Can You Afford to Live?

>> Tuesday, April 14, 2009

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.


  • Roy

    That's the kind of choice no one should have to make in a civilized society.Which tells you exactly how "civilized" the US really is. Remember Scrooge on Christmas Eve? "Are the poor houses closed? Are there no prisons?" Sounds familiar, doesn't it?

    There are times when the world is very lucky that I'm not a violent person!

  • Stephanie B

    I know we're in sync on this topic, Roy. Here's hoping (and working for) change is coming.

  • shakespeare

    Even for those insured, health care is ridiculous. With insurance--and pretty damn good insurance--it still costs me around $100 to go to the doctor for any reason. Yet I know people earning far less than my husband--and there are a LOT of those--can't afford that. As it is, that amount makes it tough for me to choose to go to the doctor, but at least I know I can pay the bill.

    It's pathetic what we have available for our own people. Absolutely pathetic. And since when is money more important than life? Why do we make some sort of moral judgment on this (Oh, no! It's socialism!) when the true immorality stems from not taking care of those in need.

    Then again, this just ensures that the rich get richer and the poor stay where they are.


  • flit

    I SO don't understand those people that are just fine with the US ~system~ the way it is.

    Have been known to get into it with them on more than a few occasions - it just seems so incredibly wrong - and selfish and yes, uncivilized.

    Canada's health care system is far from perfect - but I've never once had to choose between feeding my kid and getting them medical care. Nor have I ever had to stay in a job I hated because without it, my family would be SOL. Oh yeah, and we Canadian's live longer than you guys too.... go figure.

    I honestly don't get why anyone would tolerate it, never mind defend it! Mind boggling!

  • Relax Max

    I agree with you 100% - all citizens should have decent high quality health care. It should not be decided on some sort of warped "merit".

    I also believe that all children should be brought up in decent, high quality housing, and that it is a disgrace for them to do without just because they are poor.

    I also think it is horrendous that so many children are malnourished in this country, who do not eat as well as children whose parents have a lot of money.

    It is outrageous in this land of plenty that many children who have HUGE potential are denied a college education just because they can't pay for it. In reading your post, I know you will agree with me that our government needs to be doing a better job in paying for education for these deserving people - after all, what is good health care if you don't have enough education to get a good job?

    So much to do.

    I think it IS political.

    I hate the bloated wasteful systems in many areas of our society: health care; insurance; education; food services; housing; and so much more.

    But socialism just doesn't work, simply because you soon reach a stalemate average; and that average is very very low quality indeed. Look to Cuba and North Korea to see the future of long-term socialism.

    My solution is half socialism and half capitalism. The half capitalism is to trade a medical education in return for 10 years of service to your fellow man's medical needs before you can open your own clinic and play golf. The socialism part is to REQUIRE EVERYONE to pay, through payroll deductions or other forced taxes, into a system of Government health-care that gets rid of the fat-cat insurance companies altogether and insures every citizen has a right to get medical care, including wellness care, because he paid into the system.

    What does this mean? I means I "sort of" agree with you in that we need a form of universal health care, and no one gets turned away. But I also think every single one of us should be FORCED to contribute - "Each according to his ability", as Karl Marx said.

    God I love your posts. You make me think. :)

  • Mike

    Very good post - I just don't think that government is the answer unitl they get their own act together. They can't run themselves and manage their own finances - let alone to try and run healthcare. Someplaces it may work, but until our government getting its act together, it will be very difficult here.

  • Stephanie B

    Thanks for the thoughtful responses. I'm not saying correcting this issue is easy. I'm saying I think it can be done. But the first step is to decide making health care a given for everyone is required. We'll probably have issues whatever route we choose (and I agree, Relax Max, on cutting out the fatcat insurance companies). If we don't stand up and say, having 47 million uninsured, having people made destitute by diseases and conditions they did nothing to "deserve", having people forgo treatment because it's medicine or food, that can't be acceptable.

    Once we've determined that such a situation is not acceptable, we can and will find a solution. It's the in-between state where those that are "covered" shrug their shoulders over those that are struggling, largely because they haven't seen how ineffective being covered is if you get colon cancer or breast cancer and because they can't see past their own interests.

    If we say, no one goes uncovered and we will streamline the reimbursement system so doctors can go back to practicing medicine instead of spending their energy trying to make a living while tangling with insurance companies, we'll have made a start. We will have to pay for our healthcare, but we are paying now, believe me, and we're still not breaking even.

    I don't know the final answer, but I'm afraid we will never find it until after we admit what we have now is just not good enough.

    And, Relax Max, you couldn't have given me a better compliment.

  • Patricia Rockwell

    I saw this issue when we purchased our present home. The young couple we bought it from had to sell it because they had to move in with their parents. Why? Were they irresponsible? No. They had just had twins--born several months prematurely-- and even though they had good health insurance with the husband's work, the cost of neonatal intensive care for months for two babies totally used up all of their coverage. Although we were actually doing them a favor by buying their home, I felt guilty.

  • Stephanie B

    It's too common. I have friends with Federal government insurance that lost their home when he got prostate cancer and had to scramble to work jobs in different cities because they were a higher pay grade. He survived the cancer, but what a nightmare afterwards.

    I had a baby and Lee had a vasectomy last year. No complications, no headaches, everyone healthy, but it was still thousands out of pocket with our excellent insurance. How do people living closer to the poverty line cope? What if the baby was born early or caught pneumonia? The cost could be devastating.

    I had a friend whose baby, born four month premature, was in the hospital for more than a year. I can't even imagine the costs involved.

  • Phyl

    I'm always kind of astonished that people can say, "Government doing it just can't work," when they've got, well, the second-largest country on earth sitting right on top of their heads -- doing it.

    Universal health care, managed by government agencies, can't work?? I look around my country and all I can think is, "Voila!"

  • Stephanie B

    A number of the complaints just don't wash. We can't trust the government for health care (unless we're over 65 or a veteran), but we can trust the government to supply water, provide police, libraries, postal services, fire services, emergency services, armed services, and schools. That's right, we can't trust 'em with pharmaceuticals, but we can trust them with nuclear weapons.

    Especially compared to the private sector who always puts the little guy first!

    Do you know why politicians are always trotting public-private solutions? You can't get a kickback from an all-public solution.

  • Bob Johnson

    I could never figure out why the US can't get it together and do some kind of universal medical program, they can send a man to the Moon, have the most powerful military in the world, yet when it comes to taking care of their own, the are sadly missing the boat, we must be missing something in the equation, like maybe special interest groups that want to keep it the way it is for some reason. Again I am so lucky to be living in Canada.

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