Note: although “In Search of Wisdom” was designed to be apolitical, many of the issues involved are burdened with political considerations. Can’t be helped!

The chart below was taken from National Geographic Magazine a few months ago. It makes it clear that the United States is far behind other countries in the way we manage health care. It shows three aspects: average life expectancy, average per capita costs, and the average number of doctor visits per year. One can see that the United States in 2009 spent more than 2.8 times as much per person as Japan; we were only one of t

wo countries without universal health care -- the other being Mexico (in red) -- and our life expectancy was  a full five years shorter than Japan’s. The average person in Japan sees the doctor more than 12 times a year, whereas in the US it’s less than four visits per year. And yet I see almost no discussion in the press or the Congress of these and similar data. Why aren’t we over there in Japan studying how they do it?

I would guess that a lot of it has to do with our stupid American Exceptionalism: we just know we’re better than everyone else, -- except for one small consideration: We are not.

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Comments

[NB: The contribution below was written several years ago, but is just as pertinent today, especially since the Congress of the US is entering debates on the budget that will deeply affect our health care system for future generations. It is from our son, Chris]

I would like to share a story with you that has implications regarding the current debate about health care reform.  Over the summer, my mother-in-law had her first hospitalization in the entire 77 years of her life.  She has been an upstanding, valuable, productive member of our community for three generations, supporting not only her own children but also her grandchildren through her tireless but meagerly rewarded efforts as a seamstress.  She is poor and widowed, and although she has toiled all her life, she has always used what earnings she has made to help support others.  She has also been very hardy and self-sufficient, exercising regularly and eating well.  

After several visits with her primary care physician, she was hospitalized for a difficult and unresponsive urinary tract infection.  Bad luck struck her with a severe allergic reaction to one of the antibiotics being used, and she ended up with a rare disorder known as Stevens-Johnson Syndrome.  Though relatively rare, this syndrome has been known to strike unexpectedly and seemingly randomly from allergic reactions to foods or medicines even as common as ibuprofen, even when the victim may have consumed the substance regularly in the past with no negative effect whatsoever.  The results can be catastrophic, even fatal.  Typically, the outer layer of skin dies, turns black, and peels off the patient, leaving him or her exposed and vulnerable to infection from the environment.  The effect is similar to having a full-body second degree burn.  Sometimes the patient is left blind or with other lasting impacts.  In Lily's case, she was lucky to escape with "only" some hearing loss.  Now, three months after her initial hospitalization, she is on the road to recovery faster than her doctors had anticipated, due in no small part to her general ruddy disposition. [See note below]

Needless to say, it has been a stressful time.  Even from inside her plastic tent in the ICU, she worried aloud about how much her treatment was costing and how in the world she would ever find a way to pay for it.  Fortunately for her, I could inform her that she has been covered by not one, but two forms of public health insurance:  Medicare, and MassHealth, the public plan that has been set up by the state of Massachusetts to cover people like her who could not afford private insurance.   Just imagine what could have happened otherwise!  Likely she would have died a very painful death by now, abandoned in her time of need by a health system that cared less for her well-being than for her money.  Personally, I feel proud to live in a state that has instituted universal health coverage.  And although it is not a perfect system, I am also proud to pay taxes to support it.  What has happened to Lily could happen to any of us at any time with no warning.  What would you do?  

Every other industrialized nation has understood that some socialization of healthcare makes sense and ultimately saves money and lives at the same time.  The idea of private capitalization on people's health as a business model ensures that the population that needs it the most will benefit the least, but pay the most.  I find it ironic that those that were eager to jump all over candidate Obama for being a "redistributionist" will fight just as hard to protect the interests of the insurance lobby.  What is insurance if not redistribution of wealth?  The difference, of course, is that private insurance companies answer first to the interests of their shareholders.  A public insurance policy would answer first to the healthcare customer.   I'm also concerned about the myopic view driving much of the healthcare debate about how costs are allocated.  Currently, the uninsured and underinsured cost the taxpayer more than they would if they were insured under a public plan.   When people live outside of the health system, it guarantees that they will enter it only when faced with an emergency, and usually via the emergency room, by which time treatment is at its most expensive and generally still gets paid one way or another by society at large.  Despite our dearly beloved heritage of rugged American individualism, we still must function as a society, and being part of a society demands that we help each other out when in time of need.  I also find it ironic that there are many in our society who would proudly trust our government to protect our way of life with their children serving in our armed forces and expect society to pay for that through taxation, but in the same breath accuse the government of over-reaching and being "un-American" when it considers helping to protect its own citizens' health through the same system of taxation.  The old adage, "It takes a village..." still applies today, no matter how big the village.

Sincerely,

Chris Fitch

Arlington, MA 

        3/15/2013

Note: Today Lily’s hair, which was white, has naturally returned to black. She is back at work as an independent seamstress, contributing to the community and to the economy. She has a close circle of friends and is fully enjoying life.    rmf

        6/6/13