[1] I sat comfortably in my padded green chair that swiveled without the slightest of a squeak; my tidy red ironed uniform tucked neatly into striped black pants with a black belt to match, buckled into exactly the third hole. The desk was trim, the floors polished and the glass spotless, marked only by a gloss printed ‘St. Luke’s Hospital`. The doors glided open as a man slowly limped in, his worn out boots squeaking sharply, as they dragged a complementary muddy print on the tile with each arduous step. “How can I help you, sir?” I asked. His rumbling voice was terse, sharpened slightly by an untrusting trepidation. “I’m uninsured. How much is your help gonna’ cost me.” A nurse behind me responded that anything would be a few hundred dollars, and asked if he had tried an Urgent Care. Before she had finished, the glass had slid back open. “They’re closed” he mumbled leaving a few more tracks. I think his work badge had read Williams, or maybe it was Wilson… it didn’t matter he was gone.
[2] And the story of this man is no isolated case. As a volunteer at St. Luke’s Emergency Department I regularly see patients in the greatest need of medical assistance. Yet no heart condition or broken limb can prevent the frequent question of insurance coverage and co-pay cost. If the answer is no or anything more than a few hours’ wages, more often than not, seemingly terrible illness and injury heads right back out the door. While these stricken individuals join the thousands of unnecessarily ill Americans, those who decide to stay join the thousands of heavily indebted Americans. Medicine today has transformed into an inefficient, unaffordable enterprise for which even the simplest procedure can rack up thousands in bills, meaning that universal health care is a necessity and moral duty to the people.
[3] The United States health care system remains far out of line with the economic supremacy and general standard of living America prides itself upon. Even the most basic indicators of health care point to a comparatively shameful system in an otherwise flourishing state. Amongst highly developed regions, the United States ranks at a shocking 23rd in life expectancy at birth, 31st in life expectancy and 33rd in infant mortality rate. Astounded? Well you should be considering the United States spends the most on health care per capita of any country around the world at $6,719[1]. And this number is constantly on the rise; in 2006, health insurance premiums increased 7.7%, twice the rate of inflation, and was up 78% from 2000[2]. All of these factors point to an organization that is flawed and blatantly wasteful.
[4] Proponents of the current system cite that medical statistics are negatively skewed by our diversity which contributes to a greater socioeconomic disparity. Though this is admittedly true, do they mean to say that these constituents don’t really count?! If anything, these “numerical outliers” find it the hardest to dish out thousands. The problem is compounded by the fact that these individuals are often the ones who cannot afford insurance and comprise the over 46 million uncovered Americans[3]. For this approximate 15% of our population, few doctor visits, poorly managed chronic conditions and untried life-saving medical procedures are a reality of life[4].
[5] So what does the government say to these citizens? The simple fact is that there is truly nothing for the government to say. From a purely judicial and philosophical perspective, the general welfare is the birthright of any American as articulated in the Preamble of the Constitution and UN Universal Declaration of Human Rights. And the US is alone in this crime in that not only are we one of the few if only wealthy countries without universal healthcare but even in less developed countries, alternative programs are available. In India for example, alongside expensive state-of-the-art medical facilities are government run hospitals that offer care for free to any patient. Though conditions in these hospitals can be revolting and negligent to say the least, those with little more than the clothes on their backs can receive medical attention without the fear of debt and hardship. Here, even for those who can afford insurance, preexisting conditions prevent affordability, and in certain cases, the availability of any coverage.
[6] The results are horrifying and can be hard to fathom for those of us fortunate enough to be insured and in good health. Reports from the American Journal of Medicine found that 62.1% of all bankruptcies in 2007 related to medical expense and worse yet, 78% of these individuals had medical insurance[5]. And this accounts for only the crushing state of bankruptcy, which is no more difficult than someone barely clinging on laden with massive debt. At the moment, the government remains powerless to mediate insurance rates and co-pays as the McCarran-Ferguson Act excludes insurance from the majority of interstate commerce that is subject to federal antitrust regulation[6]. And so insurance remains inadequate and increasingly out of reach.
[7] To illustrate, take the example of Lillie Paquette whose 70 mph encounter with a severely drunk driver, left a close friend dead, and her fighting for her life as a lung collapsed, her kidneys failed and a shattered bone severed a major artery in her brain. Against all odds, Paquette would survive and two years, much therapy and repeated surgeries later, she would be back on her feet, running and living life again. But little to her knowledge, the sad truth was that her physical trauma was the least of her long term problems. In the months to follow, Lillie began receiving her bills starting with a $91,000 statement for her brain surgery. As surgeries, facial reconstruction, physical therapy and hospital stays began to tally up, Lillie faced hundreds of thousands in expenses wielding a meager $25,000 student-insurance as her only defense. Though grants and other sources of aid would lessen the blow, the Paquettes still paid thousands when insured and not at fault[7].
[8] Sometimes worse yet than these unforgiving financial circumstances is the state of those who forego care to avoid racking up expenses. In addition to inhibiting preventive doctor visits, this situation contributes to chronic illnesses as the uninsured skip physicals or turn away from the ER, in some cases leading to far more expensive procedures.
[9] And the solution is right in front of our eyes; universal healthcare. Not only has this proven effective in nearly every developed country, but potential existing methods have proven successful within the United States itself. One such experiment began a half decade ago when Massachusetts passed laws requiring that all citizens purchase health insurance of some form and also instituted heavily subsidized public coverage based on household income. By 2009, all but 2.5% of residents were insured which was down significantly from rates three years ago and less than a sixth of the national rate. The number of doctor visits soon rose, medical bankruptcy fell in relation to national levels, and most importantly, necessary care was available to most everyone. But the program soon faced significant fiscal shortcomings as hospital funding was diverted to new programs which steadily ran on negative budgets[8]. However, financially responsible medical models are in place such as the Mayo clinic which “spend(s) about 20-30 percent less than some other parts of the country, and yet ha(s) better outcomes”, as President Obama cited in an ABC interview with Diane Sawyer[9]. The office of Veterans Affairs has seen similar success with its tens of millions of dependent servicemen. Despite comparatively minimal federal funding and donor revenue, the VA has managed to aid its immense community through high productivity and minimal service costs[10]. If the medical success of Massachusetts’ reform were effectively coupled with the efficiency and capacity of groups like the Mayo and VA, universal coverage would bring health to each and every American.
[10] Nonetheless, the concept of insurance for all raises immediate questions and legitimate concern. Perhaps most commonly, universal health care is inappropriately correlated with socialized medicine. The latter concept presents a definite threat to the viability of a doctoral education, healthcare as we know it and the integrity of medical study. But, state-run coverage differs fundamentally from socialized medicine in that it simply facilitates the costs of care while staying clear of the service sector and free enterprise medicine itself. Many also worry that the overuse of hospitals with reduced expenses will introduce a system of rationing, similar to that in Canada. However, the problem faced in Canada does not translate as the US has as much as a 35% surplus of infrastructure[11]. This currently untapped reserve capability offers a backbone for continued state-of-the-art facilities even with increased usage.
[11] Beyond the obvious health gains are several economic benefits. Even those who escape the worst of today’s system are less productive or indebted, all of which have a significant toll on the economy. Furthermore, insurance in the form of employment benefits also greatly increases the price of American goods. So when you or I buy anything, built in is the cost of care for employees involved in production which few other countries have to deal with, thereby making our products less competitive. This also inhibits entrepreneurship as employees are afraid of leaving plans offered by their stable employers and cannot afford coverage for future employees. Though this isn’t to say that some costs wouldn’t be incurred, they dwarf net monetary gains.
[12] The majority of Americans support and are willing to accommodate any cost necessary to institute long overdue universal healthcare[12]. But the vitality and health of the United States transcends economic or moral ideals and defines our essential duty. Coverage cannot be a privilege but must be a certainty for all. If so, maybe someday every American will see the glass Emergency Room doors as a gateway to affordable help; an opportunity for advanced care and not a socioeconomic barrier to life.
Works Cited
Works Cited
Battista, John R., and Justine McCabe. "The Case for Universal Health Care in the United States." Connecticut Coalition for Universal Health Care. 4 June 1999. Web. <http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm>.
Brokaw, Tom. "Sudden Impact: Drunk Driving." Dateline NBC. MSNBC, 1 May 2004. Web. 15 May 2011. <http://www.msnbc.msn.com/id/3794580/ns/dateline_nbc/>.
Davis, Karen. "The Costs and Consequences of Being Uninsured." In The Literature. The Commonwealth Fund, #663. Web. <http://www.commonwealthfund.org/~/media/Files/Publications/In%20the%20Literature/2003/Jun/The%20Costs%20and%20Consequences%20of%20Being%20Uninsured/davis_consequences_itl_663%20pdf.pdf>.
Dole, Bob. "VA Holds Lessons for Health Care." POLITICO News. 4 Apr. 2011. Web. <http://www.politico.com/news/stories/0411/52443.html>.
Gilbert, Roy F. "Health Insurance, Competition & the McCarran-Ferguson Act." Health Reform Watch. Seton Hall University, 21 June 2009. Web. <http://www.healthreformwatch.com/2009/06/21/health-insurance-competition-the-mccarran-ferguson-act/>.
"Health Insurance Jumps Twice Inflation Rate." MSNBC Health Care. Associated Press, 26 Sept. 2006. Web. <http://www.msnbc.msn.com/id/15014332/ns/health-health_care/t/health-insurance-jumps-twice-inflation-rate/>.
Himmelstein, David U., Deborah Thorne, Elizabeth Warren, and Steffie Woolhandler. "Medical Bankruptcy in the United States, 2007: Results of a National Study." The American Journal of Medicine (2009): 1-6. PNHP. Web. <http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf>.
Levi, Michelle. "Poll: Majority Would Pay Higher Taxes For Universal Health Care." Politics & News. CBS, 6 Apr. 2009. Web. <http://www.cbsnews.com/8301-503544_162-4923731-503544.html>.
"National Center for Health Statistics." CDC NCHS. Centers for Disease Control and Prevention, 3 May 2011. Web. <http://www.cdc.gov/nchs/>.
"President Obama's Interview." Interview by Diane Sawyer. Good Morning America: Politics. ABC, 24 June 2009. Web. <http://abcnews.go.com/Politics/Politics/story?id=7910304>.
"Should All Americans Have the Right (be Entitled) to Health Care?" Right to Health Care ProCon.org. 29 Apr. 2011. Web. <http://healthcare.procon.org/#Background>.
Smith, Tovia. "Tracking Universal Care In Massachusetts." NPR News. National Public Radio, 18 Sept. 2009. Web. <http://www.npr.org/templates/story/story.php?storyId=112974074>.
"Universal Health Care." UHC Action Network. 2007. Web. <http://www.uhcan.org/>.
Walt, Carmen D., Bernadette D. Proctor, and Jessica C. Smith. Income, Poverty, and Health Insurance Coverage in the United States: 2008. Rep. U.S. Census Bureau, Sept. 2009. Web. <http://www.census.gov/prod/2009pubs/p60-236.pdf>.
[1] “Should All Americans Have the Right (be Entitled) to Health Care?" Right to Health Care ProCon.org
[2] "Health Insurance Jumps Twice Inflation Rate." MSNBC Health Care
[3] Walt, Carmen D. et al. Income, Poverty, and Health Insurance Coverage in the United States: 2008
[4] Davis, Karen. "The Costs and Consequences of Being Uninsured."
[5] Himmelstein, David U. et al. "Medical Bankruptcy in the United States, 2007: Results of a National Study."
[6] Gilbert, Roy F. "Health Insurance, Competition & the McCarran-Ferguson Act."
[7] Brokaw, Tom. "Sudden Impact: Drunk Driving."
[8] Smith, Tovia. "Tracking Universal Care In Massachusetts."
[9] "President Obama's Interview." Interview by Diane Sawyer.
[10] Dole, Bob. "VA Holds Lessons for Health Care."
[11] Woolhandler, Steffie et al. "Single-Payer FAQ."
[12] Levi, Michelle. "Poll: Majority Would Pay Higher Taxes For Universal Health Care."
