by Stephen J. Fallon, Ph.D. -
Special to the SGN
Last week, when the Supreme Court upheld the Patient Protection and Affordable Care Act (ACA), I found myself in the perfect laboratory of national opinion - Atlanta's Hartsfield-Jackson Airport. As CNN announced the breaking news, passengers waiting for flights started speaking out:
'There goes the middle class,' groused a guy behind me.
'Now we know what we need to do - get that guy (President Obama) out of office,' snorted a woman sitting with her elderly mother.
'This is why our forefathers left England. It's socialism!' insisted a history-challenged senior.
Right now, more Americans have accepted Gay marriage than the ACA. What's behind this virulent hatred of national health care?
Now, I'm not saying that there aren't legitimate concerns about the ACA in its current form. We can have a good debate about the details of its roll-out. But first let's put some oft-heard arguments to rest.
'The U.S. has the best health care in the world.'
Not if you agree that health care should prevent untimely death. The U.S. is in eighth-to-last place in the industrialized world when it comes to life expectancy. The only relatively developed nations we outlive are the Czech Republic, Estonia, Hungary, Mexico, Poland, Slovakia, and Turkey. We rank dead last among highly industrialized nations. Not exactly what you would expect for the country with the 'best' health care.
'We just can't afford universal health care.'
We're already paying for universal health care - we're just not getting its benefits. The U.S. pays two-and-one-half times per person more for health care than the average for all other industrialized nations. Pre-existing condition exclusions block many Americans from getting health insurance, and high premiums block others. So, many of the 50 million uninsured Americans use the emergency room as their primary health care provider.
The average emergency room visit costs $1,318, or $1,565 for patients over age 45. Worse, by the time uninsured people get to the ER, their conditions are often much more costly to treat. For example, we spend more than any country in the world on hospital admissions for preventable diabetes. When patients can't pay, you and I are already picking up the tab through increased insurance premiums, and increased taxes as hospitals write off their losses.
'Well, we don't want to be like Canada, with its rationed health care, or socialist like France!'
Agreed - we're an innovative capitalist country. But since we're paying more and getting less for our health care dollar, just saying no to 'socialist Obamacare' isn't good enough. Let's borrow a better business model from one of the industrialized nations that has a successful health care system but stops short of universal coverage. Can you think of one? If you can, you must have gone back in time, because ever since Israel adopted its system in 1995, we're the only nation in the industrialized world that does not have universal health care.
That's right, it's not just Canada and France that have universal health care, but also Australia, Austria, Bahrain, Belgium, Brunei, Cyprus, Denmark, Finland, Germany, Greece, Hong Kong, Iceland, Ireland, Israel, Italy, Japan, Kuwait, Luxemburg, the Netherlands, New Zealand, Norway, Portugal, Singapore, South Korea, Spain, Sweden, Switzerland, the United Arab Emirates, and the United Kingdom. And they all pay less per person and live longer on average than we do.
Not a single American I've spoken to who is opposed to the ACA knew this most basic fact. Too often, they're getting their news from the same sort of polarizing instigators who also warn about the evil 'homosexual agenda.'
The truth is, we can't afford not to have universal health care. Among those employed, medical expenses are the number-one cause of household bankruptcies in the United States. You can sock away savings all your life, but when genetics, age, bad habits, or just plain bad luck brings a major medical issue to your home, all your financial reserves can vaporize in an instant.
So go ahead and call universal health care 'socialism.' I believe government has two core functions: defend the nation's people against enemy attack, and defend citizens from unnecessary death. No town buys its own tanks or jet fighters, and very few households can save up enough for a medical catastrophe. This is why societies have governments in the first place, not just socialist governments.
Take it from Mitt Romney, who supported an individual mandate to establish universal health care in 2006, 'Folks, if you can afford health care, then, gosh, you'd better go get it. Otherwise you're just passing on your expenses to someone else. That's not Republican, that's not Democratic, that's not Libertarian. That's just wrong.'
Sticking stubbornly to our broken, privatized model is just wrong.
Stephen Fallon is president of Skills4, a health care consulting firm that provides services to CDC- and HRSA-funded providers, primarily Gay- or minority-based agencies and clinics. Find out more at www.skills4.org.
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