| 03.18.2018

Expand care, don’t reduce


There’s a tacit fear lingering above health movements like GMO Right to Know, and the 40 percent of New Yorkers supporting Mayor Michael Bloomberg’s judicially defeated and intellectually-indefensible prohibition on large sugary drinks.

These people are not concerned about GMO ingestion or soda overconsumption — if you support either movement, you probably monitor these as best you can anyway. What they fear, and what all Americans should feel sincere trepidation toward, is finding themselves caught in the racket known as American health care, a racket that will persist exactly as long as our irrational fear of nationalizing health insurance does.

Steve Brill of Time Magazine highlights the fear of American medicine’s status quo, which requires two words for complete explanation: price gouging. Benevolent administrators at Sacred Heart, MD Anderson Cancer Center or Gritman charge more for care, drugs and facility use than is conceivably reasonable — not because they have to, but because they can.

In a typical market, price gouging amounts to a non-issue because overpriced items linger on shelves as people opt for less expensive options or choose not to buy the product altogether.

Health care is different. Opting out of health care means pain, death or both. So when you’re sick or hurt, you go to the hospital. Health care never has been, and never will be, a free market.

Since it isn’t a free market, like buying a car or a head of lettuce, we should follow the lead of every other developed nation and socialize health insurance. All we need is a one page bill extending the versions of nationalized insurance we already have, Medicare and Medicaid, to cover every American.

As evidence, I could reference the fact that, according to the American Journal of Medicine, 62 percent of all bankruptcies in this country are related to medical debt. But I won’t. Nor will I point to the 69 percent of those who file medically-related bankruptcy possessing insurance at the time of their filing.

The best case for nationalizing comes from the hospitals themselves.

Hospitals have what’s referred to as a chargemaster — what they use to set billing rates for the uninsured. The figures on a chargemaster are made up of arbitrarily reached totals routinely valued at tenfold the good or service’s price to the hospital, devoid of any relation to real world costs.

In concrete terms, it’s why hospitals bill more than $2,000 for a CT scan, while Medicare, which reaches its payouts based on legitimate costs including hospital overhead and administrative compensation, will pay around $275 for the same scan according to Brill.

Exponential increases like these are present at every level in a medical setting, from replacing an aortic valve, to supplying gowns for hospital stays to paying for an ibuprofen tablet.

The solution to this has already been stated, and is present in almost every developed nation – France, Canada, the United Kingdom or Germany to name a few. It’s no coincidence each of these countries has found socializing health insurance as the only means to treating every citizen at an affordable price.

Yet, because of our collective fear of nationalizing any industry, we treat the capitalistic root of our ballooning costs as sacred, while pondering why our $2,000 CT scan costs a German $272, a Spaniard $123, and a Canadian $122 according to Brill. This is also the motivation perpetuating pathetic attempts to tinker with public policy, like the Bloomberg ban,  Hilary Clinton’s old model of requiring all employers to cover their employees’ health insurance, sometimes unfounded hysteria over GMOs, or Obamacare which, –for all the good it does — falls drastically short of what it could have been.

What we’re living through now is the oft-repeated prophecy of Winston Churchill about our country: “We can always count on Americans to do the right thing, after they have exhausted all other possibilities.” Apparently, we have a few more possibilities to work through.

Brian Marceau 

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