Did you know that health insurance is only 106 years old? First introduced as simply wage insurance against lost work time in 1911. In 1911, there were few options available to remedy potentially deadly circumstances. You either recovered on your own or succumbed to death. The first insurance policies only guaranteed that your income continued while you recovered or until you died.
As you may know, in the past 100 years, everything from aspirin to antibiotics to transplants to gene therapy has been developed that has nearly doubled the average life expectancy from about 40 to around 80 years. In 1911, an infant had only about a 50% chance or living just 12 years. This has been reduced to a mere fraction today due to the development of vaccines, cures and safety gadgets for many of the common reasons children died 100 years ago. There are many more of us living much longer now. This improvement in the futile battle against death has created an ever growing population of breathing, but otherwise fairly unproductive old people. And they require a great deal of care to continue breathing until their body parts dissolve into utter uselessness and die.
Acerbating our new-found longevity is a life style that promotes disease and atrophy of muscles and other organ functions. We eat the wrong stuff, we are too inactive and even “healthy” food is either loaded with synthetic ingredients for “color and freshness” or at the very least, grown in soil that is increasingly loaded with numerous elements produced by an oil-dependent civilization, aluminum, strangely enough, being of particular concern.
Moreover, today’s developed society is more carefree and even cavalier about engaging in harmful behavior promoted by media and “miracle” care readily available for when carelessness results in injury or illness. Young people think they will live forever and be patched up quick when things go wrong.
Healthcare providers take enormous advantage of our fear of death, ironically coupled with a carelessness and disregard for behavior that would surely have killed us just a century ago. Faced with a choice between death and a heart transplant, is there any amount of money one would not pay, assuming one could pay, to get that heart transplant? Of course not and healthcare providers understand this basic self-preservation principle. The result is ever-increasing prices for every imaginable treatment, cure and preventative aid.
The latest figures I’ve seen claim that in 2015 the total amount spent on healthcare in the U.S. was $3.2 TRILLION dollars. That works out to $9,990 per person – every man, woman and child would pay that much if the cost were distributed evenly – about $833/month for each member of your household. This is an amount that only 1.5% of Americans could comfortably afford. Adding to this impossibility for the vast majority of working Americans is that most of the care provided is provided to people who are not working – the very young and the very old. The people who need it cannot pay and the people who can pay don’t need it.
So, now we grapple with what to do about this precarious dilemma in which we find ourselves. Just 10 years ago, it was possible to buy health insurance from a variety of companies which, to a degree, held down costs with the simple application of competition. Today, there are just two primary sources of health insurance: your employer or other large group, or the government (ACA, Medicare, Medicaid). Government services are funded by our taxes, group insurance by labor. A working person is forced to for pay both hrough employer deductions for their own insurance and income tax to pay for the government services.
Many people believe that healthcare is a right. What moral society would not care for the ill among them? Indeed, ER’s provide enormously expensive services to uninsured or high deductible insured individuals from which little or no payment can be expected. This shortfall is presumably reimbursed by very high premiums and deductibles from people who believe it is their obligation, necessity or mandate to actually pay these high prices.
Other people believe they should have the freedom to choose not to have insurance or to choose insurance that covers only what they wish to have covered ala carte. But those people also demand care when they do require services, covered or not. Our moral society provides it, lest we be labeled careless, heartless or even murderers.
There are also people who believe in survival of the fittest. No insurance for anyone. You either pay for care when you need it or you don’t get it. When your numbers up, you just go on to whatever is the next existence, if any. This approach is largely dismissed by our pampered society. While life is precious, it is also 100% temporary whether you spend a lot of money extending it or not. This fact calls into question the usefulness of extending life as long as possible. Yet, few people are willing to just let Gramma die when dialysis could keep her around another five years.
The inarguable conclusion is that if you want to live as long as possible, it usually will cost a lot of money, especially if you have been careless in the upkeep of your own body. Irresponsibility is costly, but nevertheless demands extraordinary measures when the heartbeat is in jeopardy.
As a society, we have decided that no one in need should be turned away. We have also decided that it is too costly to do that. The solution would seem to be to reduce drastically the cost of healthcare services. Unfortunately, though, we believe that life itself is priceless; worth paying most any amount to preserve, despite the ultimate futility of that activity.
Healthcare services are costly for a variety of reasons. The high cost of education, equipment, facilities, research and development, investor expectations and simple price gouging (greed) of individuals who will pay anything to draw another breath are just a few of the reasons.
If life is priceless, should its preservation also be priceless? Should doctors and nurses be educated for free? Should hospitals and clinics get free electricity, pay nothing for water and electricity? Should medical equipment, supplies and medication cost only what the raw materials, labor and delivery cost (non-profit)? Should investors simply be allowed to deduct their gift as charity? In short, should healthcare services be mandated to be non-profit with national salary caps for all related occupations? Is a doctor or nurse worth more than a teacher or a plumber? Should healthcare responsibilities be undertaken, not to make a lot of money, but to provide the healthcare morality we all demand?
I consider that holding healthcare services as a fundamental societal requirement, like military service, would require a sweeping fundamental shift in the reason we provide it. Not to make money, but to survive as long as possible. Community service, not a vehicle to reach the ranks of the wealthy. Do it because it needs to be done, not because it is a lucrative career. The only perk of working in healthcare could be totally free services for oneself. Everyone else would pay for unlimited services that cost dramatically less. Once the prices are reset, an average cost could be deducted from everyone’s paycheck that would be reasonable and sufficient to cover not only the workers, but everyone who doesn’t work. That deduction would be distributed directly to local service providers, limited by city, county or state perhaps. A “tax” to be sure, but one paid to the community, not the government.
So, what do you think of my plan? Admittedly, it would probably be impossible to leap into a Star Trek style civic responsibility, but there seems to be no other solution short of survival of the fittest and wealthiest. I’m all ears if you have something better, as is the rest of the country. Surely, I or one of the other 320 million inhabitants of this country has a solution we can all agree on. Bookmark this blog post and return often to see what others have to say or to post your own solution as a reply! Maybe, just maybe someone has the solution no one else can contrive!