As you know, I love reading Sullivan's blog, even when I disagree with him. And I'm not sure I've ever disagreed with him more than today, with his posts that are dismissive of a national health system that would provide universal coverage. In criticizing the British system, Sullivan praises of some kind of nebulous freedom that doesn't actually exist in health care for the majority of Americans.
I think the key phrase that he uses is, "if most Americans with insurance" had to live under the British system, they wouldn't like it. Ah, there's the rub. We have almost 50 million citizens -- roughly comparable to the entire British population -- without any insurance. Their "freedom to choose a doctor" consists of not going to a doctor when they're sick, or going to the ER when they get really sick, leaving them with the "freedom" to pay a big medical bill that they can't afford at the end.
At least an equivalent number of Americans are under-insured. Their "freedom" consists in choosing between a couple of employer-sponsored plans whose premiums (even when the employer covers half or more) are still more expensive than the cost to the average British taxpayer. The 100-page HMO documents are totaly incomprehensible unless you're a medical or insurance expert, leaving HMOs with plenty of legal loopholes to deny claims when they receive them.
Then there are the pretty-well-insured, like my parents, who are reasonably wealthy. They pay the high premiums, but can afford it. This year, when my dad had the audacity to need a quadruple bypass and heart valve replacement, he freely chose an excellent doctor and received high quality care. Thank goodness he is recovering -- no doubt, that is an advantage of the U.S. health system. And still, after the HMO paid their part, my parents are saddled with an almost six-figure bill that they're scrambling to pay.
It's no wonder that, according to a 2005 Harvard study, two million Americans go bankrupt each year (about half the total bankruptcies) because of medical bills. Seventy-five percent of those people actually have health insurance. The U.S. spends a whopping 16% of our GDP on health care, but our infant mortality rate is worse than Cuba, and our life expectancy is just below Bosnia. I love my country like my own family, which is why I find these figures so disgraceful.
Look, there are a lot of different ways to get to universal and equitable coverage, with or without a UK-style single payer system. But if universal health care equals socialism, then I say, guilty as charged.
Friday, December 5, 2008
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