Saturday, March 12, 2016

The Sad State of Great Healthcare

"We all know the U.S. has the best medical treatments, but only if you have a lot of money"

That is my best attempt at remembering a quote from a German colleague years ago in Changsha. I'm sure I didn't get the quote word-for-word, but you get the gist. Does the U.S. have state-of-the-art medical facilities and doctors and treatments? Absolutely. But, it comes at a price. A steep price.

A week or two ago I was discussing healthcare with a Turkish colleague and her husband, who is himself an occasional colleague. The original topic was the cost of childbirth in the U.S. For the most part, they spoke well of their experience, but they also spoke of the surprises, the charges for tests that were extra, charges that would never have been considered extra back in Turkey. This led us into a conversation (rant) about the state of the U.S. healthcare system in general.

What the hell is wrong with the U.S.? That was the basic sentiment of our conversation. From their experiences abroad, from my experiences abroad, from our experiences with people whose countries have socialized (or relatively socialized) medicine, we just cannot fathom why so much of the U.S. population rejects the idea out of hand. Are those other systems perfect? By no means. But, neither are they evil.

I know many of the objections. The U.S. is bigger than those other countries, so it is much more difficult to do. People will need to wait for care. There will be rationing of treatments. Patients will not be able to choose their own doctors. Medical research will stagnate. Taxes will go up. Do you know who cares about questions like these? The wealthy and those with good insurance. (I separate the two because the truly wealthy have no need of health insurance, but rather can pay out of pocket.)

Here's the thing. I have health insurance for my wife and myself through my employer. There are three insurance options and only one that I can afford, so when someone tells me, "You could have chosen the better plan," I say, "The hell I could!" Already I pay 11.4% of my gross income to the insurance company. The deductible is so high that it could use up to and additional 10.8%. That makes for a possible expenditure of 22.2% for healthcare for a person WITH insurance. And that doesn't include dental (for example, the wisdom tooth extraction my wife recently required, costing more than $600 when all was said and done). How many lower middle class families (not to mention the poor) can realistically afford to spend more than a fifth of their income on healthcare?

There's the rub. All of my colleagues and I have health insurance, but that doesn't mean much. I have had a pain somewhere within my lower torso for more than two weeks. One Sunday it was so bad that I could barely walk. Have I gone to the doctor? Nope. I can't afford it. My colleague spoke of how in Turkey she would take her child to a doctor a second time to make sure he was well before sending him back to school (and possibly making other kids sick). Here, she can't afford to do that, so off he goes back to school. Good luck, kids! I know many in the same situations. Do we care about doctor choice? Do we care about high tech treatment? Do we care about taxes? Many of us would simply like to be able to see a doctor. Any doctor!

People worry about taxes, but that's not the majority. How do I know this? Because according to government statistics, my family's income is WAY less than average, but it's also WAY more than the median. For those of you not statistically knowledgeable, median refers to the middle point, which means that half are above the median and half are below. Therefore, WAY more than half of the families in this country make less money than we do. Do I worry about the taxes that come with universal healthcare? Absolutely not. There's no way it would surpass the burden I have now with insurance premiums and deductibles. I'd come out ahead, as would most of the U.S.

I like U.S. healthcare. I like the fact that my son can get treatments here that were not available to him in China. I appreciate that the government foots his medical bills because the Lord knows how many doctors he sees and how much his meds cost each month. I fully recognize that were he stuck with the Chinese medical system, he would be severely handicapped or dead right now. So, don't hear me saying that I hate everything about the U.S. medical system. I do not.

The U.S. has a great medical system, but only for those who can pay for it (which is a minority of the population but probably a majority of the politically active) or for those with diagnoses like my son's, whose insurance the government pays for. I refuse to believe that the U.S. lacks the intelligence to figure out a system than can help the well-off and downtrodden alike, not to mention the very squeezed middle class. On the contrary, we lack the will. Those in power and with influence lack compassion. The insurance industry has to much money in politics. Corruption. Of both the heart and pocketbooks.

Is universal healthcare the best answer? Maybe or maybe not. Nevertheless, something has to be done, and I see no one with any plans (other than Bernie) to actually address the needs of most in this country, not just their electorate and political donors.

Right now, even with "Obamacare", we're already paying a steep price: The lives of hundreds of millions (not an exaggeration) who lack adequate access to healthcare. As long as the status quo remains., America will not be great.

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