Get Sick, Go Broke
Newsweek Online ran a strong story today about the impact of medical problems on financial health. It began with 12-year-old Candace Jackson who has $90,000 of medical bills not covered by insurance. Last week on Warren Reports Matthew King’s mom worried about running up against the lifetime caps on their health insurance, with $1.5 million in medical bills so far, and multiple surgeries in the future.
Candace and Matthew are today’s headliners, but one in every five families in America is dealing with unpaid medical bills. The see the abyss.
So I have to ask: How many more Matthews and Candaces and millions of other children and their parents and grandparents will have to go flat busted over health care before someone leads us to real change? How many will have to lose their homes? How many will have to file for bankruptcy? How many will have to wake up in the night sick with fear that they can’t pay both the phone bill and the doctor bill?
The stories never stop. And the data back them up.
The Newsweek piece relies in part on my research with Drs. Himmelstein and Woolhandler at the Harvard Medical School and Dr. Deborah Thorne at Ohio University. We reported that about half of all bankruptcies occurred in the financial aftermath of a medical problem. What really chapped the insurance industry, however, was our finding that about three-quarters of these families had some form of health insurance at the onset of their illnesses or accidents. We concluded that not even the insured were safe in America.
The insurance industry response did not respond by examining the problem to find out what it was about their coverage that left families so vulnerable. (Perhaps they already knew the answer?) Instead, the industry hired someone to try to make our data “controversial.” Professor Melissa Jacoby and I re-analyzed those data, and we tried to isolate every complaint from the industry so that readers could review the data themselves, but the results came out the same: medical problems were connected to about half of the bankruptcy filings.
There is surely no one left in America who doesn’t have a cousin or a neighbor or a dear friend who hasn’t been put in the financial cross-hairs by an illness. Even business owners are starting to worry about footing their share of the bill. So why isn’t this the number one political issue in America today? Why aren’t politicians who are nervous about their jobs hanging onto this issue like a life raft? Why aren’t ambitious job-seekers who want to unseat those politicians shouting from the rafters that they will push for a serious, comprehensive plan to help ordinary Americans deal with the fallout from a serious medical problem? I guarantee that one in five Americans would be listening. And their cousins and neighbors and dear friends.
While the insurance industry tries to direct attention elsewhere, and while the politicians talk in half-measures or no measures at all, millions more families—families like Matthew’s and Candace’s—cannot wake up from their financial nightmares.
I can't keep reading these stories and looking at the pictures of these children. When does it stop?
I just wanted to send a reply from someone who has lived in both Canada and the United States. I was born in Canada and I have lived in Canada all my life, but I did move to the United States to work for three years. Although I had a terrific job in a prestigious institution in the United States (which, I might add, owns its own health insurance company) I was still paying $135 per paycheque for family health insurance coverage. (I do wonder whether this is a low number compared to other companies.) From what I can tell, income tax rates were virtually identical to what I pay in Canada now.
I decided to move back to Canada after only three years because of a few things. The first one was real estate prices, (we just paid $126000 for a 4 bedroom, 2 bath home with a pool here in Canada). The next reason I moved was because in Canada, women (and men) are entitled to take 1 month of pregnancy leave and 11 months of maternity leave on the birth of a child. The pregnancy leave and 1 month of maternity leave are with 100% of income (paid jointly by the employer and the unemployement system), the rest of the leave is with 60% of income (paid by the unemployment system). Despite having taken out student loans for all 9 years of my education, I also owe about 1/3 of the student loans of a similarly accredited professional in the United States. The final reason I came back is for the health care system, which everyone in Canada sadly takes for granted.
I truly believe that there has been a campaign by the U.S. health care industry and the media to discredit the Canadian health care system in both the eyes of Americans and Canadians.
Americans need to believe that a nationalized system won't work so that the health industry won't lose its strangle-hold; Canadians need to believe that our nationalized system doesn't work so that the health industry can get a foot hold. This has to stop.
I am writing this to tell you that the nationalized system of health care in Canada DOES WORK. In Ontario we have beautiful facilities that are well run. I roomed with a young man who was in school to become a cardiologist and he had worked in different U.S. hospitals, and then in the University hospital in London, Ontario - and he said that the Canadian facility was more hi-tech than other places he had worked.
My current doctor in Canada originally trained and worked (and his father worked) in Michigan - and now in Canada, he refuses to take any private insurance - he will only deal with the central public insurance plan because he KNOWS HE WILL GET PAID!
There is a great book out there called "Critical Condition" that everyone should read (Canadians and Americans) and it really highlights all of the problems with the U.S. health care system. The number one problem is administrative inefficiency because the doctors and hospitals must employ people specifically to track down insurance companies to get paid - and the insurance companies hire people to do everything they can NOT TO PAY. Did you know that both Canada and the U.S. pay approximately 6% of GDP for health care administration? Where is this money going in the U.S. if in Canada it can be used to give a whole population health care?
In Canada, if you are a citizen or permanent resident, you apply for a health card, prove your address, have a photo taken, and then carry the card with you. As long as you have the card you are always admitted to your GP or any specialist or any hospital and the bill gets paid - you hear nothing more about it, no matter how much service you've required. We also have prestigious university hospitals where all kinds of research takes place, just like in the U.S.
We still have a problem with too few doctors, this is because we have only a few medical schools with very few spots open, and it is also because some of our doctors go off to the United States thinking that they can get rich quick. This problem is being addressed by various government inititiatives including opening more medical schools, opening more spots in the medical schools, and putting incentives in place for interns to stay in rural towns, etc.
Also, you probably have heard that there are huge terrible wait times in Canada to get surgeries done. For a personal anecdote, in 2000 I had to have knee surgery with an orthopaedic surgeon - I only had to wait three weeks to get in. Nonetheless, the governments have been addressing this issue and you can now go to the Ontario website to see what the average wait time is. For elective surgeries, to me these wait times are really not that bad:
http://www.health.gov.on.ca/transformation/wait_times/wt_data/data_ontario.html
I guess my last word would be to say that in Canada, no one will ever go bankrupt for being sick.
Health care is considered an essential human right that will not be compromised by putting it in the hands of private companies. Let's be honest, the first priority of any private company is to make money, all other priorities come second. Is this really who you want in charge of your health care?
I just want my friends in the U.S. to know that these and many other issues that affect your day-to-day life are the result of *government policies* that either help or hinder regular people. From my vantage point it seems that the government in the U.S. has been a little too preoccupied with programs that help the rich at the expense of regular people. When the real estate bubble bursts in the U.S. what will happen to the regular person with no safety net then? What will happen to the economy generally when so many people fall through the cracks?
August 25, 2006 7:35 AM | Reply | Permalink
Thank you. This is the best defense I've heard re the Canadian health care system. Any chance you could shorten it and send it to the NY Times, Washington Post, LA Times and any other widely read newspaper?
"Well, I think if you say you're going to do something and don't do it, that's trustworthiness." GWB-Aug. 30, 2000
August 25, 2006 11:10 AM | Reply | Permalink
As long as the insurance industry which controls health care retains very powerful lobbyists this won't change. This industry arguably has one of the most well lubricated revolving doors on capitol hill. The industry is staffed on both sides by a very chummy group that looks out for itself, health care insurers and pharmas first and foremost. This is the only industry posting consistent double digit growth numbers year over year for a decade or more. That growth is about unregulated cost and profits. Not to mention immense fraud. Abramoff is a chump compared to these guys.
thepeoplechoose
August 25, 2006 12:11 PM | Reply | Permalink