Americans Think They Are Healthy, But Big Gap Between Perceptions of Rich and Poor

My neighbor Joe Berns offered a solid critique last week of the Koch Brothers’ flunkies’ claims that American capitalism works great for everybody. New Harvard research  offers an interesting perspective on that critique in perceptions of health in the world’s greatest capitalist society. The study finds a bigger gap between rich and poor Americans in their perception of the quality of their health and access to health care than between the rich and poor of most other countries. The Atlantic summarizes the data in this chart:

Only 12% of the richest third of Americans report “fair” or “poor” health. 38% of the poorest third report fair or poor health. That 26-point gap (which the Harvard researchers found is independent of whether or not Americans have insurance) is larger than in all but two of the other 31 nations surveyed.

Notice that our richest third report better health than their income-counterparts in most other countries. America’s middle and poor also express better perceptions of their health than the same groups in many other countries. Whether our perceptions are accurate is open for debate, given, for example, that the U.S. leads the world in obese adults and young people. But to the extent that perceptions are valid, our capitalist society appears to be delivering pretty good health results to all Americans relative to the rest of the world, but better results to rich Americans than to poor Americans.

If there are disparities in how well we deliver health care to America’s rich and America’s poor, you’d think the Senate might want to give us some assurance that they are going to make the system better for everybody, right? No dice:

Senate Republicans are working to finish their draft health care bill, but have no plans to publicly release it, according to two senior Senate GOP aides.

“We aren’t stupid,” said one of the aides. One issue is that Senate Republicans plan to keep talking about it after the draft is done: “We are still in discussions about what will be in the final product so it is premature to release any draft absent further member conversations and consensus” [Caitlin Owens, “Senate GOP Won’t Release Draft Health Care Bill,” Axios, 2017.06.12].

Unable to overcome the reality that the Affordable Care Act’s protections of health insurance coverage are better than anything oozing out of Republican slogans, Republicans are signaling that whatever bill they are hiding from us is just for show:

It’s starting to become more likely that the Senate GOP has decided that passing a bill may be impossible and that the best result may be to craft some legislation that is designed to fail simply as a show vote. Party leaders are now openly talking about the idea.

“I still think in the end there is a huge reason why we have to get to 50 on this,” Sen. John Thune of South Dakota, one of McConnell’s top lieutenants, told CNN on Monday. “Obviously, we’re going to have a vote on this one way or the other. But if we don’t pass something and we go into ’18, you know, it’s on us to try to get this fixed” [Matthew Sheffield, “Fearing Public Outcry, Senate Republicans Aim to Keep Health Care Bill Secret Until Last Possible Minute,” Salon, 2017.06.12].

The case for capitalism in health care is mixed: the Harvard study shows American perceptions of health better than in many other countries, but with a greater gap in satisfaction between rich and poor. Our democracy has yet to overcome our capitalist impulses to implement the sensible Bernie Sanders solution (Medicare for Everyone!)… but at least our democratic pressures may be keeping the Senate from making things worse.