Thursday, August 13, 2009

Health Care: Inside and Out

If you've been watching the news, or generally been anywhere other than a completely secluded bunker, you've been bombarded with various talking points for and against health care reform. While I don't tend to be overtly political on this blog, I felt the need to at least post a couple items I thought were well-reasoned and well-put.

First, to respond to a couple pervasive worries with some facts: one of the main rallying cries I hear for resistance to reform is that "America has the best health care in the world." Or the more damningly "specific" generality: "you never hear of people flying to other countries to get health care, they come to America to get the best in specialized treatment."

As for having the best health care in the world, the World Health Organization, an entity of the UN with no discernible left or right agenda, ranked the U.S. 37th in the world. Not first. Not in the top ten. Not even in the top thirty. 37th. Remember that number, remind people of it. I think people don't hear it often enough. Other reports ranking fewer countries (Australia, Canada, Germany, New Zealand, U.S.A., and the United Kingdom)— ranked the U.S. system next to last in terms of: quality, access, efficiency, equity, and healthy lives. The only figure I have ever seen ranking the U.S. at the top is in the amount we spend on health care, not the quality of care we receive. Ours is the most expensive system, by all figures I've seen, but it is certainly not the best.

But what of this other claim, that people fly to America from other countries and not the other way around? It sounds right to Americans, we've heard stories of these sorts of things, so it's a particularly useful tactic. I've watched clips of Glenn Beck and other Fox News talking heads employing this as gospel, and I've seen man-on-the-street interviews showing that this message is resonating. And there is some limited merit to this, people do fly to America for procedures; but this only means that we have high levels of technology and research for specialized procedures, and says nothing of general health care. Again, we're 37th in the world. This belief that "people only fly to America" also completely ignores the budding Medical Tourism industry (in doing research for this post I even came across the site Specialized care doesn't speak to the health care system in general, and yes, people do fly (and drive) to other countries to receive care.

I would honestly think this would be less of a debate, but it's clearly as contentious as anything can be. So I would ask you to please do something:

Call your representative.

Let them know how you feel. If you have a personal story about health care (as most of us do), share it with people. It's easy to dehumanize this and make this into simple political talking points. But this isn't a political debate. This is an ethical and moral matter, and as such I think it only makes sense that even some otherwise conservative religious groups are embracing the message: it is morally imperative that in one of the wealthiest nations on earth we have affordable, quality, persistent health care for the people of that nation.

For two great discussions on this, please watch the above video of Bill Moyers' interview (thanks to Anders Nilsen for passing this along) with a former Health Insurance executive and, for the somewhat lighter side, the below video of Stephen Colbert's interview with Sick author Jonathan Cohn. Both are eye-opening in their own right (though the former more so than the latter).

The Colbert ReportMon - Thurs 11:30pm / 10:30c
Jonathan Cohn
Colbert Report Full EpisodesPolitical HumorMeryl Streep


Tony said...

Medical tourism absolutely goes the other way.

I heard just last night about someone driving to Mexico to get their teeth fixed, because they couldn't get insurance in the U.S.

Turbo Cowboy said...

What if the wealthiest simply don't give a fuck about less fortunate and their struggle with health care ?

Paul Hornschemeier said...

Unfortunately, I think that's a fair amount of what's happening in this debate.

I would suggest that not caring about our fellow American citizens that are less fortunate is the antithesis of what we would typically call American values. I think we should care about neighbors and our fellow countrymen, and in general I think we do. I also think that while it is anyone's liberty to not care, it should not be the liberty of the individual to inflict whatever situation he or she wishes on his or her fellow citizen. That is to say: companies comprised of citizens should not be able to do as they please with other citizen's health. That someone who pays for health insurance can be dumped for having a pre-existing condition (in many cases when there was not one) is unjust. That people who work diligently and contribute to society cannot obtain even basic health coverage is unjust. And I think striving for justice is an inherently American value.

Speaking personally, I was – at age 24 and having completely sufficient funds – denied coverage by Blue Cross simply because I had been fitted for a heart monitor when I was a teenager. There were no negative findings from the monitor, I was given a clean bill of health, yet I was still denied coverage years later. I had to go through months of applications until I found an insurance company that happened to not ask about heart monitors. And that's just the bureaucracy and idiocy faced by one perfectly healthy and relatively affluent person. Millions upon millions of people have infinitely worse stories.

I think that when we care only when it's our own family being affected by insurance and the health care system that we do a disservice to our country, and our country is the poorer (figuratively and literally) for it.

Anonymous said...

I'm a 30 years french man. I wanted to share my experience : here in France, health care system was an obviousness for my parents in that sense that human rights declaration was in adequation with facts.
But since the 2000's, trend isn't favourable. Health care system was under attack by successive (right wing)governments and we can see now a two gears Health appears. Because of the economical crisis, we should protect wealth persons interests, nevrmind if the first persons affected by this crisis are poor people...
French health care system is still alive but for how long ?
I wish things were changing in the US for american people first and to show to the whole world that, in crisis times, we can choose to protect the weakest.
Sorry for my bad english...

Tim said...

I started writing a comment here yesterday, then deleted it, but after the news today about the British MEP who is in the middle of a shit-storm ('scuse language) for criticizing our National Health Service, I thought I'd wade in…

Yes, the NHS is a mess. Yes, the doctors and nurses are overworked and underpaid (but hey, where aren't they!?), and yes it needs more money - lots more money. But the concept - free healthcare for all - is a grand one, and while the execution of it undoubtedly isn't anywhere near perfect, the idea of it NOT being there would absolutely horrify me.

I've never been able to understand the idea of people in the States being turned down for treatment if they're not covered by insurance - or even, like you, being turned down for insurance because of a trivial matter from years before! It's this sort of thing that reminds me never to take the NHS for granted.

Paul Hornschemeier said...

Thanks, Yann and Tim. It's great to hear two perspectives from people in other health care systems. Those are perspectives to which more people in the States should be exposed. I think a fair amount of the fear and anger about this debate (if one can call some of the vitriol "debate") is based on ignorance, as is often the case with resistance to progress.

ULAND said...

1- The W.H.O has not political agenda? Are you joking?

2- I'm not concerned with wether "our" healthcare is the best in the world or not, but there is no indication that the quality of care would increase because the State would start to collect revenue for these industries on their behalf, in the form of taxation.

3- There was a period where the inability to pay for care would have sparked two concerns; determining wether or not prices were fair/equitable and if not regulating these industries ( sort of like we used to), second, if it were determined that prices were in accord with the *real economy*, the question would become why aren't Americans making enough to pay for healthcare.
Given the degraded nature of our dialog, where it's bleeding heart foolishness on one side vs. gun toting xenophobes on the other, I'm afraid we'll never really know. We could be taken for a huge ride here, wherein a huge number of americans will become totally dependent upon the state, and their employers like Wal-Mart will be off the hook.

Paul Hornschemeier said...

1. No, I was not kidding. If you have credible evidence of that organization having a political agenda, and more relevantly having one that would appreciably skew its estimation of America's health care compared to the 36 countries it ranks above it, please feel free to share.

2. I also am not (foremost) concerned with whether or not we have _the_ best health care in the world, my overriding point is that we're not even close to the best, yet pundits on the right routinely regurgitate the falsity that we are number one, an unfortunate byproduct of American exceptionalism.

And while I think that you have a point that there is no guarantee that specific care would increase in quality as a result of health care reform including a public option, the mere fact that some 46 million people who can't afford health care would then be able to have health care immediately impacts the overall health of the nation. So I would argue that improves the quality of health care. More people receiving care (and hopefully much needed but often (presently) economically prohibitive preventative care) is an improvement. A massive improvement.

3. I'm not sure that I understand your point here. Wal-Mart under the current system is already off the hook in many, many ways. There are countless documentaries and articles on this, but one that details the health care situation of that retailer well is "walmart: the high cost of low price," which can be downloaded via torrent online. And I'm not sure what the "huge ride" here would be. Is Medicare a "huge ride?" It's certainly problematic and in need of tuning, but I think seniors in this country would argue rather emphatically that it is an overall good. Extending that sort of good to the general populace seems to me to be itself a good. And a good I hope our elected officials have the fortitude and backbone to enact.