Several months ago the owner of a nearby store had a stroke. He was a young guy, believes he got it because of some medicine he took at the direction of his doctor. He and his wife, as business owners, didn’t have health insurance. Their medical costs are well over six figures.
So here’s a guy who’s doing his best to live the American dream. One sickness and it’s over. They’re trying to sell the business, which does OK.
The U.S. medical system works great for me. I have to pay a deductible and we’ve had enough work on our kids and me done that we have to make our payments over time, but it hasn’t bankrupted us. My prescription for my high blood pressure medicine costs $40 a month, and that’s the most we ever have to pay for drugs. We have insurance. For 40 million other Americans, that’s not the case.
Malcolm Gladwell, author of Blink and The Tipping Point, wrote a great story in The New Yorker in which he discusses U.S. healthcare.
A country that displays an almost ruthless commitment to efficiency and performance in every aspect of its economy — a country that switched to Japanese cars the moment they were more reliable, and to Chinese T-shirts the moment they were five cents cheaper — has loyally stuck with a health-care system that leaves its citizenry pulling out their teeth with pliers.
An interesting point is made in describing “Moral hazard,” which Gladwell describes thus:
“Moral hazard” is the term economists use to describe the fact that insurance can change the behavior of the person being insured. If your office gives you and your co-workers all the free Pepsi you want — if your employer, in effect, offers universal Pepsi insurance — you’ll drink more Pepsi than you would have otherwise.
But later he dismisses moral hazard when it comes to medicine.
We go to the doctor grudgingly, only because we’re sick. “Moral hazard is overblown,” the Princeton economist Uwe Reinhardt says. “You always hear that the demand for health care is unlimited. This is just not true. People who are very well insured, who are very rich, do you see them check into the hospital because it’s free? Do people really like to go to the doctor? Do they check into the hospital instead of playing golf?”
Well, no. I don’t.
However, at a blog entry on the Marginal Revolution Web site, the author makes several valid points. The one that struck the most was a response to Gladwell’s point just above. Perhaps the notion that more patients will abuse the system isn’t the issue. A bigger problem is doctors ordering tests that aren’t needed.
Those who argue for tort reform claim doctors do this because they’re afraid if they don’t they’ll get sued. Another problem, however, would suggest doctors aren’t doing too many tests under the current system, they aren’t doing enough. Administrators dictate what can and can’t be insured and what doctors can and cannot do. In the case of a Bainbridge Island cancer patient I wrote about earlier this year, the reason she had been able to get care at all is because she left the managed care her provider offered and found a doctor not only willing to try different things, he’s good at helping get insurance companies to cover what he’s prescribing.
And on the other side of the border, Canadians have a healthcare system I’ve heard Americans love to criticize. It has problems. It needs more money. But here’s the thing. I’ve never met a Canadian who would trade their system for ours. And I’ve met plenty of Americans who would be glad to make the exchange.
The Kitsap Sun