Is this a special case or are healthcare costs generally this high in America?
Yes they are ridiculously high, even after factoring in cost of living / currency rates or as a %age of monthly salary, if you are comparing it to costs in a different country. 1 month after coming here (to America) from India (1999) I had to get wax from my left ear cleaned as it was blocking my hearing.
They squirted some liquid in my ear and got the wax out. 2 weeks later, I got the insurance Statement. It cost $ 800. I was astonished. In India a year before, I'd paid a Doc 100 Rupees (at that time, $2 equivalent in USD) for the same exact thing.
A month later, I had a chest x-ray taken, and some weird quirk in insurance it wasn't covered. So I had to boot the bill. $ 576 for 1 single chest x-ray. My take home at that time as a software engineer was about 2500 / month after tax and deductions, so this was 23% of my paycheck!
Health Insurance coverage is too closely tied to employment. In order to get continued coverage, you are more or less working "for the man" till you die.
Well, that's just a rip-off price.
>Health Insurance coverage is too closely tied to employment. In order to get continued coverage, you are more or less working "for the man" till you die.
At age 65, you can enter the single-payer system!
The first one is the right to an informed choice, including information upfront about the price of treatments.
So people on one side of the fence are not happy about the very high medical costs required to keep a child alive. They do not understand the humanity behind the numbers.
On the other side of the fence are parents who are not happy that some people think their child is an excessive burden on the system. They (understandably) do not understand (or at the least, are looking away from) the numbers behind making their child viable.
The author correctly identifies one side's shortcoming wrt balanced discourse, but does not see the blindness of her own implied position -- that no cost is too high to save a life. Nowhere in this piece does she broach the subject of numbers and real cost [1].
Finding balance is very difficult in any area, especially in areas where you only have _one shot_ (an example is your child's education, where many parents feel that no amount of investment is enough, and more is always better). But since the system does not have infinite resources, it's a necessary conversation to have (which the author could have brought up, but failed to do so -- understandably, since this article is a strategic opinion piece meant to further the author's self-interest, which I completely respect).
A billion dollars to save a child's life, we would likely agree, is too much. $1,000, we would likely agree, is entirely justified. Where we draw the line, why, and how we get there (of urgent need is our relationship with end of life care and treatments) is an important conversation that we are failing to have, and those of us on both sides of the fence are equally culpable for this shortcoming.
[1] The large 6 figure bill and post insurance $500 bill is only used qualitatively in the introduction.
Hopefully you see why your argument is disingenuous. If you're really so hard on hypocrisy, you should go out right now and give every last penny to someone else's medical expenses. Or are you only generous enough to spend other people's money?
The idea is that if everyone gives a small amount, then a large amount becomes available those unfortunate few that need it.
Sure, when I go to the emergency with my child and his swollen ankle, I get charged 28€ (IIRC), which later get reinbursed. This is the highest medical bill I can think of (except dental and optical). A 100,000€ bill would not appear anywhere.
In addition, Boston Children's Hospital is one of the premier hospitals in the world. Given the specialized nature of the problem and the fact that heterotaxy cases are pretty rare, even without insurance, the chances are high that the child would still have been treated and the hospital would have eaten the cost.
Thus, pre/post/no Obamacare, the child still would have had the treatment. Thus, you cannot derive a political position from this case.
However, if we examine the author's motives, she seeks a society where any child who shares her son's ailment (or other life threatening but treatable -- albeit expensively -- diseases) can receive treatment, whether or not they share her fortunate circumstances or not.
In that light her rhetorical strategy remains reasonable.
It doesn't make economic sense to spend, as an extreme example, $500M of public money to save one life. If we did whatever medical treatments we could, at whatever cost, we'd go broke as a society very quickly.
Utilitarian optimization places some upper bound on the amount of money we should be willing to spend to save a life. Making people pay for their own care approximates this bound but with more variance.
Your statement illustrates one of two competing views. The following statements are extremes of the two positions.
1) The government by default owns all your money, and any money you get to keep after taxes is just a tax break.
2) You own your money by default, and the government should not take your money except to provide things that the market is unable to (some examples of which are law enforcement, military).
Those who espouse one of these views, tend to see people who espouse the other as morally wrong and evil.
60% of Americans want single payer [2].
"A majority of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. And a growing share now supports a “single payer” approach to health insurance, according to a new national survey by Pew Research Center.
Currently, 60% say the federal government is responsible for ensuring health care coverage for all Americans, while 39% say this is not the government’s responsibility. These views are unchanged from January, but the share saying health coverage is a government responsibility remains at its highest level in nearly a decade.
Among those who see a government responsibility to provide health coverage for all, more now say it should be provided through a single health insurance system run by the government, rather than through a mix of private companies and government programs. Overall, 33% of the public now favors such a “single payer” approach to health insurance, up 5 percentage points since January and 12 points since 2014. Democrats – especially liberal Democrats – are much more supportive of this approach than they were even at the start of this year.
Even among those who say the federal government is not responsible for ensuring Americans have health care coverage, there is little public appetite for government withdrawing entirely from involvement in health care coverage. Among the public, 33% say that health care coverage is not the government’s responsibility, but that programs like Medicare and Medicaid should be continued; just 5% of Americans say the government should not be involved at all in providing health insurance."
Emphasis mine.
[1] http://www.npr.org/sections/goatsandsoda/2017/04/20/52477419...
[2] http://www.pewresearch.org/fact-tank/2017/06/23/public-suppo...
I just pay for everything under the table with cash and it's much cheaper. If doctors can avoid American "insurance" providers (which are not allowed to function as actual insurers, and have to keep margins up by being as stingy as possible), they can save a lot of money and effort.
I may not like it come tax time, but it makes sense to me. I consider the half I don’t keep another sort of contribution to society. And of course look for ways to minimize it–money doesn’t save itself. But I don’t fight over the concept– I rely on services paid directly from taxpayer money each day. The one thing I would hope for is efficiency– but I don’t think starving and cutting systems inherently improves them. It’s just a shell game.
We spend billions per American life saved on terrorism.
We regularly spend $50M / life on infrastructure; hundreds of millions on an overpass over a dangerous intersection to save a handful of lives.
We regularly force companies to spend well over $10M / life on health & safety regs.
Medicaid costs about $800K / life saved.
Collect premiums via payroll taxes->fund healthcare providers. That greatly simplifies it, but there are many other first world models we can pick from. This is not hard.
I entirely agree with you on that and your assessment on how the finance/tax part of it is not as scary as some would think, it might even perhaps not be the hardest part of the problem.
My personal belief in single-payer is that it is the only way to create a leverage to either create a public offer of healthcare goods and service, or radically modify the power imbalance and drive the prices of goods and services way down. The thing that worries me is that in both cases, what I understand as being a total healthcare bubble, which I am sure is a well organized lobby, won't exactly be thrilled at letting things happen without a fight :)
http://www.pgpf.org/chart-archive/0011_health-outcomes
Americans being "fat", sedentary, and certain demographics having expensive chronic illnesses aren't the cause (except perhaps heart attack mortality, which I'm not going to spend the time this evening digging into), if that's your implication.
Socialised medicine works successfully in other countries to the US, including my own. That's the only data point I need.