September 11, 2009
My colonoscopy saga-4: Some final thoughts
What is interesting about my experience is that even physicians whom I know personally and to whom I have told this story are surprised that whether I am charged for a colonoscopy depends on whether any polyps are found.
I also spoke about my experience at a health care panel a couple of years ago. Another panelist, a professor at another university, said that he thought that it was perfectly reasonable for us to treat health care like any other commodity and that consumers should shop around for the best deal. I responded that this was absurd. Health care is not a commodity to be compared like buying detergent. People often confront the health system in situations where they are deeply troubled or their plight is urgent or where they have few choices.
There is absolutely no justification for profit making entities like health insurance companies to be part of the system. No one has ever been able to tell me what value they add to the system. In fact they are parasites, a drain, and a hindrance to the smooth working of health care delivery. Health care services should be as universal and as profit and bureaucracy-free as your police or fire or library services.
Imagine applying the same health care logic to those other things. Suppose you had the same system for police protection. There would be separate police stations and you would have to pick a plan every year that specified your police station and the police officers who would serve you, and the services would be charged depending on what your policy said and your needs. So having a policy that would have police officers only come to investigate minor burglaries would cost less than to have them come to investigate an assault or a missing person. Such a system would be considered insane.
It used to be the case that fire protection actually was private and you would have to buy insurance in order to get firemen to come to your house to put out a fire. The system changed to a universal, single-payer public system because the unchecked fires of people who did not have insurance would spread to the houses of those who had, and people realized that fire-fighting was best dealt with as a communal responsibility. There are some things that the community should be collectively responsible for, and police, fire, and health should be among them.
The current health system in the US is run primarily for the benefit of the insurance and drug companies and also for the benefit of specialist doctors. All those groups make a lot of money within the current system at the expense of people who are sick. The US is the only country in the developed world that does not have either a socialized system like England or a single-payer system like France or Canada, both of which could be easily adopted in the US, by expanding and improving Medicare.
Even many developing countries like Sri Lanka have government-run single-payer systems as a foundation, with private health insurance supplements for those who want extras, such as private rooms in hospitals.
Some years ago, my mother in Sri Lanka was diagnosed with colon cancer. When her doctors found this out, they recommended surgery and her surgeon said that the best place for it would be in the government hospital. So she went into hospital, had the operation, and followed up with chemotherapy and radiation, all of which extended her life for some years. All the costs of her surgery and hospitalization (including intensive care) and post-operative out-patient care were free. All decisions about what treatment she should receive were made exclusively by her and her physicians, with no insurance or hospital bureaucrats involved. No conversations were required with anyone other than the doctors and nurses who treated her. No paperwork, no claim forms, no deductibles, none of maddening bureaucracy that people in the US are routinely subjected to by their private, profit-seeking health insurance companies, however sick they are.
The added value to her quality of life and to her family from not having to deal with all these hassles: immeasurable.
If Sri Lanka can do this, with a per capita health expenditure of $163 vs. $6,096 in the US, i.e. one-fortieth, why not the US?
The answer: The US can easily do it. The US spending per capita on health care is about twice that of other countries like France and Canada which have far better health care delivery systems based on the single payer model. If the money it currently spends on health care were used to fund a single-payer system, the US could easily have the best health care system in the world. Instead it has one of the worst in the developed world, entirely due to the fact that the parasitic profit-seeking entities that dominate the system, and the politicians they buy and control, seek to benefit at the expense of the sick.
It is as simple as that.
POST SCRIPT: Incredible bike riding
(Thanks to Norm.)