Sunday, November 9, 2008

Universal Health Pain

The concept of universal health care makes me sick.  Was that too blunt?  Perhaps I should restate: any mandate or policy moving America towards a nation with so-called universal health coverage of insurance is, in my humble opinion, nauseating.  I got really sick last week and had to stop off at the George Washington University ER, so I got to thinking about my old stomping ground of universal health care's symptoms and cures.
If anyone is still reading this, my statement might have made you sick.  After all, we as Americans and human beings have a duty to look out for each other and not sit idly by while a poor, innocent child dies from a toothache (think back to this story that reignited the Medicaid debate  We have an obligation to our fellow man to help if he has fallen ill through no fault of his own.  Seriously, what doesn't sound perfect about a system of health care where everyone gets equal treatment no matter his income and no one dies from the street from a simple condition which could be treated had that person been insured?
Well, unfortunately that's precisely the problem: everything sounds just dandy, but it can never work in this country.  It's not about there not being enough money or not having the proper authority supervising health administration - it's about reality.  Democratic presidential candidates call for a world in which no sick person goes untreated, and it's hard not to slap on a sticker in support of such ideals (okay, maybe it's easier for the people reading this blog).  They claim that if only the government was given enough authority, we could attain that dream.  Snap out of it, think about what is being proposed, and give a good second look at utopian policy.
What does universal health care really mean? Universal health care is defined differently depending on whom you ask.  The primary difference is that universal health care implies universal coverage for all medical needs.  Universal health insurance, on the other hand, just means that everyone has a policy, not that everyone actually gets access to care.  Whenever you debate health policy, you need to differentiate between access and coverage, and universal coverage in no way means that all people get access to care.  There is no guarantee that a doctor could see you or that a hospital would treat you faster.  In Canada, for example, it's even illegal to buy better quality insurance than what the government gives you.  Under President-elect Obama's plan (yeah, I know, I'm still trying to get over that one too), essentially everyone gets insurance if they want it, but it's not mandatory.
Government sponsored facilities are not exactly "universal" either - they're expensive and don't actually treat the root of the problem.  For any of you that have waited in a publicly-funded urban hospital for 6 hours with an IV tube hanging out of your arm before a nurse even brought you back to a bed, you know how ridiculous the promise of government-provided care really is.  I personally have sat in public clinics before, and they're not that great.  You sit in agony and pain while people around are either equally ill or simply aloof, and the staff don't seem to care either way because it's not exactly worth their while to make you feel better.
Wouldn't this help sick people get health care? Forget about the type of care received, the fact that the government is promising everyone a doctor to see them or a hospital in an emergency means that you have to wait a long time, and you might not get it when you need it.  By "long time", I mean more than just the line to get into a football game or speak to your advisor, I mean months or years.  In England where there is a National Health Service (the government-sponsored part of their health care system), nearly 900,000 patients are waiting for admission to hospitals.  On top of that, shortages force the cancellation of more than 50,000 operations each year.  You often hear on the news about Canadians coming across the border to get operations because their government makes it illegal to get private insurance, and who really wants to die while waiting in line for an operation for an MRI?  If you want an anecdote, ask a Canadian at your school (there are many at Cornell) - I'm sure you could get an interesting tidbit or two.
And what about the children???  Everyone wants to help the children.  In 1997, the State Children's Health Insurance Program was enacted to get health care for children of working poor families.  Surprise, surprise - eleven years later, kids are covered by insurance but not getting to see the necessary doctors.  Surveys on emergency room usage indicate that SCHIP-covered children are still using emergency rooms for non-emergent care, which is something they should be seeing a primary care doctor about.  If our country can't handle 21 million children, how are they supposed to cover 280 million other citizens as well?
Who would pay for this program? We're already spending about one-sixth of the GDP on health care, and that number is rapidly rising.  Taxes already take 1/3rd of our income, and no one really knows the details of dear Bailout yet.  The Tax Foundation does this really awesome analysis where it shows how long it takes out of every year to pay off taxes, and in 2008 the report was that due to the amount of taxes coming out of the average American's paycheck, it took until the 23rd of April to pay.  So while you're reading this, enjoy about 2 months of freedom before you start working off next year's debt to the government for probably at least 5 months (this is only my guess).  Many state-level plans propose payment through increases in cigarette taxes, which is ironic, because those who are poor smoke much more than those who are wealthy.  In fact, according to the National Center for Policy Analysis, the poor spend four times as much of their total annual consumption on tobacco as the wealthy.  It begs the question, who are we really helping?

All of this information put together is hard to digest, and it's certainly not the whole picture.  But when you start to delve into the data, you can't help but to lose the idealist attitude towards universal health care.  There's no cure for ideological and impractical policies, but there is a treatment: reason.  It's about time we start using it.

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