Imagine you are a prisoner. You wake up every morning and live in a cell. You can’t go where you want when you want and everything in your life is controlled by others. Now imagine you had a stroke and you can’t move the left side of your body. Which would you prefer?
Would you change your mind if you knew that you had great insurance when you had the stroke?
I didn’t think you would.
This illustrates most starkly how crazy the discussion about health care in the USA is.
We have now had both major parties take a crack at the US health care system in the last decade. Both had the presidency and majorities in both houses of Congress when they made their plans. Both had a chance to really focus on the scientific consensus of what is wrong with most Americans. Both failed miserably.
The Affordable Care Act (ACA), the first failure, was passed in 2010. Death rates went up as more people got coverage. While not directly causing it, the ACA did nothing to stem the crisis of opioid use, an epidemic that is destroying and cutting short tens of thousands of lives a year.
This is because the ACA was not about making Americans healthier, it was about making sure insurance companies and hospitals followed its new regulations.
It’s no surprise that there is broad dissatisfaction with its details.
As misguided as it was, the ACA accomplished a few things that were beneficial. Among them, it allowed people to purchase insurance without being discriminated against for having had a toenail infection a decade previously or a single abnormal lab test. It also attempted to make Medicaid into more of a safety net for people with low incomes.
For this reason, the ACA was slightly better than the horrifying non-system hodgepodge of regulations that existed before it was passed.
Yet even with the ACA, people were spending thousands of dollars a month to get “insurance” that paid for only a tiny percentage of their non-catastrophic medical costs. They were slightly less likely to go bankrupt, but medical costs remain the most common cause of bankruptcy in the US three years after the ACA was fully in effect.
These problems with the ACA created discontent and a second attempt was made recently. The alternative chose to gut the two provisions of the ACA that were actually beneficial.
This plan would have created more medical bankruptcies, left people even more on the hook for their own routine expenses while paying as much or more for insurance. On balance it is probably a good thing it failed, but that leaves us where we were before. With a system that doesn’t create any true benefits for patients.
Why did neither side put forward a plan that would change how often people get sick?
The purpose of a health care system should be to make people have better health. This means a proper health care system would do its best to keep people from ever needing to use the system because they are ill.
Our current health care system’s purpose is to generate revenue. If you doubt this, read An American Sickness by Elizabeth Rosenthal. Dr. Rosenthal talks about the strong industries and how they lobby Congress to get the rules changed to benefit them. She echoes many of the complaints that doctors who practice medicine focusing on lifestyle have been making for years. There simply is no institutional interest in keeping people from getting sick.
My country spends nearly a trillion dollars on healthcare every year. A tiny fraction of that money, let’s say two billion dollars, could be spent to convince the public that lifestyle changes work to prevent disease. Add another two billion to subsidize those behaviors and pay for the whole thing with an increase in taxes on sugar, nicotine and alcohol (all things nobody thinks people should consume more of). Nobody suggests this. The health care industry isn’t interested in it. They make more money when chronic disease rates go up.
I’m left shaking my head. Both sides have had a crack at the system. Both sides did nothing to help Americans get healthy or avoid medical expenses causing bankruptcy.
So you are on your own at the moment. Not being sick benefits you far more than any insurance package can. Fix your own health. Exercise regularly. Don’t smoke or drink. Add as much whole plant food to your diet as you can, removing processed foods, oils and animal products to the degree you can.
If what you are doing isn’t working, try lifestyle changes first, prior to using pills or surgeries to fix problems that may not need them.