>I am less than satisfied with our medical system here in the United States. This sentiment derives from both personal experience and policy analysis. Let me explain.
Insurance Companies
I watched Michael Moore’s new documentary, SiCKO, approximately one week after receiving a large sum of money from my insurance company for medical bills dating back to 2006. This reimbursement came only after acidic phone calls and emails. In fact, every reimbursement over the past year and a half has been delayed until I’ve filed complaints and become “unfriendly” on the phone. So yes, I already greatly disliked our health system with its third-party payers (insurance companies) before putting Moore’s documentary into the DVD player.
Cost
The high cost of care here is frustrating. For example, I received an MRI in South Korea for less than $200 (which my insurance paid for); I’ve been told this procedure would cost closer to $2,000 here in the U.S. While births are estimated to cost between $7,000 and $9,000 in the U.S., our American friends just had a baby in South Korea for $160 out of pocket.
Even with insurance here, you can still go under. Last year my wife had an outpatient surgery, and our portion of the bill, the part insurance didn’t cover, was $3,000. I’m glad she had insurance back then, yet it is frustrating to still be paying off the bill a year later. A study published in Health Affairs has estimated that approximately one half of all personal bankruptcies involve medical bills. Crippling.
Let’s look at this from a macro view, rather than the micro view of my life. Spending on health care as a percentage of GDP has risen significantly in the U.S. In 1960, it was 5.1% of GDP; in 2002 it was 15%. Also, the U.S. spends more per capita on health care than does any other country (Rand Health, U.S. Health Care).
This leads me to two different thoughts. First, if we’re spending the most, then our system should be the best, and consequently, our health should be the best. Second, if it turns out that we don’t have the best care even though we’re spending more, then we shouldn’t fear the so-called “high cost” of other systems (read universal health care/socialized medicine).
Performace
Is this the best health care system that industrial societies have devised? The World Health Organization’s 2000 ranking of health care systems around the world placed the U.S. at number 37. Forty-one countries have longer average life spans than the U.S. (Boston Globe).
Also, “American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway” (CNN.com, Jeff Green, 10 May ’06). Our infant mortality rate places behind 32 other countries (Wikipedia).
So, no, we are not the best. We can be humble and realize that we can learn something from other countries. But then why do people from other countries come to the U.S. for medical treatment? I agree that we have some of the best medical equipment and some of the best research hospitals. People in foreign countries with significant financial resources can afford to come here for world-class treatment in these fine centers. But excellent equipment and expertise in specific centers is very different from having an overall healthcare system that provides for all of its citizens. In fact, we are the only industrialized western country that does not offer universal healthcare.
We have free public schools, free libraries, free police protection (yes, there’s no “free lunch,” these are financed through taxes). Why do we accept these government services, but then worry about “socialized medicine” when the conversation turns to our nation’s health? And increasingly, Americans are going abroad for medical treatment. Three Billion New Capitalists describes “medical tourism.” For example, it may be less expensive to fly to India to have hip surgery than it is to have the procedure at home–possibly one tenth of the cost.
Access to Insurance
My wife and I are currently among the 47,000,000 people in this country without health insurance (National Coalition on Health Care). Reason? We’re currently unemployed. Attaching medical insurance to the place of work is crippling. If you change jobs, then you have to go through a waiting period before benefits begin at the new job. Also, ailments that were being treated in the previous plan are now considered pre-existing conditions. Because of my neck problems, I’ve been told that group plans are my only chance for coverage.
What other insurance is through the employer? Only workman’s comp, as far as I can tell, which makes sense. But we don’t lose our auto, fire or life insurance when we change jobs. Why health insurance? Let’s take a look.
I took Human Resource Management during my business studies, so I can share a bit of the history of how we got here. In the 1940s, employers were looking for ways to increase employee compensation while staying within wage limits. Non-wage benefits were seen as a positive way to cope with the system. A good idea, right? Sure, at the time. But with decreased job stability and increasingly stubborn insurance companies, it is time for a new system.
Hopefully, tax laws will change soon, making it easier to get insurance directly. However, even if these laws do change, the dramatic upward trend of healthcare costs will continue to push insurance out of reach for many individuals and families.
We have seen that the U.S. healthcare system is (a) expensive, (b) below industrialized performance standards, and (c) not reaching millions of people. We need to admit that it is in our society’s best interest to consider other systems.
Options
What countries can we learn from? How about these (WHO world ranking): France (1), Austria (9), United Kingdom (18), Canada (30) and Australia (32) are good starters. We don’t have to copy every policy from any one country, but we can learn from them. It’s time.
You can start by watching SiCKO. This film can’t replace a more systematic analysis of the issue, but it is a good place to get motivated to do the more mundane policy and statistical research needed to improve our health.
Summary
We have world-class facilities and practitioners in certain research centers, but we have nearly 50,000,000 people who can’t afford these services because they lack health insurance. Even with insurance, medical costs are still debilitating. Getting health care through an employer creates significant problems. While U.S. citizens on average pay more for healthcare than anyone else on the planet, our system still ranks only 37th in the world. I think we need to seriously consider major changes.
Possible Solutions
I am for universal health care coverage. This can take different forms. Two options are national care provided by the government and compulsory health insurance through the private market with government subsidy. This is sure to continue as a headline issue as we move to the next presidential election.
Continuing Ed Starter-kit
Overview of health care systems (Wikipedia)
Overview of U.S. health care (Wikipedia)
Overview of U.S. health care (The National Coalition on Health Care)
Overview of Canadian health care (Wikipedia)
US/Canadian Health Care Comparison (Wikipedia)
Illness And Injury As Contributors To Bankruptcy
Learning from International System Comparisons
Rand Health, U.S. Health Care
Jim Wallis and Socialized Medicine (anecdotal)
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