“Some men see things as they are and ask why. Others dream things that never were and ask why not.” – George Bernard Shaw
That was the thought circulating in my mind as I thought about a young friend living, for the time being, with stage-four metastatic breast cancer.
Her doctor feels she needs to be on two “specialty” pharmaceuticals that enhance the efficacy of her chemotherapy. Only one little problem: the pills cost $6,000 a month, and her insurance won’t cover “specialty” drugs.
She applied to the pill’s manufacturers, both large pharmaceutical companies, one domestic, the other foreign, for financial assistance. Their answer? “You make too much money to qualify for assistance.”
"The United States likes to talk about its “health-care” system. It’s the most expensive in the world, costing roughly $6,000 a year, per capita."
Yes, she makes a good living – $7,000 (gross) a month, north of $80,000 a year. Solidly middle class. But the pills would take her net income down to just a thousand dollars a month, and it’s pretty hard to take care of yourself, much less yourself and children, on 12 grand a year.
Hers is certainly not a unique case, just one of the more illustrative and more tragic. She’s asked for something so that she may live. Society told her the option was to die.
My friend’s case is shocking, there is no doubt. But along with all of the cases that just out and out stun and shock are also the millions of smaller insults that are and that no one asks why.
Insults such as the nation of those who, unlike my friend, don’t have a problem with insurance that won’t pay. They just don’t have any insurance, period.
That includes another young woman, a past director of one of Bloomington’s most successful food pantries. She simply couldn’t afford health care insurance, but no matter because no one under 30 has health problems, right?
Wrong. She was diagnosed with euroendocrine carcinoid, a rare cancer, last Spring. She entered treatment, but only after having to sell her house to pay for it and, even then, it didn’t pay for very much.
The system that isn’t
I could go on forever. I’ve got a few stories of my own, such as the time I received a hospital bill for $3,800 for a procedure my insurance company (a large one that shares its name with the title of an Ayn Rand novel). A little curious as to how I could have a $3,800 bill when my deductible was $900 and my maximum co-pay another $1,000 on top of that, I called the insurance company.
"It’s obsessed with money, when it should be obsessed with care-giving."
After just a couple minutes of inquiry, the answer came back: “Our computers were acting up that day. I’ll submit it for re-processing.”
I can’t make this stuff up.
The United States likes to talk about its “health-care” system. It’s the most expensive in the world, costing roughly $6,000 a year, per capita.
But it’s not really a “system” at all. It’s a balkanized hodgepodge of conflicting interests, all trying to not be the last ones standing when the money music stops playing.
It’s obsessed with money, when it should be obsessed with care-giving. Those uninsured who get through the system (few and far between) are subsidized by others. And what Medicare, or Medicaid won’t pay, someone has to.
And that someone is usually the insured among us. We pay hyper-inflated costs for trivial procedures. I once had a broken arm that required an X-ray and a plaster cast. Perhaps two hours of labor and 20 bucks worth of materials. The bill?
Twelve hundred dollars.
And our health care isn’t even very good, despite how much we pay for it. The World Health Organization (WHO), which ranks the health care quality of nations, puts the United States No 37. Just ahead of No. 38, Slovenia. Just behind No. 36, Costa Rica.
And one that could be
Most of the 36 slots ahead of us on the WHO’s survey are occupied by advanced western democracies, like ours but with actual health care systems.
"And our health care isn’t even very good, despite how much we pay for it."
France is No. 1, followed by Italy. Japan comes in at No. 10. The much-maligned U.K. and Canada? Eighteen and 30, respectively.
In fact, the only advanced western nation with a crappier health care rating than ours is New Zealand. Forty to our 37.
In addition to their better levels of care and coverage, the other advanced western nations share another trait separate from us: their systems are cheaper. They average about half the per-capita annual healthcare cost that we do.
Better and less expensive. Who could argue with that?
Well, we could. Or at least a well-fed minority of us for whom the current system-non-system works very well.
And that minority works overtime to convince us of everything from weeks-and-months long waits in Canada for emergency operations (not true) to not being able to choose your doctor (France’s system not only maintains doctors in private practice, but it encourages second opinions for just about everything).
A heaping pile of bullshit, a fetid stew of lies. And that’s before they add on, just for good measure, the “socialized” pejorative.
As if health care was responsive to market forces. That, all else being equal, people would have appendectomies round the clock if only they were “free.” That there are those cancer-free but who would jump at the chance for a round of chemotherapy if they didn’t have to worry about getting a bill for a hundred grand.
Burn the village to save it
Absolutely insane. As crazy as is any attempt to redeem what we have now through incremental tweaks and reforms. Health care isn’t like car insurance, and it’s inherently not amenable to the model.
What’s needed is a scrape-off. A hard reset. Put up a dart board covered in strips of paper numbered 1-10. Blindfold the Surgeon General and have them throw a dart at it. Whatever number the dart lands on, implement that country’s (as determined by WHO’s rank) health-care system here.
And do it, soon. I know at least a couple of young people whose lives are counting on it.
Gregory Travis can be reached at email@example.com.