We’ve been debating health care, and how to operate a fair and equitable system of delivery of it, for quite some time in this country. The bottom line, as it is in most debates about most issues in which politics is involved, is money. Americans are seeminly able to become polarized about anything, and this is no exception. The rhetoric becomes shrill, the contentions of both sides more and more slanted and extreme. And the way we use words! It should be noted that this is a debate over a proposal, and like most other issues, what comes out will not necessarily be an identical representation to what has been proposed. This issue has been on the table for a long time, and a lot of people are in agreement that something needs to be done, so my guess is that something will be, but at this point, it is anyone’s guess as to what that will look like.
My own personal encounters with the health care system were fairly minimal, fortunately, until about a year ago when I woke up with a fever and some swelling and pain in my lower left leg. Three emergency room visits, several CT scans, a dozen doctors, almost a month in the hospital and one seven inch incision later, I was on the way to a recovery that wasn’t complete until, perhaps, six months ago. I also came out of the experience with an entirely new, and almost completely different perspective of the health care system than I had before I went in. Oh, did I mention that all of the above came to a grand total of almost $150,000 in expenses?
Thank God for private health insurance coverage. I mean that literally. I am grateful that the Lord has put me in a position where I can afford the almost $800 a month premiums for an insurance policy that paid 95% of the expenses, and through which, as a result, I was able to access the medical care at Methodist Hospital in the Texas Medical Center in Houston, one of the top hospitals in the country. That was a good thing, since complications from the strep infection in my leg produced a pulmonary embolism, a potentially fatal situation. There were times when as many as four doctors were at my bedside in consultation, examining me, reviewing test results, CT scans, monitoring and recommending medications, performing surgery and eventually seeing that I left the hospital in reasonably good condition, and following up to make sure I recovered.
I shudder to think what might have happened had I not had the high level insurance policy I have had for something like a decade now. Through my wife’s employer, I pay $800 a month for it. Even at that, there was a case worker in the hospital, assigned to me by the insurance company, who, I understand, reviewed every decision on almost an hourly basis, negotiating costs, determining necessity of tests, medications and procedures, monitoring my care and keeping the medical experts informed of their limits of coverage. Whether or not that had an effect on my care, I don’t know, though I suspect that it probably did. But this was one of those events which make me wonder, if I had not had this level of insurance, would I now be in bankruptcy, or would I be dead or perhaps permanently disabled because I couldn’t access the level of care I needed?
I think that is probably the bottom line that the American public must decide related to the accessibility of health care. We’ve been presented with a cumbersome, staggeringly detailed proposal for universal health care managed by none other than the federal government. It is too soon for us to have to decide on that proposal. We have not yet, in this country, resolved the question of whether or not health care is just another industry which earns profits and is distributed according to the ability of those who wish to access it to pay for it, or whether it is a basic human right that should be part of living in the most prosperous country on the face of the earth.
Health care delivery is a complicated issue. It is market-driven. Life, and the quality of it from a physical perspective, has a price tag. Insurance companies make profits by selling guaranteed payments based on a calculated risk that, over a lifetime, you will pay more in premiums than you will require in benefits, and on the fact that the stock market will provide them with a nice margin as well. Prescription drug companies base the price of the medications they produce on what they can do, and the demand for them. Those which are required to reduce pain or, in some cases, to sustain life, carry a high price tag. Likewise, corporations which have invested in a stockpile of beds and medical equipment, and pay the salaries of a staff of medical professionals to operate it as a hospital, base the cost of their services on the level of demand. In all of this, not much consideration has been given to the morality of the system as it currently exists.
As things stand right now, my life is considered more valuable than someone else’s, mainly because I can walk through the door of an emergency room in a privately owned hospital with a reputation for excellence, and be served because I carry a white card in my pocket that says a particular corporation will write checks for most of the bills that I rack up while someone without the card will either only be given minimal care to be stabilized, or will be told to go stand in a long, long line at a place where people without the white card must go to see a doctor.
There is something wrong with that. I find that quite surprising, especially compared to the size, scope and volume of the debate on defining the sanctity of human life. But I am not sure if it can be fixed by a government plan taking up more than 1,000 pages.
Americans must first decide what health care is, and where it fits in the overall moral and cultural picture before we can decide how to deliver it, or whether or not the government is the most suitable institution of our society to determine this, and administer it.