Wednesday, August 20, 2014

A Serious Question . . . and a Correct Answer

For the first time in the over four years--can you believe that?--I've been doing this blog, I'm going to reproduce something off the Net in its entirety. The site is Quora. I find myself there often because it habitually addresses interesting questions, and sometimes they are interesting and important questions, like the one below.

I've long contended that part of our problem in America is our national character, which is the cause of so much self-congratulation, but in fact is seriously flawed. The following answer makes this clear. Not only is our character flawed, but we are ignorant . . . which makes it worse.

Why do Americans seem to be so scared of a European/Canadian style of healthcare system?

Dan MunroDan Munro, knows some healthcare stuff

The fear is largely fueled by four things.

1.      A false assumption (with big political support) that a system based on universal coverage is the same thing as a single payer system. It isn't. Germany is a great example of a healthcare system with universal coverage and multi-payer (many of which are private insurance companies). We tend to lump the two together (single-payer and universal health coverage) because it’s convenient to argue a simple comparison than a more complex, nuanced one.

2.     A fear of "rationing" - which was set ablaze by Sarah Palin and her cavalier remarks about "death panels." The reality is that ALL healthcare (globally) is rationed - but systems from all the other industrialized countries start with “universal coverage”. Our system is largely based on who can afford to BUY health insurance - and if it's provided through employment (about 150 million Americans) you're chained to your employer for health benefits. It's artificial, but it's a great way to keep wages depressed because the employer is contributing to health benefits and getting a tax benefit at the same time. In other countries – employers make a contribution to the healthcare system – but those contributions accrue to the whole healthcare system – not just their employees.

3.     An attitude and culture of what's loosely known as American Exceptional-ism. There is simply no other country on planet earth that can teach us anything. This was highlighted recently by Commonwealth Fund report which ranked the U.S. “dead last” in comparison to 10 other countries. Our entire raison d'ĂȘtre is to be the world's beacon of shining success - in freedom, liberty, democracy and really everything (but especially technology).

4.     A fierce independence that has a really dark side. It took another Quora question to really help me see this one. The question was: "Why do many Americans think that healthcare is not a right for its own taxpaying citizens?" Here's the #1 answer by Anon:
The fundamental mythos of American culture, is that no matter how poor or humble your birth, you can through grit, spunk and hard work become wealthy and prosperous.

On the face of it, and from the perspective of a class divided Europe, that seems incredibly noble and empowering. The idea that there is that much social mobility, that anyone can forge their own destiny is a powerful part of the American psyche. When it happens, it is an incredible thing. Something Americans can feel proud of.

However, there is a dark side to this mythos. Which is this ... if anyone can win through hard work and effort, anyone who doesn't win, therefore deserves to be poor.

At the core of all the anti-health care reforms is the single concept "why should I pay for the healthcare of those losers?"
Added together, these 4 things all contribute mightily to the runaway healthcare system we have today. Today - the National Healthcare Expenditure (NHE) for the USA is $3.5+ trillion per year (about 18% of our GDP) and it's growing at about 5% per year (for as far as the eye can see). The system we have is optimized around revenue and profits - not safety and quality. That safety and quality is best highlighted by what’s known as “preventable medical errors” inside hospitals. That number? Somewhere between 210,000 and 440,000 – per year.
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