Thursday, December 5, 2013

Debunking healthcare myths

Healthcare is a hot topic in the United States because:

·         The controversy surrounding the implementation of the Affordable Care Act (sometimes called Obamacare) is fraying our civility and eroding our trust in government;

·         The large (now 18%) and growing (projected to reach 34% by 2040)percentage of the U.S. GDP devoted to healthcare seems to have spiraled out of control and breached the limits of affordability;

·         Lastly, but not least important, we all potentially need healthcare, perhaps only to heal or even to save one's own life or the life of those one loves.

Unfortunately, myths cloud and grossly distort the debate.

Consider just two of those myths.

First, Americans allegedly have quicker access to healthcare providers than do people in countries that have universal healthcare. That claim, according to data published in The Atlantic (Olga Khazan, "Universal Healthcare Doesn't Mean Waiting Longer to See a Doctor," November 19, 2013) is false.

In a study of 10 developed countries, all of which have some form of universal healthcare, only people in Canada have a harder time getting an appointment with their physician on the same day, or next day, that the patient contacts the doctor's office:

Access to afterhours care is somewhat better; people in the U.S. have easier access, without going to the emergency room, than do people in France, Sweden, and Canada. 

Only when it comes to getting an appointment with a specialist within two months does the U.S. rank at the top of the chart. Yet even in the U.S., half of all appointments with physicians are with the person's primary care provider.

Contrary to much hype, free enterprise medicine does not ensure fast access.

Second, all Americans allegedly have access to the healthcare they need. Some Americans pay for their own healthcare, some Americans depend upon government programs to pay for care (e.g., Medicaid or Medicare), some Americans rely on private healthcare insurance (e.g., Blue Shield/Blue Cross), and some Americans rely on free treatment in emergency rooms. Many Americans cobble together a combination of those options, paying premiums, deductibles, co-pays, and items not included in their healthcare coverage. All taxpayers and people with healthcare insurance pay for people who do not have coverage. Yet supposedly, everybody has access to necessary care.

This alleged universality of care is also a myth.

I recently saw an interview with former Vice President Dick Cheney in which Cheney both lauded American healthcare as the best in the world and emphasized that the care he received was available to all Americans. Indeed, Cheney stressed that all Americans have access to healthcare.

Then I read this recent CNN report that concluded, "Military veterans are dying needlessly because of long waits and delayed care at U.S. veterans hospitals." (Scott Bronstein, Nelli Black, and Drew Griffin, "Hospital delays are killing America's war veterans," November 19, 2013)

Not all Americans have equal access to healthcare. The truth is that people with money and influence can receive exceptional care. Americans who lack money or influence, including many of the veterans who find themselves unable to establish a normal life post-military, can receive inadequate, sporadic, or little healthcare.

What I do not understand is why so many Americans so staunchly defend an approach to healthcare delivery that not only provides second-rate access but is also by far the most expensive, per capita, in the world:



Anonymous said...

As you are such an ethicist, ethics demands that you know what you are talking about. We do not have free enterprise or free market medicine. Government has been intervening since at least WWII. Clearly government intervention has failed. A free market approach has not been tried.
Travis Cork
Conway, SC

George Clifford said...

Perhaps I lacked clarity, but your comment helps. We have not had a free market approach (which has failed), as would a free market approach (because of consumers not having the time or knowledge to become informed consumers).