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August 18, 2009

Health care

Rob @ 7:58 PM

Warning: politics ahead. If this bothers you, dear reader, skip it.

I've never been much of a gambler in the traditional sense, though I have had some fun with it occasionally. My late grandfather on the other hand (and it was usually a good hand) was very much a recreational gambler; he often had a weekly card game or something going on. He taught me one important lesson very early on, one which served him well his whole life; never gamble with what you cannot afford to lose.

The real, basic problem with the current state of US health care is that it's in the hands of the private health care industry. What people need to remember about them, and what isn't being mentioned nearly enough in the current debates, is that it is not the job of your health insurance company to keep you healthy. Their only job is to turn a profit. They do this by taking more money from you than they decide to pay out for your health care. If they pay more for your health care than you have given them, if you come out ahead financially at all, they've lost in their gamble on you. Their "good customers" are the ones who give them money and end up not needing the service, or who at least need services they can somehow get out of paying for in the end.

If you are an insured American, the entire state of your health is in the hands of people to whom you are a spin on the roulette wheel. Forget the commercials with comforting piano music and smiling actors, the leaflets with happy stock photos and soothing blue fonts. The single goal of your health insurance company is to get money from you that you didn't need to give them in the first place in exchange for a potential service they really hope you don't need, and are obliged to avoid paying for if they can. It's a pure gamble on a frankly obscene scale.

It is the job of any government to provide the basics of civilization to its citizens. Every time an American uses a public road, sends a kid to public school, sits in a park, walks at night by the light of streetlamps, calls the police, or turns on the water tap they are making use of a service of our government. If simple health care were something our entire society could support and access so easily, would that not be preferable in every way to what we have now?

Jon Blum, an American writer who moved to Australia, has this to say on the subject:

Arguing that private industry is better than government because the government can get conned into paying for $300 toilet seats, is forgetting that private industry are the ones charging the government for $300 toilet seats. The government may be fallible, but they are not inherently out to take as much of your money as they can get away with. I'd rather have at least one player on the field which has a fundamental motive beyond self-interest.

Importantly, this all involves the people who are fortunate enough to be insured in the first place. I, for one, have been among the fast-growing population of uninsured Americans for my entire adult life. This has not been by any specific choice of my own, but simply what has been available to me over the natural course of events.

Instead of some insurance company using me as a poker chip, I'm left to gamble with my own life. Do I feel sick enough to go to the clinic? If it turns out to be worse than they can handle there, am I willing to end up at the hospital despite the fact that my living expenses are barely getting paid as is? Am I worried enough about my own health to possibly lose my family's house over it? Or do I stay home, wait it out, and hope it all just somehow gets better on its own? These are the questions I must ask myself every time I wake up feeling less than great, every time I see a spot on my skin that doesn't look like it belongs.

So far, despite various issues I find myself in generally good heath; my gamble has paid off. However unlike grandpa throwing some extra cash into a round of poker with his buddies, I am forced into a bet I really cannot afford to lose. I am fully aware that realistically speaking, like any gambling streak, it must inevitably end at some point. This state of events leaves me less than enthusiastic.

My brilliant friend nostalgia from the UK puts it perhaps most succinctly of all:

Basically the reason you want socialised medicine is so that poor people don't die when they don't have to. So, erm, I sort of read anti-US!NHS stuff as saying "blah blah blah I don't care if poor people die."

3 Responses to “Health care”

  1. Mara says:

    Fuckin A...THIS! Not sure if WordPress allows HTML in comments so I'll add the part here:

    "is that it is not the job of your health insurance company to keep you healthy. Their only job is to turn a profit. They do this by taking more money from you than they decide to pay out for your health care."

    YES! This, people, this!

    And this would also be why I have a Boutique Medicine plan, where I pay a flat fee each month for unlimited visits, from B-12 shots, etc. It's in my doctor's financial interest to keep me healthy.

  2. Cyrus says:

    I don't have much more to add other than 'I really liked this post.'

  3. Mr. Anderson says:

    Not sure if you have trackbacks enabled, but I just thought you should know that I mentioned this article here. Feel free to point out anything that I missed. I honestly don't know much about medical processes or anything like that...

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