People are stunned when they hear me say I’m in favor of socialized medicine. Their opening argument is usually that there would be long waits. I just wish people who made this argument would follow it to its logical conclusion. If socializing medicine would lead to longer waits for care that could only be because a percentage of people in this country aren’t getting care under the current system. No one gets an appendectomy just because they might as well since they can. The only people receiving treatment for illnesses are ill. That won’t change. So IF (and that’s a giant IF) those people are right about the waits, that’s a sign the current system is failing. So who is it failing for?
The sick. The strangest group to pick on because it could be any one of us tomorrow, but we’re not picking on them directly, we’re just entrenched in a system that screws them over. Which most of us don’t even realize is happening. Most people contribute a substantial but affordable amount from their paychecks for insurance through work, or they look into private insurance and decide if it’s affordable or if they’d be better off crossing their fingers. Few people have insurance that won’t surprise them with huge financial strain when they need it and even fewer of those are able to maintain that insurance when they’re sick and start missing work.
Healthcare can be potentially expensive, even before costs in this country skyrocketed, that’s why health insurance exists, because you need a pool of people contributing for the minority of people who end up drawing from that pool when something happens to them. (it’s the same philosophy we use with car insurance.) But the goal of health insurance companies is to profit. So they’ve sneaked as much payment as possible onto the people who end up needing healthcare. And they eliminated offering insurance to people with a history of needing care. I’m not sure if people who haven’t been victimized by the pre-existing condition invention of insurance companies fully understand that. They eliminated offering insurance to people with a history of needing care by pricing them out of any chance to have it. I had gotten off my parents’ insurance and got a packet for private insurance. I wish I’d saved it, but I have a good memory of it because of the emotional punch of that moment when I looked at the first page and saw a list of about twenty ailments, these were general things like do you have HIV, have you ever had a heart attack, are you diabetic, etc. if so refer to a different page. Well, what I had was on there, which I was pretty sure was not going to be good. But I called. I was still entitled to insurance, but I would go into a separate pool of people and our premiums would be eighteen hundred dollars a month.
I was seventeen years old when a neurologist told me to get a job with a big company because a small company wouldn’t be able to afford to insure me. I decided I wasn’t going to spend my life worrying about being insured, which turned out to be a good decision. I moved around a bit. I lived with a feeling of freedom. I got lucky. I’ve always had insurance through work when something happened. I had insurance when I was sitting in the waiting room of a neurology clinic, and a woman turned to those of us waiting, she didn’t exactly make a scene, but she said fairly loudly, “I guess if you don’t have insurance, they don’t want to help you.” And she left. She left a neurology clinic having been refused treatment. She wasn’t trying to see her family doctor about a case of the flu that wouldn’t go away. Something was wrong with her brain. That was several years ago, and I still wish I’d stood up and offered some agreement as she was leaving. Who knows what happened to her? Hospitals are required to give emergency life-saving care to anyone who shows up and needs it, but that’s not the same as the kind of care that will actually save your life.
That might have been the same visit, it was definitely around the same time, when I came in for a follow up visit after surgery, and I’d been having headaches. The headaches had me scared already, but when I told my doctor and he immediately wanted to get me scanned, I was terrified. They had brain scanners right in the building, so I was waiting and waiting, thinking I might drop dead any minute (admittedly an over dramatic thought, but that’s how it feels when something might be wrong with your brain). I waited so long, my neurosurgeon passed by and asked if I’d gotten that scan yet. He went to find out what was taking so long. You can imagine what his impatience did for my worry. Turned out my insurance company had refused to cover the scan. It eventually got straightened out, I got my scan an hour later and there was nothing wrong. But how many times is that scenario and scenarios like it playing out across the country and it doesn’t get straightened out? How many fatalities have been caused?
I also have the unfortunate habit of waking up with headaches, barely conscious enough to get to the phone, and instead of dialing 911, I call my mom, because I’ve learned, even with insurance, how expensive ambulance rides can be. And if you’re thinking, well that’s dumb, you’re exactly right, but you also probably don’t know how devastating it feels to be trying to focus on recovering from surgery and getting bombarded with bills. I’m not alone. A twenty-something-year-old in Seattle died in a cab on his way to the emergency room. Another twenty-something-year-old without insurance went to the emergency room with a toothache and they offered him either antibiotics or pain killers, well by then he was in so much pain he chose the pain killers and he died when the infection reached his brain. All over the country people are risking their lives to avoid medical debt. But anecdotes aren’t arguments. If I start listing anecdotes, the opposing side will start talking about Canadians who come to America for healthcare. Well, who knows for what reasons a small number of people come here for care instead of their home countries, but one thing’s for sure, they’re rich, or they wouldn’t have a chance of getting appointments with our neurosurgeons.
Good care is available in this country but people are being excluded from receiving it. All the things people are terrified will start happening if the government is in charge of healthcare are already happening to people. Insurance companies will deny cancer patients further chemotherapy because their tables say it’s not likely enough to save their life. But rather than argue these specific cases of our flawed current system and the validity of our fears of an unknown future system, let’s take a step back and just think about what we want to do. Every first-world country in the world uses some form of the single-payer healthcare system. We don’t have to follow any other country’s exact example. The money is going to stay the same. It’s just going to go to different places. Imagine how much more competitive the auto industry would be if it didn’t have to insure all its employees, imagine how much cheaper cars would be. Taxes would go up but insurance premiums would go away. There might be a rip in the market but it would all be temporary. A hundred years from now people would tell stories about how America was the only country that still hadn’t gone over to socialized medicine. And people will wonder how it worked before that, and the answer would be not very well. People will say we were smart to change over, and they’ll be amazed how narrowly we were able to accomplish it.
This is not intended as a defense of The Affordable Care Act, which is not socialized medicine. Obviously it’s not a coincidence that I’m posting it while our government has shut down over a refusal to fund that law. Anyone who knows me well knows I’m a proponent of socialized medicine and have been for years. It’s not something I like to discuss online, but I’ve reached a point where I feel a responsibility to add my opinion and story to the mix. I am a proponent of The Affordable Care Act, which has become universally known as Obamacare. From what I understand it accomplishes three important things. It eliminates pre-existing conditions as a way for insurance companies to screen out ill people and virtually refuse to insure them by pricing them out. It forces all Americans to have insurance. (And the argument that this is an impingement on freedom doesn’t work. We live in a country where if you drop unconscious on the street, emergency services will pick you up and put you in a hospital and care for you until you’re better. So arguing that you should have the freedom to not pay anything into a system that will do that, is a financial impingement on everyone else who is.) And it subsidizes insurance for people too poor to afford it. In my opinion these are all good things.