Phil Carville: National fitness – The Union

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Fitness is a comprehensive topic. I usually talk about personal fitness, which involves the basics of diet and exercise. Follow the basics and you will be in good health, unless you get “sick.”
By sick, I mean you are struck down by some event such as diabetes, cancer, car wreck or physical accident. Since 78% of American workers live paycheck to paycheck, getting “sick” dramatically increases the likelihood of bankruptcy and financial ruin.
Health care ratings encompass medical doctors, hospitals, dentists, psychology, nursing, physical therapy and more. When we look objectively at our national health care rating, we find a situation that is a disgrace.
According to the CEOWorld Health Care Index, the United States is rated 30th in the world for health services. South Korea is No. 1, Taiwan is No. 2, Denmark is No. 3, and Austria is No. 4.
Nationally, we spend more per person on health care than any other country, yet we are No. 30 in health care performance. South Korea spends $3,500/person/year on healthcare or 8.41% of Gross Domestic Product (GDP). We spend $12,931/person/year, 19.7% of GDP or 3.24 times more/person but have much poorer results. Health care in South Korea is provided to all citizens and funded by a combination of payroll taxes, government subsidies, tobacco surcharges and outside contributions. Denmark spends $6,003/person/year or 50% “less per person” than we do, but with better results.
Compared to the other developed countries of the western world, the United States comes out nearly last…Yes, last. Something is very wrong here.
Too often politics, not compassion, dominate the health care debate. Denmark spends about 10% of its GDP and the average for the European Union (EU) is 9.9%. The 19.7% of GDP that we spend means that one of every five dollars spent in America will be spent on health care.
Unless something changes, the estimate for 2050 American health care costs is 37% of GDP … leaving even less for national security, education, housing, food, et cetera. What kind of a nation will we have then?
It is time to apply reason and compassion to solve the situation. If other nations in the world can do it, why can’t we?
The arguments such as “it’s socialism” or “we can’t afford it” or “we have the greatest health care in the world” are all bogus. They are obfuscations which do not lead to clear thinking and real solutions.
There are 29 countries in the world which have higher rated health care systems than we have. Some are “single payer” but most have a combination of national health care coverage and some form of private insurance. France, for example, has a national health insurance program, but the physicians are in private practice. Supplemental coverage may be purchased from private insurers.
Switzerland and Taiwan have single-payer models with high-quality care at stunningly low costs. Switzerland spends 11% of GDP on health care while Taiwan spends only 7% of GDP on health care.
Germany has a universal, multi-payer system which is a combination of 77% government funded and 23% private insurance. The German health care system has a record reserve of $20 billion Euros, which makes it one of the “healthiest” health systems in the world.
A health care system doesn’t have to be “either or” — totally government run or an unchecked free market. But whatever the system, we must start working on real solutions now!
National fitness depends upon the same issues as personal fitness: education and commitment.
We must dedicate ourselves to finding solutions to America’s broken health care system. If we are to have a vibrant, healthy democracy in the 21st century, we must have an informed, educated, and healthy population.
If we don’t start solving our major problems today, the future will not be as good as the past. Maybe it’s time that we all got involved in the solution. Time is not our friend!
Phil Carville is a co-owner of the South Yuba Club. He is happy to answer questions or respond to comments. He can be reached at

For 56-year-old Adam Cook, it’s all about being of service.

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