Things to Remember About US Healthcare

A lot of the media coverage of the healthcare debate lately has focused on the politics, probably because journalists feel like they've already spent several months explaining the various aspects of proposed reform. But there are a few things that bear repeating, because not everyone seems to remember them.

The Washington Post's Ezra Klein has one key reminder: In the US, we already ration healthcare:

We ration. We ration without discussion, remorse or concern. We ration health care the way we ration other goods: We make it too expensive for everyone to afford.

I've used these numbers before, but let's repeat them. A 2001 survey by the policy journal Health Affairs found that 38 percent of Britons and 27 percent of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5 percent. This, Americans will tell you, is the true measure of our system's performance. We have our problems. But at least we don't sit in some European purgatory languishing without our treatments. That's rationing.

There is, however, a flip side to that. The very same survey also looked at cost problems among residents of different countries: 24 percent of Americans reported that they did not get medical care because of cost. Twenty-six percent said they didn't fill a prescription. And 22 percent said they didn't get a test or treatment. In Britain and Canada, only about 6 percent of respondents reported that costs had limited their access to care.

Wendell Potter, the former health-insurance executive who testified before the Senate Commerce Committee about how insurance companies "confuse their customers and dump the sick," reminds us about the costs associated with the current system - huge risks for those who are (or might become) uninsured, and higher costs for those who have insurance:

We should ask the skeptics of a public option, who are afraid that giving people a choice of a government-run plan will lead to socialism, if they would want to go back to the day when Americans had to buy private fire insurance.

Tell them if they lived in Ben Franklin's day and they didn't have a shield on the outside of their house indicating they were insured, their town's private fire insurance companies would let their house burn down. The private insurance companies would keep your fire from spreading to your insured next-door neighbor's house, but your house would soon be nothing more than a pile of ashes.

We must remind our family members and our friends and neighbors why we are having this debate in the first place. If they tell you they don't think their tax dollars should be used to pay for someone else's coverage, point out to them that they already are paying for the care uninsured people receive when they go to the emergency room and can't afford to pay the exorbitant bills they get from the hospital. Those of us who are insured pay an extra thousand dollars in premiums every year just to cover that uncompensated care.

If they say they don't want to saddle their children and grandchildren with additional taxes, ask them if they have thought what might happen to their children and grandchildren if they found themselves among the millions of people without health insurance or, maybe more likely, among the underinsured.

Potter's testimony is also well worth a read.

Fear of change is a natural human reaction when we're discussing something as essential as healthcare. We need to remember that there's a lot to fear from the status quo, too.