Health care: we’re all in this together
July 21, 2017
Last Thursday I spent the day at the Huntsman Cancer Institute having a basal cell carcinoma successfully removed. As I lay in the reclined chair while the surgeon sewed up the two-inch incision, I couldn't help but think about the state of our health care system in the United States.
Susan and I buy our health care insurance on the private exchange as we do not have employer-sponsored health care and are too young for Medicare. We are each 54, non-smokers, and in good health with the only exception being my pre-existing condition of melanoma.
With a thought toward keeping our premiums as low as possible, we each have a Bronze plan — the monthly premium for both of us is $875. However, we must each reach a $6,000 deductible annually before we see reimbursement from the insurance company. That said, insurance does pay for preventive care such as an annual physical exam, though we have no coverage for dental and vision and thus self-insure.
Each year we are out of pocket $22,500 before we both begin receiving reimbursement from insurance for medical costs (annual premiums of $10,500 plus the $6,000 deductible for each of us).
We are fortunate in many respects: we're healthy, we have medical insurance, and we can afford it. But $22,500 per year is a lot of money, and I wonder just how realistic it is for the average mid-50's couple in America to fit this inside their annual budget.
The debate about health care in the United States has been hijacked by politicians using it as a weapon to motivate their base and get them to the polls. These politicians focus on the role of the federal and state government, rather than focusing on the fundamental needs of the entire citizenry.
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This is quite remarkable, but it took 142 years after the country was created for elementary education to be available to all children. That's right, it was not until 1918 that taxpayer funded public education was the norm – and it wasn't even K-12. It took a long time, but finally the community of citizens recognized that it was in society's best interests for everybody to have access to an education.
Public schools receive a good portion of their funding from local property taxes. Here in Utah we have an equalization model whereby the most affluent school districts with higher value tax bases, and accordingly higher tax receipts, make an equalization payment that the state of Utah redistributes to the least affluent school districts. Why is this done? Because there is a recognition that we're all in this together, and that it's in society's best interests to educate kids.
Nobody stands in front of a public school, or a county tax assessor's office, and screams "This is Socialism!" Especially nobody from a school district that receives equalization payments.
The same parallel can be drawn using social security retirement, fire protection, police protection — the list goes on.
Health care is no different than these other services — everyone needs it, and society benefits as a whole.
The United States ranks 31st in average life expectancy; Costa Rica is 30th, Cuba is 32nd, and Japan is number 1.
Remarkably, the United States spends more per person on health care than any other country in the world. We spend $9,451 per person each year. To put this in perspective, Cuba spends $2,475 and Japan spends $4,150.
As I lay in the chair during surgery, many things became clear. First, proposals to offer an average working couple tax credits to fund the purchase of health care insurance are woefully inadequate when annual health care costs $22,500. Second, while the journey will be unbelievably contentious, the only realistic destination is universal health care. And finally, 'cauterize' is just a fancy medical term for burning flesh.
If we acknowledge that society benefits when everybody gets an education, why would we not conclude that society benefits when everybody has health care? After all, we're all in this together.