Why going home to America may be the death of me: the Healthcare debate.

[Photo: I stopped by the "Wild Strawberry" protests last week and took some pictures.  I was wearing a mask, because I've been coughing since I got sick about two weeks ago]

Wednesday morning, Fanfan and I went to Far Eastern Hospital in Banciao because with all of the hoopla over the last several months--i.e. applying for Fanfan's immigration visa, preparing my documents and writing letters for my grad school applications, studying Chinese, teaching, and obsessing over closely observing the presidential elections back home--I had put surgery on the back-burner.  Then, last week, I realized that we only had four weeks left, so I had to get on the ball. 

The reason, some of you might remember, that I need to get surgery is that cancer has been coded into my DNA through a combined lineage of peoples with the worst skin in the world--no offense to all my relatives reading; after all, it's not our fault.  Having grown up on the coast of sunny South Carolina didn't help either, spending most of my summers outside at the beach or on the boat.  As a French dermatologist once told me upon seeing my back, it's not a question of if, but when I will get skin cancer.  Indeed, I am the only person in my direct family not to have skin cancer, being that my sister just recently had a basal cell carcinoma removed. 

Yes, I use sunscreen.  We all do. 

Anyhow, Fanfan and I arrived at the hospital on Wednesday morning.  After a quick meeting with a doctor, explaining my situation, we were sent across the hall to "make an appointment" and "get started."  We were a little confused, but soon learned that they were going to take two moles off right away and make an appointment to take two more off in two weeks.  Talk about no wait!

Not only had my doctor lived in the U.S. for 25 years and spoke perfect English (I mean perfect), but he had also studied International Relations at one of the schools to which I'm applying (Columbia's SIPA program).  We chatted for a while as he did the surgery, and then I was on my way.  The entire hospital visit lasted about an hour and cost NT$469, a little under US$15.  Had I not been insured, the procedure would have cost me about US$130, small change compared to how much it would have cost in the U.S.

Moreover, yesterday, Fanfan and I both went to the doctor.  Fanfan has a chronic problem with the skin peeling and getting raw on part of the palm of her hand, so she stopped by the dermatologist.  I, on the other hand (no pun intended), have been coughing since I was sick last week--the air here makes it difficult to stop coughing--so I decided to go see the ENT doctor on the corner near our house.  Both of our visits lasted a total of about 30 minutes and cost about $5 each. 

This all brings me to my point: this will be impossible in the U.S.  As excited as I am about coming home, about starting a life with Fanfan that doesn't involve keeping boxes and suitcases at hand for our next move, about studying what I love, etc., I find myself battling the creeping inquietude of being uninsured.  I haven't the money to afford insurance, which means that one illness or one accident could potentially put me in debt for the rest of my life (or kill me). 

Fanfan, on the other hand, will be covered by her Taiwanese insurance (a private company, not the national system). 

I know what many of my fellow American's are saying right now:  It sucks, but that's life.  We all pay one way or another.

I'll get to that later.

Go back to Tuesday afternoon.  Upon coming home from the hospital, I got back to the tasks at hand translating my transcripts from France for my grad school apps and arranging things to be sent back to the US.  When I do these sorts of things, I usually either catch up on the episodes of the Daily Show/Colbert Report or watch documentaries online.  In getting up to speed on our debacles in the Middle East, I recently watched No End in Sight (which I highly recommend, you can watch it here), and, yesterday, decided to watch this Frontline special on Afghanistan called "The War Briefing" (again, I highly recommend it). 

It was on the Frontline site that I stumbled across another documentary called "Sick Around the World":

In Sick Around the World, FRONTLINE teams up with veteran Washington Post foreign correspondent T.R. Reid to find out how five other capitalist democracies -- the United Kingdom, Japan, Germany, Taiwan and Switzerland -- deliver health care, and what the United States might learn from their successes and their failures.

I was shocked to see that it talked about Taiwan.  Here's the segment:

Now, to be clear, I've made my criticisms of the Taiwanese system before, and I know that all of the systems in the above documentary are not as perfect as they may seem. 

But here's the thing: none of them leave people behind.  Nobody in these countries goes broke from medical bills.  No one is denied coverage if they are sick.  No one can be denied for "pre-existing conditions." 

Sure, they are costly programs, and in some of these places the hospitals are struggling, but does that really make them worse than our system in the United States (as people often suggest).  In many cases, we spend double the amount of our GDP as other countries do, and we still have 47 million people who don't have health insurance.  Even those Americans who can afford health insurance can be denied by insurance companies on the basis of their medical history and still more those who have health insurance can be denied coverage for procedures they need at the will of their provider.

A recent study by the Commonwealth Fund has been making news lately, as its findings don't seem to back up many of the claims that care in America is the best in the world:

Key Findings

• More than half (54%) of U.S. patients did not get recommended care, fill prescriptions, or see a doctor when sick because of costs, versus 7 percent to 36 percent in the other countries.
• About one-third of U.S. patients—the highest proportion in the survey—experienced medical errors, including delays in learning about abnormal lab test results.
• Similarly, one-third of U.S. patients encountered poorly coordinated care, including medical records not available during an appointment or duplicated tests.
• The U.S. stands out for patient costs, with 41 percent reporting they spent more than $1,000 on out-of-pocket costs in the past year. U.K. and Dutch patients were most protected against such costs.
• Only one-quarter (26%) of U.S. and Canadian patients reported same-day access to doctors when sick, and one-fourth or more reported long waits. About half or more of Dutch (60%), New Zealand, (54%), and U.K. (48%) patients were able to get same-day appointments.
• A majority of respondents across the eight countries saw room for improvement. Chronically ill adults in the U.S. were the most negative; one-third said the health care system needs a complete overhaul.
• In the past two years, 59 percent of U.S. patients visited an emergency room (ER); only Canada had a higher rate (64%). In both countries, one of five patients said they went to the ER for a condition that could have been treated by a regular doctor if one had been available.

So, even if waits in some cases can be longer, even if the government struggles at time to fund it, is that really sufficient grounds to rule universal health care out as an option for the United States?  Why is the right to health not considered a part of the "pursuit of happiness" (note: do not misread that as me assuming the government is supposed to "make us happy," that is not at all what that means).  How is the right to be healthy any different than the right to an education?

At the end of the Frontline documentary, T. R. Reid brings up three elements that seem to make these other countries' healthcare systems work--setting prices, covering everyone, etc.--but I propose that there is a 4th element: the general consensus among the people that universal healthcare is a right and a necessity.  At the foundation of any debate on healthcare in these countries with universal coverage is the agreement that the system itself is not in question.  In other words, the debate is about how to make it work better, not whether or not it should exist.

We haven't yet gotten to that point in the U.S.  In the meantime, many people are one sickness away from becoming eternally in debt.  Thousands more aren't getting preventative care for diseases and conditions that will only worsen until they can no longer avoid going to the doctor, and by then the price will have multiplied exponentially.  All of this is hardly better for the economy than spending government funds on universal coverage. 

I ask those out there who are against universal coverage based on their economic philosophy to look at my situation.  I am a hard-working, motivated, young American.  I have faith that, if my health holds up, I'll be successful in the future, and I will be an asset to the struggling American economy.  Yet, it would only take one avoidable illness or accident to derail all of that and potentially put me in debt for years or decades to come.  It will effect my success and my ability to make money (and thus stimulate the economy). 

There are thousands more like me who face this same fate.  The truth is that both sides of the healthcare debate carry economic risks in their implementation.  Why not default to the side that would at least risk helping the most people?

 

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