How is it that Americans pay the most for health care, get mediocre results, and deny access to health care to many? How is it that Europeans, Canadians, and all other industrialized nations do better?
Historically, it is because Americans decided to treat illness as a risk to be insured against. That made a modicum of sense when no one had a right to health care and there was a need to spread the rising cost over a sufficient time to make it affordable. But, in fact, in the modern world, the need for health care has nothing to do with risk. Young children require health care. So do the elderly, birthing mothers, men with high blood pressure, diabetics, disabled veterans, indeed, everyone. Access determines not only who lives and dies but their quality of life. And because a disabled person is less productive and may require further care, and because the ill may pass on diseases such as tuberculosis or AIDS or Ebola, there is also a social cost and a danger to us all when health care is denied.
Most of us understand that where there is a strong social need, we share the burden. We need people who can read and write so we pay for schools. In a world of belligerent nations, we pay for a military for our common defense. We pay for roads, sewers, other infrastructure. We don’t insure against the possibility that we will need an army or a road.
But in the US we insure to provide access to health care. And those insurers need to make money to build their offices, pay their employees, review claims, deny claims, pay their stockholders. And now, in the world of Citizens United, the insurers also fund political campaigns to ensure that the law protects their income stream. All of that, a multi-billion dollar insurance industry, has to be paid for by us in addition to any money paid for actual medical providers. In short, we have introduced a middleman, some might unkindly suggest a parasitic third party, that benefits only itself and its stockholders.
Any chance of correcting this travesty? Only if we get behind Bernie and demand a political revolution that puts people and the common good first.