I went to an immediate care clinic a few days ago because my cough and breathing were not getting better and my physician’s office was closed. I had been to this clinic before – wasting an hour of their time trying to get my insurance carrier to cover the inoculation my physician had prescribed. We had spent 45 minutes on the phone with the insurance company before being told it could not be done that way.
The nurse practitioner I saw the other day and I were chatting as she filled out the innumerable computer forms & questions, pages and page long. We found that we agreed that the health care system in the US is broken and inefficient given the amount of money spent on health care. She had a problem with people on the lower socio-economic levels wanting free care. “Would they expect free milk from a supermarket” she asked. I pointed out that the administrative costs for corporate run health care is much higher than the administrative costs of VA, Medicare or other publicly funded systems. I then made a brief mention of missing the efficiency and coverage I found in the Ontario Health Insurance Program when I lived in Canada for 2 years. Despite what I hear from the republican side of the political debates I found the Canadian system to be adept at giving acute services when needed. Elective tests and procedures took a bit longer to schedule but not unduly so. And there are no multimillion dollar executives that have to get paid out of the limited pool of health care dollars.
I expected that I was going to get a bit of blow back from this former career Army nurse. But she was inquisitive about my experience. Were the taxes not higher she asked. Yes, but there were no co-pays for medical care or for other public services. “People either love it or hate it” she said. Some find a single payer system with some access restrictions a great system, but others hitting up against the same restrictions want the more open system we have in the US where if you want it and can pay for it you most likely can get it.
The problems it seems in either system come up for people when they cannot access the care they need or are not able to afford the care that is available. We are at an impass because as a society we cannot agree on an answer to the question “Is health care a commodity to be purchased by those who need it – or is it a responsibility of a society to provide basic care to all? And what constitutes basic care?”
Health care came into being as a workplace benefit provided more widely in the WWII era as an inducement to work for one company rather than another when labor was scarce. It supplemented hourly pay and other benefits. Health care was more basic with fewer ultra-modern machines, drugs, tests and surgical procedures. Thus people died younger accruing fewer long term costs. Health care costs consumed a lesser percentage of annual income so that people could pay more of the cost themselves and relied less on insurance coverage.
The liberal side of this divide generally does not want to admit that we cannot have a health care system that can provide health care for all without restrictions on what kind of care is given. The conservatives with their agenda of lowering all taxes and reducing the size and power of government will not recognize that the US is one of the few developed nations of the world which does not provide basic health care to its citizens and that this added health care cost in business helps to make us less competitive in the world market.
We did not reach an answer to the problem in that in-store clinic But it was nice to be able to talk about it without rancor, raised voices or accusation of duplicity we are hearing in the on-going political debates. We will not find a satisfactory answer by yelling at one another. It is only when we sit down and collaborate to find a workable solution. No one will get everything they want but we might find that we could put more effort at addressing the problem if we stop spending so much energy demonizing those who have a different answer or point of view.
What if we started to ask what it would take to satisfy the objections of those who do not like our ideas? Of taking their objections seriously enough to ask them to suggest ways to accomplish what we all say we want – a system of care that is effective, and efficient ,while at the same time being affordable. We won’t get it all or all at once but we can begin to get more of what we want. But getting close is still a good thing. But it requires working together and unfortunately that does not seem to play well in the congress, the statehouse or even in the council chambers of most municipalities. There are NO easy answers but certainly it should worth the work for average citizens to start demanding we find solutions rather than just blame others for the problems.