< PREVIOUS ] [ 1994 Index ] [ Ed Quillen HOME ] [ SEARCH ] [ NEXT >
As the U.S. Congress debates health-care reform, Sen.
Bob Dole has announced that our current system is the
envy of the world,
and we shouldn't trifle with it.
After all, many of us enjoy freedom of choice that Dole
boasts about -- for us, it means the freedom to bleed to
death in the lobby of any hospital of our choice.
If our medical system is indeed the envy of the world, it means only that education elsewhere is as bad as it is here. In most industrialized countries, only an illiterate would envy the American system.
Our older daughter, Columbine, just returned from her year in Iceland as an exchange student. Iceland has one of those evil Scandinavian socialist health-care systems. So Icelanders should spend more and get less than we do, right?
In 1990, about 8.5 percent of that country's gross domestic product went to health care, which works out to $1,372 per capita. This results in an average life expectancy of 78 years and an infant mortality rate of 4 per 1,000 live births.
Now look at the numbers for the envy of the
world.
In 1990, we spent 12.4 percent of our gross
domestic product on health care, or $2,566 per capita --
almost twice as much as Iceland. The results? An average
life expectancy of 75 years and an infant mortality rate of
10 per 1,000 births.
So we spend more and get less than they do. Why would they envy our system? Because we provide job opportunities for insurance agents, claims adjusters, paper shufflers and ribbon clerks, and they don't? Because we provide life-and-death incentives for people to stay in jobs they hate, and those countries don't? Because people who are injured in this country have to file huge lawsuits in order to have any hope of covering their medical bills, thereby enriching attorneys and clogging courts, and that doesn't happen there?
The same holds for bigger countries like Canada, Japan,
Germany and France. They all spend less on health care and
get better results than we do. And according to Bob Dole,
they all envy us, except that none of these poor, backward
countries has ever announced that it wanted to move to an
American-style
health-care system.
However, the adoption of a single-payer system that would save money and improve public health is apparently impossible in this country. Even the few representatives and senators who admit that they would support a sensible system will also say that it's a political impossibility.
Why? Well, look at the money from insurance companies
that goes into campaign contributions, as well as the
Harry and Louise
commercials, and the fears of
$500,000-a-year specialists that they won't be able to
continue making their yacht payments. These folks like the
present system just fine, and they can afford to buy all
the senators and representatives they need in order to
protect themselves.
Given that, there's no hope for real health-care reform. The people who own and operate this country won't let it happen. Even so, there are some other approaches that might lie within our own power:
· Crime. As Chuck Green pointed out recently, you can get state-of-the-art medical care at public expense if you're in custody.
Given the immense number of laws in this country, most
of us commit a crime or two every week, just going about
our business: failure to report suspected
controlled-substance gardeners, lying to a police officer
(Gee, I was sure I was only going 55 back there
),
employing household bleach in a manner inconsistent with
its labeling, etc.
So, when you feel under the weather, go down to the local police station or sheriff's office, and report your most recent violations. Demand to be jailed for 72 hours while charges are pending. Get your medical care, and your lawyer can show up with some bail money to get you out, and with technicalities to get you off if your offense ever goes to court.
We spend a lot on criminal justice in this country, and we might as well get something for it.
· Free enterprise. We're free citizens, right? So why shouldn't we be able to patronize the health-care providers of our choice -- herbalists, Christian Science practitioners, midwives, acupuncturists, etc. -- and pay them whatever fee we agree on? If we really believe in free enterprise, why do we grant a monopoly to one group of people?
Suppose everyone just started doing this. At worst,
there would be lots of arrests for unlicensed practice
of medicine
and patronizing unlicensed medical
providers,
and you'd be in custody, where you'd get
state-of-the-art conventional treatment. What's there to
lose?
· Feminize medicine. As it is, doctors are generally men and command lots of money and respect. Nurses, generally women, don't get much of either, even if they do the lion's share of the actual patient care.
Now, my wife Martha points out that as soon as women take over a profession, it immediately loses money and respect. If most physicians were women, the average doctor's income would drop, and doctors wouldn't be such a potent lobby. Health care would be more affordable.
So put sexism to work for the public good, and send promising girls to medical school.
< PREVIOUS ] [ 1994 Index ] [ Ed Quillen HOME ] [ SEARCH ] [ NEXT >