Why our health needs government

Rest of the world has figured out the obligation never ends -- why can't we?

August 9, 2009
BY NEIL STEINBERG Sun-Times Columnist

Boy, people can't get enough of that cash-for-clunkers program. Congress just cut loose another big chunk of money with applause all round. It's car-buyin' time!

So here's my question:

How come, when the government enters the auto finance business, that's America, mom and apple pie. But when the same government tries to handle health care, that's menacing European-style socialism?

Cash for cars? John Wayne in a Stetson hat sitting tall in the saddle.

Cash for health care? Sacha Baron Cohen in a lime green thong mincing over to pick your pocket.

The health care situation can confuse people, with all the various competing plans and systems and providers. Democrats point to the tens of millions of uninsured Americans. Republicans point in horror at everyone who ever had to wait to see a doctor in Canada.

So I'll make it simple.

A baby is sick. Cute, dimples, but with a life-threatening infection. Should the baby get treatment? Even if her parents don't have health insurance? Or should we just let her die, clutching a sock monkey, slumped against the wall in a hospital waiting room?

We treat her, right?

How about if it isn't a baby, but a 5-year-old? Let her see the doctor, or turn her away? How about a 10-year-old? Does the obligation, as a moral society, to help that kid end when she's 13? Sixteen?

My point should be beginning to dawn on you by now. The obligation never ends. The rest of the industrialized world gets it. We don't. Not yet, anyway.

In Britain, with its ooh-scary socialized medicine, the infant mortality rate -- the number of babies per 1,000 live births who die -- is 4.85. In Canada, it's 5.04.

In the United States, with our illusionary freedom of choice, our rate is 6.26, putting us right between Cuba and the Faroe Islands.

About one baby per thousand worse than Canada. Which may not seem like much.

Unless it's your baby.

The health care dilemma

Not that health care is easy. It isn't. Every decision is tough, and we are hard-wired to err on the side of caution.

What do I mean?

Remember when my son Ross got bit by that buffalo gnat during our ill-starred overnight camping trip in Yellowstone? His eye swelled shut as if he had been punched by a prizefighter.

When I saw it in the morning, I immediately gave him Benadryl -- reduces allergic reaction -- and took him to the medical clinic in Yellowstone, where the receptionist told me it would be $184, pre-paid, for a doctor to look at his eye.

Now I was certain that, if we did nothing, the swelling would go down in a day or two.

And if it were my eye, that's what I would have done.

But it wasn't my eye, it was my son's, and as I stood at the receptionist window, watching him sitting there, reading with his one good eye, a sentence formed in my head:

"If only you would have taken him to see somebody right away, we could have saved the eye . .."

I whipped out my Visa card and paid the $184 -- a luxury not available to all Americans, I hasten to add. Plus the extra $49 that the clinic tacked on the bill because a nurse -- or at least the young lady in scrubs who looked like a nurse -- took two minutes and administered an eye test, using a chart in the hall.

The doctor looked at the eye, told us to give him Benadryl as needed, and that the swelling would go down in a day or two, which it did. Aetna, my insurance company, declined to pay any of the $233 that I'm out of pocket, though my wife assures me that if I get on the phone, I might eventually beseech them to change their mind. That's the way the system works apparently. Health care by groveling.

So was I right to take him to the doctor? Every parent I run that by looks horror-struck at the notion I wouldn't.

Yet multiply that by 300 million Americans. Patients acting not on medical probability (it's a bug bite, the swelling will go down) but on irrational fear. Doctors who, worried about potential lawsuits, have lots of reasons to order up that extra test and little motivation not to.

That's what makes reforming health care such a trick; we have to expand the system -- to cover the uninsured -- while at the same time shrinking it, cutting out that waste that produces such enormous runaway costs for those lucky enough to be able to pay for coverage.

Posted by Wintermute at August 10, 2009 07:01 AM