WONDER WHY
In the not too distant past, a colleague was taken to the Emergency Room at a local hospital. It was all about a kidney stone. Painful indeed but not life threatening. While sitting in the waiting area after check in and initial triage, he observed an interesting phenomenon – one not unusual by any means – of people coming in to the ER with what seemed to be rather NOT ER conditions. Mostly they were young couples with a very young child who was being bothered by some malady or simple injury. Of course, one of the first questions asked in the process was about their insurance status and many of them had no insurance coverage at all and, while an ER is obliged to accept patients who come to them for treatment, one had to wonder why come there rather than an area Urgent Care or even a Family physician. The answer was simple. They could not afford medical insurance.
About that time, my colleague was called for treatment and was ushered back to another part of the ER and his treatment began. Now, to clarify here – he did have insurance – general coverage as well as emergency medical coverage so there was no concern here. At least, not at that point.Treatment completed, pain eased, follow up suggested. Hours later, time to exit and go home.
And then the proverbial you know what hit the fan. Sifting through the mail, my colleague found an invoice from a specialty medical group of some sort. Not recognizing it, but noting that it was a medical invoice, he opened it and found an invoice for over nine thousand dollars – yes, that’s $9,000. It was for medical services rendered at the Emergency Room at the hospital where he was treated a while back. Must be a mistake, he mused and then contacted his insurance carrier. What came out of that discussion was concerning. The insurance carrier acknowledged the invoice but reported that, while they had a contract with the hospital, they did not have a contract with the Emergency Room – a fact which revealed that Emergency Rooms are not necessarily part of the hospital in which they operate. Makes one wonder just how all this impacts on most people. Hospitals, Urgent Care and Emergency rooms are the site of usually serious medical situations. Costs for treatments are most often covered by insurance policies, though, as we have seen, not always. There are issues around networks and contracts with providers and geographical locations and the like.
Accessing medical care here in the United States is not quite as readily available as one might think . Considering the United States is one of the wealthiest nations in the world, one would think access to medical care and coverage for its costs would be high on the national agenda. Unfortunately, this is simply not the case. While the passage of the Affordable Care Act did relieve some of this issue, it was incomplete from the start, thanks to the GOP blocking significant elements in the Act. It still functions to this day but it is a constant fight with the far right MAGA republicans as they chip away at the ACA provisions , their agenda for that being the topic for another time.
What is the more underlying question remains being why this, as one of the wealthiest nations in the world, does not have a more universal coverage mode of health care. In fact, the cost of health care to the consumer in the U S is one of the highest in the world, averaging over $13,000 per person. By comparison, the average cost in most other wealthy countries is less than half of that.
In the U S, the well off can afford medical coverage. Those below a certain income level also have opportunities through Medicaid. It is the millions of people in the middle that have to contend with those high costs. Many people do have coverage through their employer but it is not free and a chunk of their wage is deducted in order to participate in those plans. It is the part time wage earner that gets hit the hardest and , again, as the ACA does help many, there are still major costs associated with medical coverage.
Here is where it gets interesting. Most of the industrialized countries around the globe have what we title Universal Medical Coverage provided “ free ”. OK, it is paid for in various modes, usually through taxes and government contributions, but consider the alternative. Clear thinking people would much rather pay a higher tax level than have to pay high medical costs, especially costs for catastrophic medical events which would certainly exceed their tax burden for coverage.
So, the question remains, why or better still, WHY, or better, WHY NOT.
Sadly, while there are several factors working here, there are, we submit two stand out. One is the failure of congress and legislatures on the state level to take requisite action to make it happen. The overwhelming reason there is the highly successful lobbying efforts conducted by, for example, the pharmaceutical companies. The other is the concept of profit margins being more of a priority than the health of the nation’s people It is time to rein in corporate America and bring it around to adjusting their business strategies.
It is time for working partnerships between government and corporate interests. Now I know that to some this may sound like socialized medicine and a case may be made for that. However, while one can still be alright with capitalism and still move toward this goal. It is the unfettered capitalism at the expense of the populace that is destructive and needs to be checked.
It is time to take aggressive legislative action and implement what every other industrialized nation has already done. In taking a serious look at tax code revisions, cost analysis and other factors and come to realize that the insane amount of the cost of health care in this country must be brought under control and in such a way that all benefit with access to quality health care across the board.