Should health care be rationed? It’s really a moot question because health care is already being rationed in the United States. HMOs (health maintenance organizations), like any other (successful) insurance company, remain profitable by taking in as much money as possible, while paying out as little as possible. Instead of looking at your car, calculating depreciation, and tossing you a check to replace your dented fender and add some new paint, they’re making similar business decisions about your hip, or whatever else is bothering you. When profit is the underlying motivator in the delivery of a service—one type of body shop isn’t all that different from another, is it? “Managed care” is just a comfortable euphemism that masks the real rationale behind the treatment you receive.
To make “health maintenance” work, HMOs drop customers that are most in need, retain customers that are least in need, limit treatment, reward doctors with financial incentives for providing the least expensive option or minimum required treatment possible, and then pass along any remaining costs that cut into their profit margin, directly onto the consumer by way of premium hikes.
Why the United States insists on remaining the only major industrialized nation on earth that fails to provide free universal health care to its citizens is a mystery. Or is it?
If managed health care organizations have enough money laying around to reward doctors for billing them as little as possible, you can bet that they have plenty in their slush fund to pay lobbyists to strike down any bill that might threaten their monopoly over medical care with something free and universal. There are also plenty of persuasive arguments that Mr. and Mrs. Joe Citizen will identity with personally, so as to dissuade any uprisings on the grassroots level. Arguments like: “Too much government control is dangerous… it puts our free enterprise system one step closer to communism.” Or: “Free and universal health care will drive your taxes through the roof—you’ll lose your home, you won’t be able to meet your expenses anymore.” Arguments that invoke fear are always the most effective—they reduce the capacity for rational thought.
Need a second opinion? Ask someone born and raised in a country that embraces free and universal health care—somewhere like Canada. Canadians who have lived and worked temporarily in the US on work visas will tell you that their health never suffered as much as the years they lived here—and we’re talking about young workers in their 30’s and 40’s … not the elderly.
In Canada, you never have to put off a regular checkup at the doctor, or cease them completely . You never have to suffer through an illness hoping it will get better, meanwhile fearing that it may require an office visit and costly medications. In Canada, you’ll never have to save up to pay for needed surgery which an American HMO might refuse on the basis that “it isn’t really necessary”. And you will certainly never have to look at your budget to see which expense can be ignored this month (the light bill, food, your student loan) just so you can afford to see a doctor, when the need for treatment can be put off no longer.
Americans have suffer more under their “free enterprise” system than any Canadian ever will under our own country’s tax-funded health care system. Despite this, every now and then, Canadian politicians begin to toss around the idea of replacing our universal-pay universal-access system, and replacing it with a privately managed system. Not surprising, really (we have large, greedy corporations here, too, eager to get into the business). There are the usual fear-eliciting arguments, plus others meant to provoke outrage, like: “Under our present system, even the rich are entitled to free health care.” Those able to rationally consider this argument are well aware that even in Canada, the rich would rather pay to have state of the art medical treatment that get the level that you and I consider acceptable, for free.
But, there’s always the danger that we’ll succumb to the temptation to adopt a privatized system. Of course, it will be over my dead body. Epitaph: Here lies Todd Lyons, killed by his managed health care provider.
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