There is a lot to discuss and unpack when talking about healthcare, and there aren’t many issues as hotly debated in this country. As both a medical professional and patient, I have seen all sides of this issue and the truth is that our system is broken, and it has been even before the Affordable Care Act.
Capitalism & Healthcare
I am not anti-capitalism. I’ve benefited from it in various ways all my life. Free markets and competition to keep prices down is a good idea in various areas, but not when it comes to healthcare.
America spends more on healthcare than any other country, yet we have some of the worst outcomes. I attribute this to the fact that we have a predominantly capitalist-run healthcare system.
Healthcare should be about healing people and keeping them healthy. It should not be about making money off of people’s sickness and suffering. The whole goal of capitalism is to create a product that will make you wealthy. And in our country insurance companies have become very wealthy off of the suffering of our citizens.
I got into the medical field to help people and I try very hard to do so. However, when their medical care is based on what their insurance will or will not cover, there isn’t a lot that I can do. If a patient cannot afford a treatment and their insurance refuses to cover it, they won’t be getting that treatment. From surgery to medications to medical supplies, a patient is at the will of their insurance carrier or lack thereof. I can call and send notes and beg and put the doctor on the phone, but an insurance company’s bottom line is cost and they will put that above their clients every time.
American politicians who get a pretty penny from the insurance industry love this talking point. They go on and on about how terrible Canada is for their wait times, etc. without conceding the fact that America rations care, as well. We just do it in a different way.
In an attempt to keep prices down, Canada limits the availability of some procedures, tests and treatments, which creates the ridiculous wait times you hear about. This is definitely an issue and it leads to “medical tourism”, which is when people leave their country for healthcare somewhere else.
On the other hand, America rations care by making it unaffordable. It doesn’t matter if a treatment is available if you can’t afford it.
The people who parrot this talking point also keep the fact that Americans leave the country for care out of the discussion. Conservative think-tank The The Frasier Institute reports that in 2016 an estimated 63,459 Canadians received non-emergency medical treatment outside Canada, whereas according to Patients Beyond Borders, an estimated 1.4 million Americans left the country for care in 2016. That’s not including the amount of Americans who get their prescriptions from Canada.
The Cost of Universal Care
I once had a relative — who is otherwise very kind and empathetic — tell me that she didn’t want universal healthcare because, “I mean, I don’t want to be a socialist country…” Having socialist-like policies does not make us a socialist country. It makes us a capitalist country that has socialist policies in some areas.
Making statements like that is like asking, “Why should I pay for the police or fire department when I’m not in trouble and my house isn’t on fire?” Because it’s for the common good and one day you might be in trouble and you might need the police, or your house might catch fire and you might need the fire department.
Another one I’ve heard is, “Why should I pay for other people’s care?” Not only do you pay for other people’s care through your taxes, but you also pay for it through your insurance premiums and other out of pocket costs.
Insurance works by taking money from healthy people to pay for the treatment of unhealthy people. So, say you have a plan through Aetna and so does Susie. Even though you’re healthy, you still pay a premium to Aetna every month. This means you are putting more into Aetna’s pool than you’re taking out. Susie is not healthy, so she uses her plan more, which means that she is taking more out of Aetna’s pool than she’s putting in. Aetna then takes the money you put into the pool to pay for Susie’s care, ergo you are paying for Susie’s (and other patient’s) care.
Now, for the uninsured. We have millions of uninsured people in America. Because medical offices aren’t obligated to treat them and emergency rooms are, they wait out their illnesses until they get to the point that they need emergency care. Preventative care is and always will be cheaper than emergency care. And who is paying for that more expensive emergency care? Taxpayers.
So, if you have health insurance, you’re not only paying for other members with your premium and other out of pocket costs, but you’re also paying for the uninsured’s care with your taxes. If you can’t afford health insurance, your taxes are not only paying for other’s care, but also your own if you need the emergency room.
If our taxes are already paying for care and our premiums are paying for care, why not just eliminate the extra money padding insurance company’s pockets and just pay for it all with our taxes?
The last time I was offered health insurance, it would have cost $400 a month with a deductible of $1,500, meaning I would have to pay a minimum of $1,500 plus my monthly premiums in one year for the insurance to kick in and cover any services. I’d rather have a slight increase in my tax bill if it means that I don’t have to pay an insurance company to screw me over.
No one — not one person — who advocates for a universal health plan want’s “free stuff”. What we want is for the taxes that we already pay to go toward the health and benefit of all Americans, not just ourselves.
I won’t pretend to be an expert on healthcare policy and I won’t pretend to have all the answers. The truth is that no policy is without flaws and there’s no way to please everyone. There will always be complaints and dissatisfaction with the way a country is run.
That being said, I find it pretty unbelievable that we are supposedly the best country in the world, yet we have some of the worst health outcomes of developed nations. Canada’s system isn’t perfect, but it’s a lot better than ours and we can learn not only from Canada, but from every other developed nation that has progressed to seeing that healthcare should be about the patients and not about profit.
We cannot claim to be number one when we fall so far behind on such an important issue.