The rising cost of health care in the United States is absolutely staggering. Within the hodge-podge of the industry, health care providers and insurers fight a delicate balance between authorizing treatment and preventing providers from overcharging for unnecessary tests and procedures. Universal Health Care efforts have been eroded away by industry lobbyist and a generalized fear of socialism. The consumer is left in the fray in an inflexible system that is weighted towards industry instead of the social welfare of the nation’s citizens.
I recently watched Michael Moore’s new documentary Sicko. Although I consider myself a liberal, I never truly believed in the way Moore goes about representing his cause. He does not tell any real falsehoods yet only shows the cozy pieces of truth that fit his views. For example he shows the French being able to live comfortable with socialized healthcare despite health care taxes. However his only similar example for the British is a doctor who gets paid very well by the government. A recruiting/contracting agent I once had who was from England told me how her and her husband were glad they moved because it was so expensive to live there. Another example is how he emphasized that the French government provides subsidized nannies to help new mothers while not mentioning that the reason is for the subsidization is because the French population growth rate is 0.58% and the government is trying everything they can to encourage citizens to have children1.
The trouble with journalists who go after the health care industry is that they are only hitting a symptom. Although some health care providers, like BlueCross BlueShield of Tennessee, are non-for-profit (not to be confused with non-profit), many of them are for profit industries designed to acquire money for their employers and stake holders. I should disclose at this point that I currently work for BlueCross BlueShield of Tennessee and have an obvious bias.
Growing up my father was insured by BCBST through his job at the Tennessee Valley Authority. For the most part the coverage was very good. My father once broke his leg in our yard, had burnt his back with radiator fluid and, in more recent years, he has needed two knee replacement surgeries. My mother has Multiple Sclerosis, a disease that is nonterminal yet degenerative and incurable. On more than one occasion, ambulance charges of over $300 were not covered. I remember my mother had fallen once, her chin cut open from hitting a table, and she didn’t want me to call an ambulance because she wouldn’t sure if it would be covered.
So what causes this state of unbalance in our health care industry? Let’s start with the doctor’s perspective. If you’ve spend several years in medical school and residency, honing the very critical skill of diagnosing and treating medical conditions, is it likely that you feel you should be paid adequately for that skill, and justly so. After all it is a career that requires its professionals to have a clear mind and be fully aware every day. Mistakes can lead to misdiagnosis, permanent impairment and even death.
On top of that, medical students typically leave school with rather lofty amounts of debt. According to the American Medical Student Association, the median debt for medical students is $119,000 for public institutions and nearly $150,000 for private schools2. This isn’t just a problem in the US. In New Zealand, the average medical student graduates with a debt of $65,0003 and in Great Britain, a medical student in his or her final year of study has all ready accumulated a debt well over GBP20,0004.
There is pressure on all sides to make money. If a hospital knows you have good insurance, they may overcharge by itemizing individual tests, equipment, etc. Insurance companies must fight to keep providers from overcharging. Within the fray you have less than scrupulous insurance companies denying completely legitimate claims while other insurers who aren’t as careful end up paying out excessive amounts of money for simple procedures. Within the mess is the consumer, the lucky one, who may end up at a hospital that realizes their need and adjusts their costs, or the not so lucky who get charged $40 for a bandaid5.
When I talk to people who are not in favor of universal socialized health care, the argument I hear so often is “Why should I have to pay for their medical insurance?” In reality you don’t pay for most of your insurance, your employer does. They cover a substantial percentage of the cost which is why individual plans are so expensive. On top of that, companies that are larger and earn more typically can afford to put more into their health plans and therefore people who earn more tend to pay less for medical benefits. In reality, you are paying for everyone else’s medical coverage. You money is put into a pool and insurance providers are required by law to keep a massive reserve in order to pay out claims in the event of a catastrophe. So why not have universal health care? If you increase the pool of people from just one insurance company to the entire populous, the overall cost for everyones goes down and is equal for everyone.
Senator Barack Obama has spoken time and time again about how our nation is suffering from an “empathy deficit.” His wife, Michelle, spoke about this in a recent interview with NPR:
“What he’s said time and time again is that this country is suffering from an empathy deficit, and if you don’t have it in you to walk in another person’s shoes, it’s going to be difficult for us to move through these problems, that what we need, as a country, is to start caring for one another in a very deep and fundamental way6.”
I don’t believe the empathy gap in the American people arose on its own. The need for industry to promote their own goods and services draws on that gap and pride. Even the health care industry uses patriotic tactics in their advertising. Take, for example, this exception from Memorial’s Chicken Soup in which a pilot decides to fly back to the States rather than have emergency bypass surgery abroad:
“Gregg Palmer, a 44-year old commercial pilot based in the United Arab Emirates was hospitalized and schedules for coronary bypass surgery at Wellcare Hospital in Dubai, when it hit him. ‘I can’t do this here,’ Greg said. ‘I’m going to the USA to Memorial Hospital for my surgery.’ … [When] Referred to Dr. Nabil Khadr, a cardiologist in Dubai, for an angiogram, Gregg could actually see the clogged arteries on a video screen. One was 78% percent blocked, another was 98% clogged, and a third was 100% blocked … After five confirming opinions [from doctors in Dubai], Gregg finally said, ‘It’s me. I need surgery.” … ‘I feel you were the main reason I recovered from my transplant and I have always trusted your opinion. I do not have a good feeling about having surgery in Dubai. I’ve always liked Memorial Hospital, and I want to come there7…”
So why fly all the way back to the United States for an operation that is essential? Did the pilot not trust the doctors in Dubai? If so, why not? Their medical technology is more than adequate. I know from my experiences in India that low income countries have good health care providers. On both of my previous visits, I knew I could rely on the doctors there and the powerful antibiotics they prescribed to me when I became ill. I have an aunt who is a testament to their ability to diagnose and treat serious diseases during her own battle with breast cancer. Did he not trust the doctors because they were Arab? After all he did go to seven different physicians. Was he raciest? Was it simply good American pride? Whatever his motivations, his decision was a risky one, not to mention a costly one, and yet it is promoted as the good and right choice by a publication for a major US hospital.
We are in a society that prides itself on its capitalism and is still living in the shadow of the fall of communism. We have an inflated sense of American pride which industry uses for its own benefit. We have an empathy gap that allows us to classify the uninsured in our country into the same bucket as the the homeless. And we simply either do not listen or do not care.
“Just to walk in the door was $500…A $40 ACE Bandage. You see that? You see where the problem is. This is absolutely ridiculous…I love this country…Americans can do a lot better. We can treat our citizens better than this5.“ -Morgan Spurlock, 30 Days.
1CIA – The Wold Face Book — France, retrieved from https://www.cia.gov/library/publications/the-world-factbook/print/fr.html on 7/30/07
2 American Medical Student Association, Medical Student Debt, retrieved from http://www.amsa.org/meded/studentdebt.cfm on 7/30/07
3 The New Zealand Herald, Saturday July 14th 2007, News:General.
4 The Herald (Glasgow) , January 3rd 2006, Society; p12.
5 30 Days. TV Series. Season 1. Episode 1. Topic: Minimum Wage
6 NPR: Michelle Obama Sees Election as Test for America, retrieved from http://www.npr.org/templates/story/story.php?storyId=11831859 on 7/30/07
7 Memorial’s Chicken Soup. August/September/October 2007. V13N3.