Jingoistic Healthcare Myths, Part I

27 Jun

Of all the healthcare myths that drive me batshit mental (and there are a slew of them), the one currently at the top of the list says:

We have a great healthcare system. No one who needs emergency treatment is ever turned away from the ER!

What an idiotic statement, and what a low bar we set for “a great healthcare system”.

First, people are turned away from ERs all the time. Sometimes an ER will flat-out refuse to treat, as happened to some dialysis patients in Atlanta. And sometimes ERs triage people, then determine the patients probably aren’t that sick. Patients are then told that if they wait to be seen, they will be charged an extra sum of money. This is the norm in my own hometown. If the patient reasonably says, “But I’ve been puking my guts up for two days and have a 103F fever and am hallucinating! I need a doctor now!”, the patient will be directed to the local walk-in clinic/acute care center – a for-profit private physicians’ office where services were priced a la carte and there is no charity care.

Second, the fact that someone in extremis isn’t usually turned away from the ER is hardly indicative of a great healthcare system.Let’s clarify a few things on that score:

  • A great healthcare system is one where people who are chronically ill do not need to rely on the ER.
  • A great healthcare system allows people to obtain treatment before they need free ER care.
  • A great healthcare system doesn’t ruin the credit of people who need the emergency room.
  • A great healthcare system doesn’t force you to lose your house and/or car and/or savings before giving you health insurance to pay for the treatment of a devastating or long-term illness or injury.
  • A great healthcare system doesn’t dump poor, sick patients on the street.

My intended, a physician, once told me about a woman who came into the clinic where he was working. The woman had breast cancer. Sad, but not shocking. What was shocking is that due to insurance problems, this woman had waited so long that the cancer had broken through the skin.

That is symptomatic of a very bad healthcare system.

Third, a great healthcare system doesn’t allow health insurers to frame the “fight” as one of payment for providers vs. care for patients. If you follow the money trail, it’s insurance companies and their lackeys who are getting and keeping the majority of the money, who are behind the most vehement anti-universal-healthcare screeds and adverts, and who have the most to lose at the end of the day. Blue Cross CEOs pocket tens and hundreds of millions of dollars in annual compensation while member premiums are increased and benefits cut, and provider reimbursement is  slashed. And the CEOs are the ones with the private jets. It’s not you, me, or Doctor Smith who takes care of you and your kids. It’s the heads of so-called non-profit health insurance companies.

So what does America have, if not the best healthcare system in the world?

We have a clusterfuck. We have an embarrassment. We have what happens when entities with a shitload of money to lose manage to convince us to think in terms of “I” about a service that should be thought of in terms of “we”.

Canadians and Europeans talk about healthcare as a “we” thing; access to healthcare is something that benefits the whole of society, that they pay for as a social service, not a product, and use when they need. Several have bluntly said to me they were able to access national health when they had no money to pay because the taxes of others allowed them to do so; and now that they are working again they fully expect to pay their fair share to help others and ensure it’s there when others need it. That’s a novel thing for an American to hear. And that novelty is very sad.

Americans like to think that you can get anything if you work hard enough, that you should be able to “pull yourself up by your bootstraps” to get anything you need. But here are some facts, kids — You can’t pull yourself up by your bootstraps if your back is broken and your fingers have been chopped off. Someone should tell the “I”-thinkers that.

We don’t have the best healthcare system in the world. We’re not even in the top 10. We’re too busy being manipulated by the money spinners to realize that we’ve been had, like the bunch of rubes we are.

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