Health Care in the United States

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VOICE ONE:

In recent years, health care spending in the United States has
grown to fifteen percent of the economy. The care is often described
as the best in the world, but the cost is a big problem. I'm Steve
Ember.

VOICE TWO:

And I'm Faith Lapidus. Welcome to THIS IS AMERICA, in VOA Special
English. This week our program is about health care in the United
States.

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VOICE ONE:

Forty years ago, a Chicago businessman had an operation for
cancer. Doctors could offer no further treatment. The cancer spread.
The man died about a year later. His medical care cost about
ten-thousand dollars.

Six years ago, an office administrator in Washington, D.C., had
an operation for cancer. Later she had treatment with radiation and
powerful chemicals. Today she feels fine. Her doctors say she will
probably live many more years. But her care cost several hundred
thousand dollars.

VOICE TWO:

Medical science today saves many more lives. But this can also
mean major debt. Government programs provide health insurance to the
poor and elderly.

Others depend on private insurance. Companies guarantee to pay
part or all of the costs of care. But the more the policy covers,
the higher the price.

VOICE ONE:

Around sixty percent of working Americans have health insurance
through their jobs. Their employers usually pay at least part of the
cost. But, as those costs increase, employers feel the pressure.

The Department of Health and Human Services reported this month
on health care spending for two-thousand-two. It says spending rose
nine percent that year, to one-point-six million-million dollars.
Health costs per person averaged more than
five-thousand-four-hundred dollars.

Some employers no longer offer health coverage. Others have
increased the share paid by their employees.

Getting insurance can be difficult for those who work only part
time. The same is true for people who are already sick.

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VOICE TWO:

Some Americans have no health insurance. The Census Bureau says
fifteen percent of the population had no coverage in
two-thousand-two. The number was forty-three-point-six million
people.

Last week a committee of experts called for health coverage for
all by two-thousand-ten. The report was from the Institute of
Medicine, one of the National Academies. The report says about
eighteen-thousand people each year die unnecessarily because of lack
of insurance.

The experts also estimated how much money the United States loses
as a result of poor health and early deaths of uninsured adults. The
estimate is between sixty-five-thousand-million and
one-hundred-thirty-thousand million dollars a year.

A top official in the Bush administration, however, says it is
not realistic to expect universal health coverage by
two-thousand-ten.

VOICE ONE:

Some uninsured people get care at university teaching hospitals.
A number of religious and humanitarian agencies like the Salvation
Army offer free or low-cost care.

But hospital emergency rooms are where many poor people go even
for minor problems. This adds to hospital costs.

The largest number of poor get medical help through public
programs at several levels of government. The federal government and
the states jointly offer an insurance program called Medicaid.
States also administer a program to aid children whose families earn
too much to receive Medicaid.

However, budget problems have led some states to reduce their
services. Florida, for example, has thousands on a waiting list for
the State Children's Health Insurance Program there.

VOICE TWO:

Another issue for a lot of people is the cost of prescription
medicine, drugs only a doctor can order. Drug companies say new
medicines cost a lot to develop and market.

The industry notes that about one-tenth of every dollar spent on
health care in the United States goes to prescription medicines. It
says these drugs represent only a small part of health care
spending.

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VOICE ONE:

Both major political parties have
offered plans to improve the health care system.

The candidates for the Democratic nomination for president have
proposed their own ideas. And President Bush recently won approval
of big changes to Medicare. Medicare is the government insurance
program for people age sixty-five and older. It also helps pay for
some younger people who are disabled.

Congress approved Medicare in nineteen-sixty-five. Lyndon Johnson
was president. Johnson proposed Medicare as one of the social
reforms in a plan he called the Great Society.

VOICE TWO:

President Bush signed the Medicare
reform act in December. The bill received the support of an
influential activist group. The group is called AARP, formerly the
American Association of Retired Persons. Members of AARP are age
fifty and older. As the nation gets older, voters get older. So this
issue is important politically.

Parts of the new law will take effect at different times.
Forty-million elderly or disabled people will receive help to buy
medicine, starting in two-thousand-six. And seniors will get a
chance to establish tax-free health accounts to save money for
future care.

VOICE ONE:

The cost of the new Medicare law is estimated at
four-hundred-thousand-million dollars over ten years. Critics say
that is too much. Labor unions and other groups also argue that the
changes are better for drug companies than for seniors. Supporters
of the new Medicare act say this is not true. They say it is
important that seniors will get their first help from Medicare to
pay for medicine.

The new law also lets private health plans and insurance
companies play a bigger part in Medicare. Opponents say letting
these companies compete with the government will damage the system.
They say seniors will pay more, not less. Supporters say competition
means better choices.

VOICE TWO:

Under the new Medicare law, patients will have choices about
their drug plan. They can stay in traditional Medicare for their
doctor and hospital costs, and choose a drug policy to go with this.
Or, they can join a completely private plan. This would pay for
hospital treatment and doctors in addition to medicines.

Wealthier Medicare patients are to pay more than others for their
medicines. But the poorest seniors would pay only a few dollars for
each prescription.

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VOICE ONE:

When some Americans buy medicine, they do not go to the local
drugstore. Some travel to Canada or Mexico to save money. Others use
the Internet to order prescription drugs from Canadian suppliers.
Canada negotiates for and buys large amounts of American-made drugs.
Prices controls in Canada mean that drugs often cost much less
there. Some people think this drives up American drug costs.

The United States Food and Drug Administration says importing
drugs is dangerous and illegal. It says this is true even if the
drugs are re-imported. That is, they were made in America and then
shipped for sale outside the country.

VOICE TWO:

But some public officials in the United States say they, too,
will try to save money. Officials in Boston, Massachusetts, say they
will buy drugs from Canada for seven-thousand current and retired
city employees. The governor of New Hampshire says his state will
use medicine from Canada for prisoners and poor people.

Another state, Illinois, has appealed to the Department of Health
and Human Services in Washington. Illinois wants to import drugs
from Canada legally. Illinois officials argue that the new Medicare
law permits this if the drugs meet American safety requirements.

VOICE ONE:

Tom Daschle of South Dakota leads the Democratic minority in the
Senate. Senator Daschle says the new Medicare law is bad
legislation. He says seniors will demand many changes.

Senator Dianne Feinstein of California was among Democrats who
voted for the law. Senator Feinstein called it a step in the right
direction. The president of A-A-R-P had stronger praise. He says it
represents a victory for older citizens.

What do those people think? Many would probably agree with this
retired nurse from Rockville, Maryland. She says: "We will find out
when the changes take effect."

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VOICE TWO:

Our program was written by Jerilyn Watson, produced by Caty
Weaver. I'm Steve Ember.

VOICE ONE:

And I'm Faith Lapidus. Join us again next week for another report
on life in the United States on the VOA Special English program,
THIS IS AMERICA.