Can You Afford to Live?

In the US, one can't really talk about health care without talking about the cost of health care. You may be gasping. Politics! Say it isn't so, Stephanie!

Well, that's my point. Why exactly is health care a political issue? When did we say to ourselves, people are only entitled the amount of health care they can afford and even contemplating otherwise is a political hot-button topic? I'm completely floored, actually, with the notion that someone thinks that's anyone should go without health care if they can't afford it.

Who really thinks one's health is a matter of merit? That only those that deserve it become ill or injured? And why--why?--do we feel the need to protect the profits of insurance companies? If the government stepped in with their own program, it would provide an unfair competition with the insurance companies because the government doesn't have to make a profit. Um, so what? Much better that US industry is at a disadvantage because we're the only first world nation that still eschews universal health care? Much better to have families decimated and destitute because someone in the family develops cancer? Why do we think it better to protect the profits of those who make those profits on the suffering of others?

I wonder if anyone has done that math. Insurance companies make money two ways: first, failing to cover anyone they expect to pay out for and, secondly, charging the customers more than they pay out. So, replacing health insurance with a government single payer system doesn't have to be expensive - in fact, well designed, covering those who were already covered means it shouldn't cost the "taxpayers" a dime and those covered still pay less. Why? No profit; just break even.

It's covering those that aren't covered that brings up the cost. To an extent. Many of those not covered today are healthy. That's why they haven't bought insurance. Many of those not covered are not healthy; that's why they can't get coverage. So, does that mean, if you're sick and can't get coverage, that you deserve to die? That you aren't entitled to be cared for? What does it say about our society that this is even a question?

I suppose, for the sanctimonious, there's a belief that people get what they deserve. I am not one of them. I've seen children who died of a brain tumor and families who, more than dealing with the devastation of the loss of their child, had to also deal with a mountain of debt that can keep their other children from college, limit their options, ruin their lives. That's not justice. That's a tragedy, an insult added to unimaginable injury.

It doesn't have to be this way. In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person. The US government spent $2724 per capita in 2004 (>$600/capita than the Canadian government, which has Universal healthcare). In France (ranked #1 by WHO in 2000 for heathcare), the government pays $3926/capita. The US, in that same ranking, ranked #37 in overall health care.

What are we paying for? Well, we're paying for tests that provide profit for doctors and clinics since visits are now paid so little by insurance companies that a doctor loses money to see you. We're paying for extra help in the doctor's office to deal with eleven billion different forms of insurance so he has four admin staff to handle the insurance hassles instead of, say, another nurse and a physician's assistant. I've read estimates where ~50% of our health care costs were related to insurance dealing admin activities. So, we double our bills to have all this private insurance and then pay the middle man for the privilege. Nice job. We're paying, through the nose, for new drugs that may or may not be better for us than the drugs we already had, depending (in some cases) on whether or not one is making a profit from them.

And, in this country, more than 47 million people don't have health insurance or any health care coverage. 47 million put off taking their kids to the doctors or live in fear of what they'll do if one of their kids falls and breaks an arm. Many have jobs that make ends meet, but little more and health and the steps to ensure health are often what falls behind. One serious infection, on bout of meningitis, and families lose their homes, their futures. And they might not get the care they need until too late.

I don't know about you, but that's not acceptable to me. Can health care be better? Yeah. Can it cost less than we're paying? You bet. People all over the world are doing it. For what we pay per capita, no one in this country should be deciding between taking their kid to the doctor and rent.

That's the kind of choice no one should have to make in a civilized society.