Out of Control

As I’ve already conceded, I am not an expert on healthcare. But sometimes it doesn’t take an expert to see through the bullshit. I keep hearing opponents of healthcare reform – or at least the public option component – saying they don’t want to lose control of their healthcare or they don’t want the government interfering with their healthcare options. Case in point, Karl Rove recently argued in the WSJ:

the public option puts government firmly in the middle of the relationship between patients and their doctors. If you think insurance companies are bad, imagine what happens when government is the insurance carrier, with little or no competition and no concern you’ll change to another company.

[Read fact-checking on Rove’s WSJ argument here.]

Here’s my question: what control do you have now? Are you really in a position right now to threaten a change to another insurer if you have a dispute with your current insurer? If you are lucky enough to have health insurance, chances are it is provided by either your employer or your spouse’s employer. In that case that employer, not you, chose your insurance provider. That employer, not you, decided how extensive your coverage will be. That employer, not you, will decide whether to curtail your coverage or pay a higher premium. That insurer, not you, will ultimately decide whether they will pay for the medical care you need or desire. So, what control do we currently have?

By most objective standards, my current health insurance with Blue Cross Blue Shield (aka Anthem) would be considered excellent. But for reasons beyond my control, BCBS could not — or would not, depending on who you ask — reach an agreement this year with Norton Hospitals, one of the best and largest hospital networks in Louisville. So, like many people I know, I now have to leave my current providers, with whom I am very satisfied, to find ones that are affiliated with another hospital network. It also means that the one and only children’s hospital in town — where I most certainly WILL take Lilly in case of emergency — is now out-of-network. It also means that when I decide to have my next child I will not be able to return to the obstetrician that is most familiar with the life-threatening complications that both my daughter and I faced during my first pregnancy, nor the hospital best equipped to treat us. And these are minor complaints. Ask a Louisville cancer patient who is mid-treatment at Norton Hospital with BCBS insurance if they feel in control of their health. I’m guessing no.

The fact of the matter is that most people who are happy with their health insurance — much of the opposition to healthcare reform — have been fortunate enough to have never put it to the test. Experts in Julie Rovner’s report, Obama’s Hurdle: Selling the Satisfied on Health Care, on NPR, explain this phenomenon and how people who have so far been healthy under their plans may be hesitant to advocate for change, but horror stories of insurance and treatment denied are abundant when you look at patients who have been diagnosed with cancer or a chronic disease. (Check out this one that my friend Kate, who has her own nightmare stories, pointed me to a few days ago.)

Not only do most people lack the control to negotiate coverage, but we also lack control over our own professional destinies because we’re caught in the quagmire of employer-provided healthcare. Consider Blogger Matt Haughey’s argument, on a.wholelottanothing.org, that national healthcare, which inherently provides more freedom of movement in the workforce, could provide a much-needed boon to small businesses and entrepreneurs.

Of course, one legitimate reason to oppose a public option is the fear that ultimately the government will find itself with a program that is so widely utilized that long-term funding is unfeasible (à la Social Security). Opponents routinely point to “welfare” systems like Canada, where 70.3% of healthcare was government-funded in 2005 compared with 45.1% of healthcare in the U.S. the same year. That’s a lot of government money and we already have too much debt, right? Well, no. Because, according to comparative statistics by the World Health Organization (WHO), the Canadian government actually spent fewer (exchange-adjusted) dollars per capita under its “welfare” system than the U.S. did under its current system: $2,410 per capita in 2005, compared with the U.S. government’s $2,862 per capita. (Stats for the UK, show the same trend.) And there is no conclusive evidence that the care provided in the U.S. is superior. In fact, Canada has a longer life expectancy and lower infant mortality rate. (See a discussion of the conflicting explanations for those stats in this comparative analysis of the two systems on Wikipedia.)

I’m not an economist by any stretch of the imagination. But to me these numbers seem to reveal that the current U.S. healthcare system is, at least, inefficient, and the much-feared national systems are not inherently more expensive or inferior. My own readings about healthcare and personal observations tell me that any delusions that individual Americans control their healthcare options are, well, delusions. So, those who oppose healthcare reform on those bases need to dig a little deeper.

Bottom line: reform is necessary. The most recent U.S. Census data reveals that nearly 46 million Americans — 8.1 million children — do not have health insurance. Those are numbers that should embarrass all Americans.

The Out of Control by MushBrain, unless otherwise expressly stated, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. Terms and conditions beyond the scope of this license may be available at mushbrain.net.