A Breast Cancer Survivor's Fix to the Health Care System
Note: The opinions expressed here are my own. They don't necessarily reflect the stance or values of this site. And, since we live in a democracy, you have the same right to disagree with my opinions as I do to make them. A simple request: If you disagree, please have the grace to do so agreebly. Thanks.
Star light, star bright…
When I see the first evening star, I always make the same wish. I’ve been making this wish for as long as I can remember: as a 6-year-old running through fields on the way home to supper; as a teenager waiting for the late bus after field hockey practice. Here’s what I say:
I wish everyone will be happy, and no one will be sick.
It's a child-like wish, but one I’ve held onto my whole life – despite the odds of it ever coming true.
I’m sure we all agree that this wish is unrealistic. Everyone in the world isn’t happy.
And someone will always be sick. And need health care.
In our current system, health insurance premiums have quadrupled in the last decade, and that rate of growth shows no signs of slowing down. Medicaid, the safety net for those who can’t buy private insurance, will go broke within 8 years, if it remains on its present course.
And a whopping 45 million Americans have neither private nor government-funded health insurance. They live in constant fear of financial ruin, one car accident away from the edge.
So when we dig in our heels against government-funded health care – rationed health care – we ignore reality and retreat to an Oz-like vision of a society where there are sufficient resources to ensure everyone’s good health. A Utopia where old people don’t have to choose between drugs and food, and middle class families aren’t bankrupted by cancer.
Wake up, folks. Health care in America has always been rationed. In our current system, you get the care you can personally afford; isn’t that a form of rationing? Even if you have employer-provided insurance, it’s the rare plan that covers 100% of your health care wants. You inevitably dig deep for co-pays, drugs, dental care, and office visits.
Heck, I have a reasonably good insurance plan at work; but I’ve already shelled out over $7,000 this year on co-pays. I’m lucky I can afford it. If I couldn’t? I’d go without my cancer drugs, and take a chance on recurrence. I’d forget the osteoporosis drugs, and hope like hell that exercise and calcium would do the trick. In truth, I’m probably one freelance job away from having to make those decisions for real, not just in theory.
And there are millions of Americans who are way, WAY worse off than me.
Is this any way to run a country?
A recent poll cited in The New York Times reports that 54% of Americans claim they’ve forgone needed health care due to its cost. In the United Kingdom, the figure is 13%. In the Netherlands, just 7%.
A Gallup poll taken last year (and also reported in the Times) asked Americans, Canadians, and Britons if they had confidence in their respective countries’ health care systems. 73% of Canadians and an identical 73% of Brits said yes, they do have confidence. Just 56% of Americans gave an affirmative response.
In Canada and Great Britain, health care is provided by the government to all citizens – rationed care. Treatment is subsidized to the point where the government has decided the ROI isn’t worth it. For instance, in Great Britain the limit is about $49,000 for treatment that will extend a person’s life by one year.
Is this putting a price on human life? Indeed it is. And that, friends, is the price we pay for using public funds to provide a minimum level of health care for all of us.
There’s no fairy godmother out there waving her wand and offering drugs, doctor visits, and an hour under the surgeon’s knife free of charge. The money must come from somewhere – our taxpaying pockets, in a nationalized system.
And that means we can’t have everything we want. That’s how government funding works. The money is spent where it’ll do the most good.
That’s why there’s an interstate highway between the capital cities of Massachusetts and New York (Boston and Albany), but not between the capitals of Maine and Vermont (Augusta and Montpelier). Highways are funded according to how many Americans they’ll serve.
And health care, under a national system, must be funded according not to how many American lives it’ll save, at any cost; but to how many American lives it can make reasonably healthy, for a reasonable amount of time.
Once we make the decision to fund health care for all Americans, and come to grips with the fact that the system will inevitably operate within certain limits, we run up against the toughest question of all: what are those limits, and who sets them?
I can’t begin to answer that question. I’m not an economist, a specialist in health care, nor any other kind of expert (save in baking chocolate chip cookies, perhaps). But I recognize the need for limits on health care spending, and the fact that someone has to determine those limits. And I’m comfortable allowing the government to take the lead here, just as comfortable as I am with the Feds deciding where to build those interstate highways.
I’m a glass half-full person. I believe that our lawmakers will eventually step up to the plate and fashion a health care system that does the greatest amount of good for the largest number of people.
If that system mandates that, at age 85, I can’t have a drug or operation that’ll extend my life another 6 months, I hope I have the grace to accept that decision.
And if the money the government doesn’t spend on me saves the life of a young mother with breast cancer, I’m totally good with that.
Personal sacrifice for the greater good is what it means to live in a democracy. It’s the American way. Let’s apply that behavior to the current crisis, and pull together to create a new system, one that offers all Americans access to basic health care.
After all, we do have that history. As Ben Franklin said, on July 4, 1776, “We must indeed all hang together, or most assuredly we will all hang separately." Thankfully, we hung together then. We can do it again now.
One final note: Just 1 hour after I'd posted this, I got the following email from my mom. She's 83 years old, and in fairly good health. Here's what she says:
"I think we older people must understand that we've been taken care of now since age 65 and are no longer contributing much to the welfare of the country. Why should we expect to continue to get better treatment than younger people who have a lot to contribute and who haven't had the pleasure of living a long life? You know how I feel about dying. If I got cancer now I wouldn't want to have chemo and radiation. Just let me live a natural life until the end (with some pain relievers). Congress would never agree to cutting off benefits to old people because they're a big block of voters. But why don't they think about the common good instead of keeping their jobs? They have good pensions and health care and could retire in luxury. I'm proud of you for presenting your viewpoint. There have to be more people like you in this world. Love, Mom."