Thursday, September 03, 2009

Can We Talk?

Like many Americans, I have aging parents who increasingly need health care. Fortunately, they have Medicare and Medicare supplemental insurance so the costs of their care are not driving them from their home.
As I walk down this well trod path I cannot help but wonder why so many younger Americans are forced into bankruptcy because of health care costs. In the wealthiest country in the world, it is unfathomable that anyone should go broke because they get sick.
As a parent who is lucky enough to have decent insurance, I have often wondered what I would do if I had to pay the full cost -- often several hundred dollars -- of antibiotics when my children got simple ear infections. If I lived closer to the economic edge, what bills would I skip? What meals would I skip? How sick would I have to get before seeking care for myself?
Our present system, which condemns thousands of citizens to economic disaster due to illness and some even to premature death, is morally indefensible.
In that context, to reduce the current national "debate" to name-calling and fear-mongering is beneath contempt.
As a person of faith, the moral bottom line for me is simple: No one should die because they cannot afford health care, and no one should go broke because they get sick.

The current system falls woefully short. The way to a better system is not clear, but there are numerous proven options around the world and some fundamental building blocks including not using preexisting conditions to deny coverage and making coverage portable with regard to employment and relocation.
An honest national debate would be looking at options and leading us toward clear decisions about what will work best for America. It is complex, to be sure, but it is not impossible. The Japanese, Canadians, Europeans, Brits and many others make national health insurance programs work. Some are public, some are private, some are hybrid systems, but all of them work better and keep people healthier than our system.
It is far past time for this national conversation and the reforms that should result. Where is the leadership with the courage to make it happen?
UPDATE: the Facebook status on health care that inspired this brief reflection has gone viral today and created a kind of virtual town hall meeting. Wow. No guns and no screaming! And, from what I've seen, a whole lot of good back and forth about various systems and the world views behind them. Maybe we can still have civil conversation, and, who would've thunk it -- on the internet.


bluemoon said...

There are several issues with our current system, but to believe that the Canadians and Brits have a better system is flat false. The taxes would overcome ALL Americans if we chose a system like this. Medicare and Medicaid are technically insolvent and because they pay less for services than normal insurances you get the $10 aspirin at the hospital because the hospital has to make up the cost elsewhere.
Again, govt. intrusion driving costs up.

Next, tort reform. The average American doctor pays $200K in mal-practice insurance a year. They have to make up the amount somewhere. So the cost is passed onto the patient.

Then, tax reform. Eliminate the oppressive tax system we have now with a VAT or Fair Tax system and let people pay for coverage on their own. Because they would then be able to.

And also, transportability. Make the policies from each state available to everyone. Talk about an interjection of competition! The next thing you would see is cafeteria style insurance plans where you could put together what you need out of the plan instead of everything you don't.

Commercial Clinics. Wal-Mart and Target are already trying this out to great success and are proven winners at reducing cost. Does anyone think the Federal Govt. can run ANYTHING as efficiently as these two companies?

I know you're probably going to run out infant mortality rates and % of care but you have to educate yourself about how other countries keep those numbers to know that we are near the top and that we also account for 90% of medical innovation in the world. You get innovation in a capitalistic economy, not a socialistic one where the govt. owns the mean of production to over 50% of our economy. Simple economic and historical fact.

Duncan Cross said...

Bluemoon - Medicare and Medicaid are going broke because our entire health care system is screwed up. The gov't programs have actually done a better job at controlling costs, but they can't keep up with the inflation in the private sector. Hospitals don't charge $10 for aspiring because the government makes them do it; they charge that much because insurers will pay it. Meanwhile real wages have been stagnant for a decade or more as rising insurance premiums eat away at our economic gains.

Malpractice insurance, tort costs, and defensive medicine are a trivial component of health costs in this country - like maybe 2%. Tort reform won't fix the system.

The problem with "transportability" is the same problem as the credit card industry - a race to the bottom. South Dakota passed laws allowing all sorts of usurious practices to attract banking jobs to that state; doing the same thing in health insurance would be a disaster. People don't need credit cards, strictly speaking, the way they need health care.

I have no problem with commercial clinics for ordinary stuff, but they aren't going to help me buy the $3000 medicine I need if my disease flares again. Meanwhile, most of the innovation in this country comes through the National Institutes of Health - a government agency. Most pharmaceutical R&D goes towards making NIH's basic research into 'marketable' products.

Meanwhile, nothing in your response speaks to the original intent of the post: that we as a society have an obligation to see that nobody is driven into penury or death by the high cost of health care in this country. The simple fact is that our 'capitalist' system has failed us in this respect; it's well past time to look at new ways to organize health care. I'm not saying there's no room for a market in health care, but making our current system more marketized won't solve the basic problem: nobody should be forced to go broke to pay for their care, and nobody should be condemned to die for their inability to afford their care.

Anonymous said...

bluemoon, I hope you are healthy, buddy.

CW, please be in touch regarding your everlovin' parents and the state of their health. We need to talk. yo'sistah