Every American knows that our health-care costs are high, and rising, and that the longer we live the higher they'll get. It's a problem that's perpetually one of the biggest and most daunting we face as a nation.
Most Americans think that health care should be made free, or at least affordable and accessible for all, by modeling our system after other rich countries' programs, which treat health care as a public good, or a right equally guaranteed and provided to all citizens. The rest think we should remain the only Western nation with a privatized system, keeping it as is, with its myriad dysfunctions and inequities.
So what would happen if our new government did manage to nationalize health care, instituting a single-payer system? Opponents claim that quality would suffer. Supporters insist that since America's a great country we could maintain or even improve quality, while adding efficiencies by investing in health-information technology, prevention and care coordination. Also, we'd save big by having the country's or even the world's top medical experts (i.e. a health czar and associated councils) to make decisions on which services and treatments are the best and most cost-effective, instead of the chaos we have now, in which millions of doctors and patients make isolated and sometimes uninformed and unforgivably wasteful treatment decisions.
That's not to demean America's hospitals or its medical workers. While our health-care system tends to get a bad rap, via otherwise enlightened critics like Michael Moore, the fact is our health-care workers have much to be proud of.
Take our cancer survival rates. The average American would be surprised to discover that, for whatever reason, they're better than any European country's. For cancer victims in the U.S., 63 percent of women and 66 percent of men are still alive five years after their initial diagnosis. The corresponding numbers for England are 53 and 45.
Of course, that's all fine and good, and again, something our doctors and nurses should be proud of. But the important thing to consider, remember, is efficiency - and fairness, and progress.
Now (this may seem heartless, but bear with me), if we were to assume that England's numbers are the right and normal numbers for a modern country with a functional health-care system, the unmistakeable conclusion is that many American cancer victims are surviving when they have no business doing so, and in the process greedily gobbling up massive amounts of our precious GDP, swelling our already-bloated medical-spending-to-GDP ratio.
Tremendous savings would be possible if we remade our system in the image of the other countries, as those 10 percent of women and 21 percent of men meant to die from cancer would die, preferably in a timely fashion, taking a significant burden off of both the system and the victims' respective families.
Yes, the families. Barack Obama often reminds us of the torment his mother, Ann Dunham, endured while undergoing treatment for ovarian cancer, because, and this is fucked up, she had to worry about how she was gonna pay for it. From her hospital bed she had to deal with shit like bills and insurance agents.
Granted, a cynic could carp that a dutiful son should have been there by his mother's side to shield her from those goddam monetary details, so Ms. Dunham could've focused entirely on getting better. But Barack, as we know, was at the time working in Chicago, busy with important things, being a law associate and a university lecturer, building his career, continuing the journey toward the job he holds today, where he has the power to eliminate such money-rooted torment.
It's sad that Ms. Dunham wasn't able to enjoy that historic journey, since she eventually lost her fight with cancer. It also seems especially unfair since, as she was treated in the U.S., she supposedly had a better chance of surviving it than had she been treated somewhere else in the world.
But here's the rub: Because she was treated here, by our outstanding doctors and nurses, it's safe to assume that she very likely lived longer than she should have, and thereby consumed more resources than she should have, resources that could have been spent more efficiently, like on treatment for other Americans whom our experts would judge as objectively more needful, or even for worthy nonmedical causes like organizing neighborhoods or subsidizing vulcanologists.
And to indulge a worst-case scenario: Imagine if Ms. Dunham would have been one of those "lucky" 10 percent of American women who survive cancer when they're not supposed to. Imagine the protracted treatments she would have undergone; the regular care she would still need; the intense testing she'd be subjected to. Imagine the massive costs all that would involve. Imagine the bills and associated distractions that would pile up for the Obama family. Ms. Dunham may have even had to file for bankruptcy, and move in and reside with her son and his young family.
No one should have to live through that.
