BookEnds

Lower Fairfield County's online book club

Health care without the insurance, and the prescription

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Still on the search for a fix for his sore shoulder, Reid leaves Canada before the end of the book to visit India and pay out of pocket at an ayurvedic clinic. I’ll save you the suspense: After weeks spent eating healthfully, relaxing, and being intensely massaged, Reid’s shoulder felt better and had a better range of movement.

You probably don’t have to believe in prana or doshas to understand that paying such intense attention to your body may serve you better than pills or surgery. But the out-of-pocket model doesn’t do one thing very well, Reid says, and that’s address any sense of fairness. Most of the world’s poorest countries don’t provide health care, and people are left to pay for the care they can afford. Reid points out that that usually means that poor people go without any care at all, and the poorest in the poorest countries can expect today before their 40th birthday.

Reid points to an Institute of Medicine study to show that about 22,000 Americans die each year from otherwise treatable ailments because they can’t afford insurance. He tells us that about 85 percent of Americans believe health care is a fundamental right. So what’s to be done? Reid says we have to decide the moral question first, commit to universal health care, and then worry about how to pay for it. He argues that framing the issue as an economic one was one of the problems in the reform effort of then-President Bill Clinton in 1993, while at the same time Taiwan and Switzerland passed universal health care. That’s because Taiwan and Switzerland framed the issues in ways that resonated within their cultures — national pride and solidarity — Reid says.

Part of what he wants to do in the book is combat some common misconceptions: that every other country has socialized care with wasteful bureaucracies and sacrifice free-market style choice. But the prescription contains elements that may be a hard sell for Americans. Everyone — rich and poor, young and old, healthy and sick — is in it together in countries that make health care universal. That means that the rich subsidize the poor and the healthy subsidize the sick. But it also means the healthy version of yourself subsidizes the version of yourself that inevitably needs medical care. That’s what insurance is meant to be, a bulwark against bad luck.

It also means that in most countries no one makes a profit from health care insurance. That  might have been the biggest obstacle all this time: that really entrenched interests benefit from our current system.

One Response

  1. Christina Haskin says:

    Thank you for highlighting the need for a moral imperative first and then design how to achieve it. PBS just reviewed the Dutch system. One interesting idea they have is 24 hour clinics that take pressure off the emergency rooms. A great book on this issue is “Overtreatment”
    by Sharon Brownlee. The book explains how the need for profits lead to overtreatment, which is not only expensive but also can cause harm.
    One thing I would like to see is a law that prohibits prescription drug advertisting from the media. In it’s place people could go to the internet and look up the current drugs for their condition.
    I believe that health care is a basic right and wish that it could be aadded to the bill of rights. Franklin Roosevelt tried to add a second bill of rights before he died and one of the items was the right to health care for all.