Health Care - Universal or Private?
Having recently had a heart attack that required a week in the hospital, two catheterization procedures for both investigation and the placing of stents, and a need for prescription drugs for the rest of my life, I’ve discovered that I have a stronger interest in the health care system here in the United States. One of the concepts that keeps getting pushed out there by politicians is the concept of Socialized Health Care, or Universal Health Care. This would be an attempt to mimic the health care systems of countries like Great Britain, Canada, New Zealand, Cuba and so forth. I’ve been doing a little bit of research and while I agree that our system of health care has a lot of issues that need to be addressed, moving to Socialized Health Care seems like a giant step in the wrong direction.
The first thing I wanted to find out was what kind of benefits socialized medicine offers. I did some searching and found some links to pro-socialized medicine sites. At the Connecticut Coalition for Universal Health Care I found an article on the Case for Single Payer Health Care in the U.S. However, reading this list of myths raised more questions than it answered. Looking at some of the broad assertions made in this article, I questioned where they got their data and whether the statistics that they referenced were applicable to the points they were trying to make (for example: does life expectancy in the U.S. really correlate to poor health care, or can it be related more to our lifestyle choices as Americans?). Unfortunately, there were no footnotes or references, so I couldn’t follow up on the facts. Not the best start.
I then read an article by Robert Blandford that detailed another approach to health care reform that still aimed for universal coverage. This article describes a combination of a Health Spending Account funded by the government from birth to age 21 with $2,000 a year. After age 21, the person would be responsible for funding their HSA (potentially with employer support) with 5% of their wages, with minimums and maximums, until their HSA reached $125,000. This money, which I believe is taxable, would be available only for medical purposes and would be nontransferable (remaining monies at death go to the person’s estate). To avoid people using this money for anything other than health care costs, a Medical Agent would have to be created to act as an intermediary between the person and their money to insure that the money being spent is being spent on approved health care. This HSA would be supplemented by Federally provided Catastrophic Insurance with a designated list of procedures that would be covered. The final level would be yet another Federally provided Basic Minimum Policy which would act as a safety net if someone exhausted all their HSA money and other resources. There are a lot of “what ifs” and “mights” in this article that are left up to the readers imagination, but it is an attempt to merge a competitive market with a universal health care system in a way that is equitable to all (and seems to be a pretty comprehensive and logical approach to the problem). My concerns with this approach are the fact that two out of the three ideas in this coverage require a Federally run health care support system (for Catastrophic and Basic Minimum coverage), that these coverages will a incur significant tax burden and that yet another agency is mandating how my wages must be spent (whereas now I can opt for three layers of health care coverage via my employer: high, low or none). While the article stresses that people could use their HSA money to buy private insurance, it also details how this system could cause the prices of private insurance to skyrocket.
Michael Moore recently released “Sicko“, a movie that compares the U.S. health system with countries that provide Socialized Health Care. I haven’t seen the movie so I can’t comment on it, but what I’ve read indicates that he questions the profit motives of U.S. health care and the insurance industry while praising the socialized medicine practiced by other countries. I’m not so sure that I buy into the belief that socialized medicine is so much better than our system. While it’s admirable that health care is available to all regardless of ability to pay, I think that the practice of such a system is much less spectacular than many would have us believe. Several of my Canadian friends have horror stories of long waits (not like sitting for an hour in the office, I’m talking 6 months or more) for procedures that aren’t considered emergencies. Then I read an article on CNN today talking about the large number of Brits who are pulling their own teeth with pliers because they can’t get a visit to a state-sponsored (NHS) dentist and they can’t afford the private dentists. There are even problems with affording the care provided by the NHS dentists, should they be able to find one. This doesn’t sound like the rosy picture painted by so many of the socialized medicine proponents.
So then I did some digging on the cons of socialized medicine. The Cato Institute published an interesting article on the myths of Socialized Health Care. Unlike the myths “exposed” by the Connecticut Coalition for Universal Health Care, the Cato article contains a large number of footnotes and references. Interestingly, the very first myth that Cato attacked was in the first bullet of the CCUHC’s article. The CCUHC stated that “The United States is the only industrialized nation that does not guarantee access to health care as a right of citizenship.” whereas Cato asserted that “no country with national health insurance has established a right to health care. Citizens of Canada, for example, have no right to any particular health care service. They have no right to an MRI scan. They have no right to heart surgery. They do not even have the right to a place in line. The 100th person waiting for heart surgery is not entitled to the 100th surgery. Other people can and do jump the queue.” The rest of the Cato article is a well-reasoned and well-researched debunking of many of the myths that proponents of socialized medicine claim as fact.
What concerns me the most is the idea that socialized medicine or universal health care is going to provide equal access to the same quality care as we have today. It strikes me that the examples of socialized or state-run medicine prove exactly the opposite is true. Those with money and connections get the best possible treatment while those without pull their own teeth with a pair of pliers in their sheds. People with colon cancer or heart conditions that require bypass surgery wait for months to have their procedures, often resulting in conditions worsening to the point that surgery isn’t necessary because death is now inevitable or has already occurred.
Certainly our system is flawed and needs work. Ideally, we would have good, affordable health care coverage that even the poorest could afford, but we need to do so in a way to allows our doctors to continue to earn excellent money for their rarefied talents and our hospitals to make enough of a profit that they can reinvest in new technology to make diagnosis and treatment all the more effective. Handing over control to the state or the federal government is a sure way to make sure that never happens. Finally, we need to make sure that we don’t eliminate choice and independence. I don’t want the government or insurance companies dictating how my treatment is performed, as that is a discussion between my doctor and me.
Ultimately, this discussion is an important one for me because my heart attacks means that I’ll be on prescription medication for the rest of my life (however long that may be…yay reality of mortality!) and will need more visits to the doctor than others. If my company goes under and I’m unemployed for any length of time, COBRA coverage will be very expensive. If I start my own business, I’ll need to pay the exorbitant monthly fees for private insurance (that will undoubtedly be much higher because of my heart condition). However, I’m not willing to give up the timely, quality care I received for the false security of a Federally run health care system that runs as inefficiently as the one they have in Canada or in Great Britain.
Another thing to note is that my health insurance company has been excellent during this time. I’ve had no complaints at all. For me, health care isn’t broken. But, as noted by the paragraph above, I could envision a time when it could be. Still, my vote would be to find reforms for the private system we have now (specifically reforms on the insurance industry). Just a little additional note: without health insurance in this country, care for the kind of work I had done on me would put me in debt for years and years. It wasn’t even the catheterization procedures that were the most expensive, it was the room and care for the 6 days I was in the hospital that pushed the bill into the stratosphere. I can’t even imagine what kind of costs are incurred by more invasive procedures that require ICU visits and long-term care. However, I still believe it’s the right of the hospital to make a profit so that they can afford the best equipment and attract the best talent. However, this system leaves a gaping hole for those who cannot get coverage from their employer or who can’t afford private insurance. It’s certainly a conundrum and I can’t pretend to have the solution (no wonder it’s such a hot button campaign issue).
