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VOICE ONE:
In recent years, health care spending in the United States hasgrown to fifteen percent of the economy. The care is often describedas the best in the world, but the cost is a big problem. I'm SteveEmber.
VOICE TWO:
And I'm Faith Lapidus. Welcome to THIS IS AMERICA, in VOA SpecialEnglish. This week our program is about health care in the UnitedStates.
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VOICE ONE:
Forty years ago, a Chicago businessman had an operation forcancer. Doctors could offer no further treatment. The cancer spread.The man died about a year later. His medical care cost aboutten-thousand dollars.
Six years ago, an office administrator in Washington, D.C., hadan operation for cancer. Later she had treatment with radiation andpowerful chemicals. Today she feels fine. Her doctors say she willprobably live many more years. But her care cost several hundredthousand dollars.
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Medical science today saves many more lives. But this can alsomean major debt. Government programs provide health insurance to thepoor and elderly.
Others depend on private insurance. Companies guarantee to paypart 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 insurancethrough their jobs. Their employers usually pay at least part of thecost. But, as those costs increase, employers feel the pressure.
The Department of Health and Human Services reported this monthon health care spending for two-thousand-two. It says spending rosenine percent that year, to one-point-six million-million dollars.Health costs per person averaged more thanfive-thousand-four-hundred dollars.
Some employers no longer offer health coverage. Others haveincreased the share paid by their employees.
Getting insurance can be difficult for those who work only parttime. 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 saysfifteen percent of the population had no coverage intwo-thousand-two. The number was forty-three-point-six millionpeople.
Last week a committee of experts called for health coverage forall by two-thousand-ten. The report was from the Institute ofMedicine, one of the National Academies. The report says abouteighteen-thousand people each year die unnecessarily because of lackof insurance.
The experts also estimated how much money the United States losesas a result of poor health and early deaths of uninsured adults. Theestimate is between sixty-five-thousand-million andone-hundred-thirty-thousand million dollars a year.
A top official in the Bush administration, however, says it isnot realistic to expect universal health coverage bytwo-thousand-ten.
VOICE ONE:
Some uninsured people get care at university teaching hospitals.A number of religious and humanitarian agencies like the SalvationArmy offer free or low-cost care.
But hospital emergency rooms are where many poor people go evenfor minor problems. This adds to hospital costs.
The largest number of poor get medical help through publicprograms at several levels of government. The federal government andthe states jointly offer an insurance program called Medicaid.States also administer a program to aid children whose families earntoo much to receive Medicaid.
However, budget problems have led some states to reduce theirservices. Florida, for example, has thousands on a waiting list forthe State Children's Health Insurance Program there.
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Another issue for a lot of people is the cost of prescriptionmedicine, drugs only a doctor can order. Drug companies say newmedicines cost a lot to develop and market.
The industry notes that about one-tenth of every dollar spent onhealth care in the United States goes to prescription medicines. Itsays these drugs represent only a small part of health carespending.
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Both major political parties haveoffered plans to improve the health care system.
The candidates for the Democratic nomination for president haveproposed their own ideas. And President Bush recently won approvalof big changes to Medicare. Medicare is the government insuranceprogram for people age sixty-five and older. It also helps pay forsome younger people who are disabled.
Congress approved Medicare in nineteen-sixty-five. Lyndon Johnsonwas president. Johnson proposed Medicare as one of the socialreforms in a plan he called the Great Society.
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President Bush signed the Medicarereform act in December. The bill received the support of aninfluential activist group. The group is called AARP, formerly theAmerican Association of Retired Persons. Members of AARP are agefifty and older. As the nation gets older, voters get older. So thisissue is important politically.
Parts of the new law will take effect at different times.Forty-million elderly or disabled people will receive help to buymedicine, starting in two-thousand-six. And seniors will get achance to establish tax-free health accounts to save money forfuture care.
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The cost of the new Medicare law is estimated atfour-hundred-thousand-million dollars over ten years. Critics saythat is too much. Labor unions and other groups also argue that thechanges are better for drug companies than for seniors. Supportersof the new Medicare act say this is not true. They say it isimportant that seniors will get their first help from Medicare topay for medicine.
The new law also lets private health plans and insurancecompanies play a bigger part in Medicare. Opponents say lettingthese companies compete with the government will damage the system.They say seniors will pay more, not less. Supporters say competitionmeans better choices.
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Under the new Medicare law, patients will have choices abouttheir drug plan. They can stay in traditional Medicare for theirdoctor and hospital costs, and choose a drug policy to go with this.Or, they can join a completely private plan. This would pay forhospital treatment and doctors in addition to medicines.
Wealthier Medicare patients are to pay more than others for theirmedicines. But the poorest seniors would pay only a few dollars foreach prescription.
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VOICE ONE:
When some Americans buy medicine, they do not go to the localdrugstore. Some travel to Canada or Mexico to save money. Others usethe 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 lessthere. Some people think this drives up American drug costs.
The United States Food and Drug Administration says importingdrugs is dangerous and illegal. It says this is true even if thedrugs are re-imported. That is, they were made in America and thenshipped for sale outside the country.
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But some public officials in the United States say they, too,will try to save money. Officials in Boston, Massachusetts, say theywill buy drugs from Canada for seven-thousand current and retiredcity employees. The governor of New Hampshire says his state willuse medicine from Canada for prisoners and poor people.
Another state, Illinois, has appealed to the Department of Healthand Human Services in Washington. Illinois wants to import drugsfrom Canada legally. Illinois officials argue that the new Medicarelaw permits this if the drugs meet American safety requirements.
VOICE ONE:
Tom Daschle of South Dakota leads the Democratic minority in theSenate. Senator Daschle says the new Medicare law is badlegislation. He says seniors will demand many changes.
Senator Dianne Feinstein of California was among Democrats whovoted for the law. Senator Feinstein called it a step in the rightdirection. The president of A-A-R-P had stronger praise. He says itrepresents a victory for older citizens.
What do those people think? Many would probably agree with thisretired nurse from Rockville, Maryland. She says: "We will find outwhen the changes take effect."
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VOICE TWO:
Our program was written by Jerilyn Watson, produced by CatyWeaver. I'm Steve Ember.
VOICE ONE:
And I'm Faith Lapidus. Join us again next week for another reporton life in the United States on the VOA Special English program,THIS IS AMERICA.