I worry a lot about the state of health care in the US. The system we have now is unsatisfactory and unsustainable. And access to health care is so vital. But I don’t see a solution coming any time soon.
The most common argument offered against the US moving to a system of universal health care (whether it is “Medicare For All” or whatever) is that it will be a “government takeover” of our health care. It will “give the power and control over health care decisions to the bureaucrats in Washington DC.”
The idea that “The Government” is going to be making your medical decisions is supposed to scare the hell out of you. It’s supposed to conjure up images of some bureaucrat in a cheap suit sitting in a nondescript office in Washington writing prescriptions and deciding whether or not Grandpa gets to have his chemotherapy this week. OMG “Death Panels!” The Democrats want to turn us into Venezuela! This is a typical scare tactic by conservatives and the CEOs of multinational corporations who think that our money works better when its in their bank accounts. “The Government is the enemy! Be afraid!” We’ve heard it all before: in the 90s they wanted to privatize Social Security. Then it was Charter Schools. And then privatizing roads and bridges all over the country. In the US, we’ve been trained over the last 40 years to believe that the Free Market is our friend and that The Government is our enemy. And we’re convinced. Because a fear of The Government plays nicely off of our historical enmity of Communism and fear of its “political twin” Socialism.
And if a government takeover of our health care system is bad, then the system we have now must be good, right? Because the implicit assumption is that our current system gives We The Patients, in consultation with our doctors, total control over our health care decisions. We sit down with our doctor, decide what’s best for us, and off we go on the Road to Better Health. But that’s pure rubbish. And anyone who has ever had anything to do with what passes for “health care” in this country knows it. The real people in charge of our medical decisions are the insurance companies.
I should know. When I was diagnosed with a serious, chronic, degenerative disease five years ago, my husband and I sat down with my doctor to discuss the treatment options. We weighed all the factors including the potential outcomes, the side effects, how long and how widely each drug had been in use, the clinical trials and real world outcomes, and the delivery methods (such as frequency, dosage, and pills vs. injections) for the various drugs. And we came to a decision that Drug X would be the best option for me. And off I went on the Road to Better Health, right?
Wrong. My insurance company would not cover Drug X. Since the cost to me without coverage would be in the tens of thousands of dollars per month, that was obviously not an option.
So we reconsidered and decided on a second choice, Drug Y. (In fact, it was not really a “second choice.” It was, more accurately, an “only choice.” Because Drug Y was only drug the insurance company would cover.) And so I started taking Drug Y. And fortunately it’s worked out okay for me so far. But after several years of relative success on Drug Y, I have now been informed by my insurance company that they are dropping coverage for it. The only treatment option for me now is Drug Z, a generic form of Drug Y, which has only recently been approved. There have been no clinical trials on humans for Drug Z, and although the manufacturer claims that it is “chemically equivalent” to Drug Y, in fact it is NOT. My doctor, a very well-respected specialist in the field, does not recommend the switch to Drug Z. Moreover, the dosage and delivery is much worse than Drug Y. But given the price without insurance coverage, there is absolutely nothing I can do about it. The fact is, it’s my insurance company who is prescribing my meds.
How can anyone honestly claim that medical decisions are between a patient and their doctor under our current health care system? There is absolutely no truth to that statement whatsoever. The only entity that has any meaningful say in my treatment options is the insurance company. And the only thing that matters to my insurance company is profit.
The fact is, given a choice, I’d rather have my life-and-death decisions made by a bureaucrat who isn’t basing all of their decisions on what will deliver the most profit to shareholders. And if the experience of every developed country in the world is any indication, it would deliver much better results at a much lower cost than the system we have in the US right now.
So next time someone tries to sell you on the line that a “government takeover” of our health care system would be bad, maybe ask yourself if the system we have now is actually any better. It’s not.