My Take on Health Care, Part I--Anecdotes

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Interesting that I was getting all set to write and publish a lengthy entry on the sorry state of our health care system for today when I got sidetracked and then called out.

Because I met a foreigner last night, someone from India, and he had a few choice words about the way things work over here.

He was there with his brother and towards the end of my assessment he asked me this:

Him: Why is stuff over here so expensive? Over in India, you can get 100 Valiums for one American dollar. Here, a prescription of the generic stuff is much more expensive. Same thing with Tylenol.

He then proceeded to tell me that his wife needed a D and C last year. The hospital charged over $8,000 for the procedure and sent them a bill for half. Even after all the insurance wranglings, they were still stuck with a bill for over $400. Which seems relatively reasonable from our perspective. However, he called some doctor friends back home to see what the same procedure would have cost him had he been there. Without fail, all his contacts said the couple would have been out no more than about $40 or so. Not only that, the procedure would have cost the clinic in India no where near 8 grand...more like half of that.

He genuinely wanted my take on things.

So I went off--but I warned him I was stepping on my soapbox beforehand.

I told him, and I truly believe this, that our health care system is in the hands of lobbyists, and thus, corporations (read: pharmaceutical companies, insurance companies, privately owned hospitals). Our costs are so high because they CAN be. The private sector is at the helm, and has been for some time. Their concern is the bottom line. The company's in the black. CEO's are paid outrageous amounts of money. Stock holders are getting their share. Everyone is happy, right?

And then you have the AMA, which also has a powerful lobby. I think for the most part, doctors have a sense of entitlement about their paychecks because they went to school for SO long and they're SO smart. Fine. But bloated salaries for a select few mean the costs have to be recovered somewhere. And since hospitals are not public facilities (even the teaching hospital in my area is private. They have a lease with HCA--the state let go of it over a decade ago) there's no tax revenue. Technically. Hospitals will always accept Medicaid and Medicare, so there are still government subsidies going on. So where does the revenue come from? Well, from us, of course.

And who gets the biggest squeeze? The middle class. The cost of health insurance has risen at ridiculous rates over the years. The rich can take the hit. The poor and elderly can get on state insurance. The ones in the middle take the brunt and that hit is huge.

My guy pointed out that in India, higher education is free. FREE. Kids who show promise as physicians early in life are flagged and sent to undergrad and then medical school at no cost to themselves. I would make the argument that if you don't have to pay for school, you don't get it in your head that you'll get to instantly earn a six figure salary upon exiting school.

Think about this: people go bankrupt in this country from medical bills.

Bankrupt.

How is this just?

One of my own, a social worker in another part of the country is doing all the right stuff. She is educated. She has a job. Her husband had a job. They had great insurance. Until he lost his job. Now, even with her insurance coverage, she is looking at possibly forking over $500 a month (!) for her child's asthma prescriptions. That is a ton of money, I don't care who you are. The tragic irony for her is that she works for a hospital.

How is this just?

Another one of my own, a dear friend and another social worker, had to pick up and move to a different part of the country a couple of months ago. The economy tanked in her state and she literally could not find a job. She HAS to have a "real" job with health insurance because she's Type I diabetic. She literally can't afford to not have health insurance--insulin is expensive.

How is this just?

I'm just getting started. More tomorrow. ->