When I had some serious health problems as a kid, my family’s medical coverage came from—of all places—the government, because my father worked for the Department of Defense. When I was out on my own and suffering bursitis in my knees, aggravated by fencing, I was enrolled at a state university and got health care there—provided by the governmental institution that a state university is.
After that I worked for other people for decades, and had employer-provided insurance (and as an aside, I can vouch for the fact that employers can choose to change insurance carriers at will, so the myth that people with private employer-provided insurance don’t have to worry about losing or changing their insurance is just that, a myth).
These past several years, though, I’ve been a self-employed freelance writer. I have to pay for health insurance coverage for myself and my family out of my own pocket. The premiums for a good policy are high, so we have a semi-adequate policy with premiums we can afford.
But we’ve been lucky. And many, many people are worse off than us.
A serious car accident, a heart attack, a stroke, pneumonia—anything that put one of us in the hospital for an extended period of time, or required extensive outpatient care and therapy—could force us into bankruptcy. There are plenty of people out there closer to bankruptcy than us, or already there, who would have an even harder time with major medical bills.
What’s been missing in the heat and flash of a health care debate that largely revolves around buzzwords: Obamacare, death panels, socialized medicine, is people. Because in the end, health care—in the immortal words of the sf film classic Soylent Green—is people.
The debate has become about numbers. 47 million uninsured, or 30 million? How will the profits of the private insurance companies be protected? How will the taxpayers pay these bills?
But these are not the questions that we should be talking about. We should be talking about people. Uninsured, underinsured, fully insured, it hardly matters. When someone is in the hospital for an extended period, health care bills can rapidly run into the hundreds of thousands of dollars. If you’re paying 20% of that because you have full coverage, that’s still enough to drive a middle class family over a financial cliff. If you’re uninsured or underinsured, of course, it’s worse.
And really, when someone is sick or injured, that person and his or her family members are already worried enough. The last thing a parent should have to fret about when his child is in a hospital bed is what that hospital stay will do to the family’s food budget and rent payments. If a mother is incapacitated so she can’t earn her living, should her family have to worry that she won’t have a home to come back to because the hospital expenses are pushing them toward foreclosure?
The bills wending their way through Congress not only guarantee the survival of the private insurance system, but enhance its future profitability by forcing another 30 million or so people to get coverage. Of course the insurance companies love these bills, and of course they’re fighting tooth-and-nail against a public option because that’s the only thing that offers any competition, any incentive to improve service, reduce profits and keep premiums affordable.
But the system these bills protects is backwards to begin with. It puts the critically important issue of providing health care into the hands of corporations that exist to make money. The way profits are arrived at in the insurance business is this: many people pay premiums. Not all those people need expensive medical care, so the difference between the premiums coming in and the expenses paid out (and of course overhead, salaries, etc.) is the profit. In this system, profit can be maximized by paying out less—by cutting people who are sick, not accepting people who have been or are likely to get sick, refusing to pay for certain treatments, etc.
Because health care is really about people, keeping them well and getting them well if they’re sick or hurt, then our entire system is turned around. Instead of making people the emphasis, we’ve made corporate profits the emphasis and people simply the means by which those profits are made. We’re suffering under a system where the medical care of the people is not only not a societal priority, but is actually a hindrance to the system’s primary goal, which is corporate profit.
The richest and most powerful country in the history of the world should not stand for this. Why do we accept that corporate profit is an inviolable right, but that keeping the citizenry healthy is not? What’s the moral or ethical basis for such a position?
Health care reform is a start, but it’s a baby step in the direction we need to go. And the sooner, the better. American has long been held up as a shining example for the rest of the world, and in many ways, that’s legitimate. But in the area of health care, we’re far behind, and instead of catching up, we’re falling back more all the time.