Health Care
Among all developed countries and
many un- and underdeveloped ones, the United States stands alone as the only
country that does not guarantee health care for all citizens. Not only that,
but our health care costs us much more than other countries pay, sometimes more
than twice as much, and our health outcomes do not compare very well either.
For instance, the U.S. ranks 46th in life expectancy, with males expected to
live 76.61 years and females 81.65. This is lower than Chile (78.54, 82.80),
Costa Rica (78.53, 83.39), Slovenia (79.26, 84.44), Martinique (79.85, 86.10), Singapore
(82.06, 86.15), and 40 other countries large and small. Other statistics, such
as maternal mortality rate, are especially revealing. Compared with nine other
developed countries, the U.S. rate is highest at 23.8 per 100,000 live births.
Next highest is Canada at 8.4. The Netherlands is lowest at 1.2.
The U.S. spent $12,318 per person
on health care in 2021, the highest costs per capita among OECD nations. Next
highest is Germany at $7,383. The average among the wealthy OECD countries was
$5,829. Japan spends $4,666 per person, and South Korea spends only $3,914.
This discrepancy is largely due to the fact that U.S. health care is a
for-profit system. Republicans have insisted that we just need to turn the
market loose in order to rein in health-care costs and get better results. But
for a variety of reasons, the market simply does not work in health care. When,
for instance did you last go shopping for the best deal on angioplasty? Or have
you ever seen a hospital offer a two-for-one deal on appendectomies? The nature
of human health problems makes comparison shopping virtually impossible. The
two largest culprits in creating outrageous health-care costs are
pharmaceuticals and medical equipment. Let me use my own experience as an
example.
Four and a half years ago, I was
playing basketball one morning, as I have done now for over 30 years. Another
player, stepped on my foot and knocked me over. My foot stayed in place, while
my body tipped over backward. This rearranged the bones in my foot. I had two
displaced metatarsals, a cracked cuneiform bone, and a Lisfranc injury (a torn
ligament in the center of the foot). All this damage required surgery to repair.
I now have a plate and seven screws in my foot that tend to set off alarms in
airports when I fly. My foot healed fine, and I’m playing basketball on all that
hardware, but my encounter with the American health-care system left me both
amazed and baffled.
The real shock came when I
received the itemized bill from Intermountain Health Care for my morning in the
operating room. The doctor’s bill as actually quite reasonable, but let me
share with you a few of the highlights from the hospital’s “Itemized Statement
of Services.” The prices I will list are what IHC billed my insurance. What the
insurance paid was, of course, a fair bit lower since the hospital was in their
network. If I hadn’t had insurance, I would have been responsible for the full
amount.
The hospital billed the insurance
about $25,460 for “medical supplies.” The operating room, by contrast, was a
mere $7,547.40. The total charges amounted to $35,542.13, 70 percent of which
was for medical supplies. I wondered what on earth could be that expensive.
Well, the itemized bill explained it.
The plate (Plate Ankle Lapidus CP
0 Offset) was billed at $5,332.32. I have to wonder about the thirty-two cents.
Really? They couldn’t round it to $5,330? One of the seven screws was billed at
$2,852.28. Three other screws were $907.39 each. The others were only $653.86.
The local hardware sore apparently doesn’t carry these screws. The hospital
also billed for a pin, three reamers, a K-wire, and other odds and ends. One of
the reamers was billed at $2,219.32. And some sort of unthreaded guidewire came
in at $2,935.68. I asked the doctor what on earth that was. “I don’t know,” he
said. “I didn’t use it.”
The item on this itemized
statement that had me scratching my head, though, was the “Bit Screwdriver T8
AO Quick Coup.” Yes, my insurance got billed $2,201.76 for a screwdriver. I
can’t help but wonder why. Don’t they do surgeries like this rather frequently?
Don’t they have a screwdriver in the drawer from the last surgery like mine?
Couldn’t they sterilize it and reuse it? If not, then I want that screwdriver.
I mean, they obviously don’t need it. I asked the doctor for it. He just
laughed, but hey, that screwdriver is a testament to the insanity of the
American health-care system. I’d bet even the military doesn’t pay that much for
a screwdriver. And if they did, they’d probably use it at least twice.
The doctor explained that he has
to buy a kit for the surgery. It includes all kinds of stuff, some of which he
doesn’t even use. And $2,200 screwdrivers are apparently thrown away. He
complained about the medical supply industry and pharmaceuticals. That’s where
people really get ripped off, he said. Why? Because health care has become an
industry, and profit drives everything, and these businesses charge what they
can. That’s why we need to get the profit motive out of health care and go to a
single-payer system like almost all other countries, a system focused more on
patient care than on profit.
And this brings us to the two
political parties. The Democrats, of course, passed the Affordable Care Act, an
admittedly imperfect system that nevertheless reduced prices for many Americans
and ensured that millions of Americans now have insurance who previously did
not. If they could, the Democrats would pass into law some sort of single-payer
system comparable to what other nations offer. The Republicans? Well, they have
been trying to repeal the ACA ever since it was passed, and since John McCain
prevented them from accomplishing that dastardly deed, they have worked hard to
undermine the ACA at every turn and have tried to deny health coverage to
millions of Americans.
The Republicans used to claim they
had a better plan. Of course, they never unveiled it. It is still a secret. But
now they don’t even pretend to have a better alternative. And yet they still
promise to kill the Affordable Care Act. In the entire civilized world, it is
only the U.S. Republican Party that wants millions of people to be without
health insurance. Only the Republicans Party wants hundreds of thousands of
families to go bankrupt every year because of medical debt. Indeed, every year,
530,000 American families file for bankruptcy due to medical bills. Overall,
66.5 percent of all American bankruptcies are due to medical bills. Medical
bankruptcies do occur in other countries, but no country compares with the
United States. Total medical debt in the U.S. totaled $45 billion in 2020.
If we were to ask what the
Republican policy on health care is, we would be unable to answer the question.
The party created no platform in 2020, other than slavishly following Donald Trump’s
whims. There is similarly no Republican platform this year. They are running
not on ideas or policies but on culture-war issues and criticism of the
Democrats for many things the Democrats aren’t even accountable for.
So, if Latter-day Saints want to
promote poor but expensive health care, which is denied to millions of poor
Americans, they should vote Republican. But if they really take seriously the
scriptural injunction to care for the poor, the sick, and the disabled, they
will support a measure to introduce in America a universal, single-payer
health-care system patterned after any of a dozen or two that are working fine
in other countries. Once again, this means believing Latter-day Saints simply
cannot vote Republican.
