Health care


All of a sudden, the comments are piling up, particularly from someone who must be a new reader. In response to a recent post, that was mostly about religion (but touched on healthcare) this commenter, after calling me a religious bigot, had this to say about health care:

And as far as universal healthcare goes, I think we pretty much already have it. I got gravely ill with no healthcare a few years ago – and I got everything I needed. I could not believe the generosity of my doctors. This complete stranger gave me free pills.

No one in this country is turned away at the hospital for lack of ability to pay. I still owe thousands but I pay a little bit every month. I have been told that I could pay LITTERALLY one dollar a month and never have it go on my credit rating or the bill to a collection agency.

I intend to pay every single nickel. I am profoundly grateful for them making me well again.

If we adopt a system like they have in Cuba than I think we will kill the goose that lays the golden eggs. We want money in healthcare because money fuels Research and Development. We are advancing in leaps and bounds at an ever increasing pace because our system is not run like the post office. 

So, let's talk about heath care.

First, let's get down to basics. Health care costs money. It seems self-evident that we should try to get a health care system that gets the most bang for the buck. For some reason, a lot of people in this country seem to feel there is some moral superiority involved in funneling that money through the private insurance industry rather than the government. If the delivery of health care were more efficient that way, then that would be fine. But it's not. As Paul Krugman has pointed out on many occasions, approximately 20% of the money we give to private insurance companies is spent on denying our claims to benefits. (Sorry, in my hasty response to the comment I said 25%). That compares to about 2% spent on the same function in Medicare. That's a lot of wasted money.

Health care is a basic necessity. It is a cost of living and the cost of health care is the functional equivalent of a tax whether paid to an insurance company or the government. The way in which we are currently financing it is grossly inefficient. It imposes a cost on employers not borne by employers in any other developed country. It is literally driving our auto companies out of business. It is a strain on small businesses, like my law firm. We learned recently, for example, that we are looking at a 26% jump in the cost of covering our employees. Believe me we would be ecstatic if this mess were replaced by a single payer system.

The commenter seems to feel that it's wonderful that he got free health care when he couldn't afford to pay. But someone else was paying-the taxpayers and premium payers. As a taxpayer I don't mind paying for his health care, but I do mind paying more than I should have to pay, and the inefficiencies in our cobbled together "universal health care system" make me do just that.

But let me tell you something about the commenter's universal health care system. At least 50% of my legal practice is devoted to Social Security Disability cases. People who apply for disability tend to be poor to start out with. They are the people who work at jobs that wear their bodies down. But even if they don't start poor, they end up that way, given the fact that it takes about 2 years from the day you apply to the final decision from an administrative judge. A goodly number of my clients have no health care, or start out with health care and lose it, or are forced to change doctors because the medical care provided as a stopgap by the state isn't accepted by the doctors of their choice. One of my clients recently broke his leg. He got free care to set it, because it was an emergency, but he had to remove the cast himself because that wasn't an emergency and he couldn't afford to pay for the service. (So much for no one being turned away) Most likely if he'd been persistent he could have found someone to do it, but he had mental problems too, so he wasn't quite up to that. Maybe the commenter will pay for the care he got from that hospital, but most people who get care like that don't pay for it because they can't. I would advise him to look through the files in the bankruptcy court-they're public records, and see how many people take refuge there because of an inability to pay medical bills. Oh, and by the way, guess which group of my Social Security clients gets the best health care. Those vets who qualify for VA health care, a socialized medical system in all but name, that was vastly improved during the Clinton years and which Bush has not yet been able to ruin. And if you think it's just the poor who can't get health care, think again. It's also the middle class sick, as we learn in today's Times. What a great system! Health care for all, except for the sick.

Finally, let's talk about Cuba. Cuba is a poor country. Quite likely rich people here can get better health care than the average person there. But given its disadvantages, the Cuban health care system does a better job of delivering health care in an equitable fashion than does ours. It's hardly a feather in our cap if, with all our money, those with good insurance here get better care than the average Cuban.

The commenter suffers from a peculiarly American disease: the belief that America is number one in everything because -well, just because. We are the richest, we have more freedom, we have the best healthcare, we have the best athletes, we have the best of everything. It doesn't matter that most of it's not true, it's an article of faith so we don't question it.

The cruel fact is that our health care system is not the best in the world, except for the system for the very rich. We have models here at home-the VA, Medicare, that along with the lessons to be learned from other countries, should enable us to come up with an efficient, humane health care system. What we lack is the political will, because what we have is too many deluded people who think that we already have the best of all possible systems in the best of all possible countries.
Posted: Monday - March 05, 2007 at 07:52 PM          

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