US Health Care Makes Me Feel Ill

Over at Omnibrain, Steve Higgins has started something of an uproar with a post containing this statemtent:

I can't think of one legitimate reason why people shouldn't be charged more for living an unhealthy life style. After all, the inflated health care costs are in large part due to peoples unhealthy life choices like smoking, drug use (drinking mainly) and obesity.

I had intended to speak to this in the comments, but it's really a post on its own.

You see, Steve lives in the US, where health is a commodity, measured and sold. It results in some ghastly gaps in health care, and means that politicians play football with people's lives.

Consider Bush's refusal to expand free health care for kids--despite the fact that it is his financial policies have resulted in more struggling families skimping on spending to get by as US debt skyrockets, the dollar sinks, and inflation drags at the paycheque.*

What Steve proposes, I feel, would result in a sharp decline in the number of poor people who carry insurance. As it is, some forty million--over ten percent of Americans--don't. If you raise the payments, a lot of them are going to decide that they can't afford it. Even if it's as low as ten percent, there would suddenly be 43 million uninsured people. And uninsured people cost the system more. Assuming they get treatment, although some hospitals will turn people away (and don't get me started on that merde).

But that doesn't tell the entire story. By far the greater problem, morally, ethically, and socially, is the vast number of people who cannot or do not carry sufficient insurance for all eventualities. The underinsured actually get a worse deal than the uninsured, since they pay into a system that may deny them treatment anyway (a polite way of saying "allow them to live or die"), based exclusively on whether they paid for the Gold Coverage or the Platinum Coverage.

Steve has a point. And what his point illustrates is the great failure of market-based health care. In all such systems, insurers cherry-pick the healthy, the wealthy, and the young to fill their vaults. And on the other end they pick and choose the drug brands, doctors, and treatments they will generously allow you to use. While their profit profile takes on Nepalese proportions. Let's face it, the companies in the health-care sector aren't in this for the good of their fellow human beings (assuming they themselves can be classified as such).

Against this sort of corporate profiteering, the consumer is helpless to do anything but bend over (Oh--but your plan doesn't cover the lube. You'd better brace yourself ... ). This is why the US must instead turn to the Canadian-type single-payer system of universal coverage.

Sure, not everyone gets the best of care. And waiting times for nonessentials are pretty steep. But generally, everyone (and by this I mean a far, far greater proportion of the population) gets what they actually need.

If you prefer to have unhealthy people paying more--the mechanism is in place, more or less: Smokers, for example, pay a minimum (in Ontario) of five dollars per pack in federal and provincial taxes. Tobacco tax revenue is 1.45 billion, and the government claims health care costs of 1.7. We could easily close that gap.

Except that that doesn't account for federal taxes in that five dollar cost, which go into transfer payments from the feds to the provinces, particularly for health care. In other words, smokers are pretty much financing their own health care costs. If I'm obese and I consume loads of junk food, well I cover some of that cost too.

An added benefit: No-one need worry about poor people. Since they're more likely to be smoking and eating piss-poor food anyway, they're funding the system as a result of the choices that force them to lean more heavily on that system.

Now one could argue that there are other costs. $2.6 billion in lost economic productivity alone in Ontario. But I'm looking at this the way a US "Health Maintenance Organization" would. In terms of the bottom line to health care.

So why do US politicians fight to let her kids stay uninsured? Beat$ $even kind$a hell outta me. Ask all those legislators who are taking bribes ... sorry, I mean "donations" from Big Pharma.

Canada's system has its problems, including rising costs, aging population, drive-by consumers, and the failure to allocate a proper place for private health care within the framework. But we have almost no uninsured people. If my life is at risk, they don't need to check my Blue Cross coverage to see whether I get the cheap drug or the expensive one.

And we barely need discuss whether to tax the fat, smokers, or drug users.

*(Side question: why is it that it's all Republicans who accumulate this debt? Aren't they supposed to be, like, all fiscally responsible or something? Yet Reagan was the first to break one trillion in debt, and HW put the country about $3tr in the hole. Finally--one thing Dubya's better at than his daddy! The US has accumulated nine trillion in debt: $9,000,000,000,000, and is on course to hit $11tr by the time the clown leaves office. Clinton, by the way, managed to leave the biggest surplus the US has ever had.)