US Health Care: The Problem.

So just what is the problem with US healthcare? Let me give you an example that is very close to home. It occurred right in my community, a place of education and affluence and also a place where people silently suffer.

The woman who cuts my daughter’s hair immigrated to the US from South Africa a number of years ago. She has always worked as a hairstylist. Her current work situation is structured such that she is a “contractor” who leases her workspace from the salon she ostensibly works for. She is technically not an employee of the salon and as a result, she receives no benefits and no health insurance. She is one of the 45 million Americans whose only health plan, as Alan Grayson, US Congressman from Ocala, Florida, so boldly stated on the floor of the US House of Representatives last summer, is, quite simply: “don’t get sick”.

Unfortunately, she did get sick. It turned out to be nothing serious from a medical standpoint, but she did have an episode of acute asthma triggered by an unanticipated exposure to a neighbor’s cat. Her bronchodilator inhaler was empty and because she had no doctor and no health insurance,she had no choice but to seek assessment and treatment in the emergency room of a major regional hospital. The assessment and treatment of this relatively straightforward clinical situation took a total of seven hours, and resulted in being subjected to numerous blood tests, EKGs, chest x-rays, and other unnecessary tests before finally receiving the simple nebulizer treatment that made her better. Afterward, she was billed nearly $2000 for her medical “treatment”. In a primary care setting, this would have been a relatively routine office visit and would have cost a fraction of the bill she was sent. Worse yet, since she was unable to pay this bill, she was turned over to a collection agency who harassed her and significantly damaged her credit rating. The bill was eventually negotiated down and settled but not without significant stress, aggravation and financial hardship. This scenario plays itself out thousands of times each day in the USA and is the leading cause of personal bankruptcy in the USA. And the majority of those who go bankrupt, DO have health insurance, albeit woefully inadequate.

But this person was lucky. She did not have a life-threatening, chronic illness. For a truly heartbreaking account of what’s in store for people who don’t have health insurance and are unfortunate enough to have a life-threatening chronic illness, I would refer you to the prologue of T.R.Reid’s book,The Healing of America. There he tells the story of a 32-year-old woman who had severe systemic lupus erythematosis (SLE) who died because she was unable to get the treatment she needed due to lack of health insurance.

As Mr. Reid states in his book:

“those Americans who die or go broke because they happened to get sick represents

a fundamental moral decision our country has made. Despite all the rights and privileges

and entitlements thatAmericans enjoy today, we have never decided to provide

medical care for everybody who needs it. In the world’s richest nation, we tolerate a

healthcare system that leads to large numbers of avoidable deaths and bankruptcies

among our fellow citizens. Efforts to change the system tend to be derailed by arguments

about big government or free enterprise or socialism--and the essential moral question

gets lost in the shouting.... All the other developed countries on earth have made a

different moral decision”

It’s time we stop shouting and start caring about our fellow citizens. It is ironic indeed, and not just a little hypocritical, that in a country that still has political arguments about whether it is a “Christian nation”, caring and compassion are so absent from the discussion. T.R. Reid is right: It is, in the final analysis, a moral issue.We have the wealth, the know-how and the technology, but do we have the will to change what is so obviously unjust?

Next, I’ll share a few thoughts on human rights and health care from author Henning Mankell’s fictitious Swedish police detective, Kurt Wallander.