying not only about its price but about its safety, its provenance and its healthfulness. There is a gathering sense among the public that the industrial-food system is broken. Markets for alternative kinds of food — organic, local, pasture-based, humane — are thriving as never before. All this suggests that a political constituency for change is building and not only on the left: lately, conservative voices have also been raised in support of reform. Writing of the movement back to local food economies, traditional foods (and family meals) and more sustainable farming, The American Conservative magazine editorialized last summer that “this is a conservative cause if ever there was one.”

He cites post-World War II policy as the foundation for the food and energy dilemma we have today:

This did not occur by happenstance. After World War II, the government encouraged the conversion of the munitions industry to fertilizer — ammonium nitrate being the main ingredient of both bombs and chemical fertilizer — and the conversion of nerve-gas research to pesticides. The government also began subsidizing commodity crops, paying farmers by the bushel for all the corn, soybeans, wheat and rice they could produce. One secretary of agriculture after another implored them to plant “fence row to fence row” and to “get big or get out.”

The chief result, especially after the Earl Butz years, was a flood of cheap grain that could be sold for substantially less than it cost farmers to grow because a government check helped make up the difference. As this artificially cheap grain worked its way up the food chain, it drove down the price of all the calories derived from that grain: the high-fructose corn syrup in the Coke, the soy oil in which the potatoes were fried, the meat and cheese in the burger.

Subsidized monocultures of grain also led directly to monocultures of animals: since factory farms could buy grain for less than it cost farmers to grow it, they could now fatten animals more cheaply than farmers could. So America’s meat and dairy animals migrated from farm to feedlot, driving down the price of animal protein to the point where an American can enjoy eating, on average, 190 pounds of meat a year — a half pound every day.

But if taking the animals off farms made a certain kind of economic sense, it made no ecological sense whatever: their waste, formerly regarded as a precious source of fertility on the farm, became a pollutant — factory farms are now one of America’s biggest sources of pollution. As Wendell Berry has tartly observed, to take animals off farms and put them on feedlots is to take an elegant solution — animals replenishing the fertility that crops deplete — and neatly divide it into two problems: a fertility problem on the farm and a pollution problem on the feedlot. The former problem is remedied with fossil-fuel fertilizer; the latter is remedied not at all.

What was once a regional food economy is now national and increasingly global in scope — thanks again to fossil fuel. Cheap energy — for trucking food as well as pumping water — is the reason New York City now gets its produce from California rather than from the “Garden State” next door, as it did before the advent of Interstate highways and national trucking networks. More recently, cheap energy has underwritten a globalized food economy in which it makes (or rather, made) economic sense to catch salmon in Alaska, ship it to China to be filleted and then ship the fillets back to California to be eaten; or one in which California and Mexico can profitably swap tomatoes back and forth across the border; or Denmark and the United States can trade sugar cookies across the Atlantic. About that particular swap the economist Herman Daly once quipped, “Exchanging recipes would surely be more efficient.”

(Credentials might be a problem to appointing him to be Agriculture Secretary. He is very wise; but his credentials would be unorthodox: he is the Knight Professor of Science and Environmental Journalism at University of California-Berkeley, rather than an agricultural professor.

Nonetheless, there is a petition circulating for appointing Pollan as Secretary of Agriculture.

To: President-Elect Barack Obama

We citizens of The United States of America request the appointment of Michael Pollan to the Office of Secretary of Agriculture of the United States of America.

Through his academic lectures and papers, published books and articles Mr. Pollan has proven capable of gathering wide-ranging research, organizing it into a coherent whole and reaching non-biased conclusions. This research has provided him a unique understanding of the history, development, and contemporary practices of U.S. Agriculture and its relationship to the health of the citizens of The United States. He is singularly qualified to identify inefficiencies and present improvements in production, nutrition, and our problematic reliance on petroleum and petro-chemical based fertilizers, for the benefit of food producers and consumers both. As an academic and journalist, Mr. Pollan is free of the type of conflicts of interest rampant in the current administration which have led to abysmal performance and deficient oversight of industry at the expense of the people.

It is our belief that this scholarly approach coupled with his unique ability to synergize and coherently communicate to a wide audience makes Mr. Pollan the best choice for Secretary of Agriculture in an administration whose stated goals include affordable health and healthcare for the citizens of this nation and wholesale change from the practices of the Bush administration.