No More False Dichotomies: Healthcare: commodity or basic human right?

In the fascinating and timely PBS Frontline program “Sick Around the World,” which aired last week,
T.R. Reid, a foreign correspondent for The Wash-ington Post and an NPR commentator, asks the same simple question of each main source: How many personal bankruptcies in your country result from a health crisis?

Each time, the person answering looks perplexed. It just doesn’t happen. “It would be a disgrace,” says one. Nor do the citizens of the five capitalist democracies that Reid visited — Japan, England, Germany, Switzerland and Taiwan — receive bills for medical services. Each country spends drastically less on healthcare than we do in the United States, with wildly better health statistics to show for it.

That’s right — other countries have solved this dilemma, or at least found a workable middle ground. None of the systems are perfect, but they all seem to provide something fundamental to human health and dignity.

But not the United States, not yet. It’s not going to happen here until we surmount our blind fear of “socialized medicine,” which we seem to equate to worshiping at Mao’s grave three times a day.

That very term is part of the problem. A classic definition of socialized medicine means it would be run solely by the government. Think Cuba or Afghanistan.

But that’s not what happens in the five countries that Reid visited. They all have something more accurately described as social insurance systems — they socialize the financial risk of getting sick — but the providers are typically a mix of public and private. And in each country, while citizens may pay a bit out of pocket, insurance companies can’t make unfettered profit, they can’t cherry-pick patients and they can’t turn you down for a pre-existing condition.

The healthcare issue has festered in our country for a while now, and there is little to suggest we’re headed for the sort of change we really require to end this national disgrace. But now does seem to be a key time; as the 2008 presidential election looms, poll after poll shows that Americans rate healthcare as one of their three key issues.

Unfortunately, none of the three major candidates is preaching the sort of drastic change we need; Hillary Clinton and Barack Obama hint at it but don’t go nearly far enough, while John McCain seems to think the system will right itself if we just feather the nest of unfettered capitalism a bit more.
We need to keep pushing these folks.

I spoke to U.S. Sen. Dick Durbin (D-Ill.) last week when he was in New Albany to stump for Obama, and asked him why the United States can’t find its way to something more like those nations featured in Reid’s report.

“Because the current healthcare system in America rewards so many providers,” he told me. “It is so profitable for insurance companies, pharmaceutical companies, technology companies and many specialists. They’re making a fortune off the current system, and they don’t want to change it. ?We have to step back and say, ‘Our goal isn’t making a few companies and a few people profits, our goal is making America healthier with affordable and accessible healthcare.’ That means taking them on.”
This is a moral issue, and no doubt a huge challenge. But as “Sick Around the World” suggests, there are solid examples that we can look to, and then figure out what works best for us.

To those who invoke that thickheaded knee-jerk reaction about why I don’t just leave the United States if I dislike it so much, I say that is a false dichotomy. Get over yourself — it’s not as if Americans have a monopoly on ideas. As Reid points out, we borrowed text messaging from the Finns, sushi from the Japanese and “American Idol” from the Brits. Those things are entrenched now.

To those who understand we are in crisis but feel overwhelmed by conflicting versions of reality, I say join the crowd, then get busy. Hit the website (; search for “Sick Around the World”) and spend some time reading (you can watch the whole show online). Arm yourself with facts. Ask questions. Demand answers. Talk about it with your friends.

Above all, ask yourself this: Is healthcare a basic human right or just another commodity? How much better would our lives be if we simply didn’t have to worry about losing everything over a health problem?

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