Free Coronary Artery Bypass? Not Likely…

This Week’s “Thursday Reflection” is by Micah Demers.

I was diagnosed with diabetes at age eight.  I grew up in a middle-class family and was an active child who ate a healthy diet.  I didn’t play a lot of video games or have a working television for the majority of my childhood.  On top of that, diabetes doesn’t run in my family.  Somehow, a virus attacked my pancreas and left those darned beta cells out of commission (they definitely had it coming to them with a name like “islets of Langerhans”).  Today, I am excited to have the opportunity to discuss my experience within the US Healthcare System and the cost associated with that experience.

Let’s forget about the two trips to the emergency room and the two hospitalizations since my diagnosis.  My conservative estimate of the cost of my medical supplies since that point in time is $138,000.  Oh, and that doesn’t include the insulin or two insulin pumps I have used.  That’s enough money for me and my parents to buy a new Jaguar XKR-S Coupe with a little extra to spring for a really nice custom bass.  I’ve never been worried that someone was going to hold a gun to my head and force me to buy a Jaguar; but I am so grateful for the insurance coverage that has made my life affordable. Here are three thoughts that I feel can be taken from my experience:

  1. Healthcare costs have spiraled out of control in the hands of the private market
  2. Health insurance coverage, whether believed to be a right or a privilege, is a necessity
  3. The unpredictability of health issues creates an environment where a free market cannot govern healthcare cost and payment

I think we can all agree that the cost of healthcare in the US has grown out of control.  Take a look at these sobering statistics that I posted on Facebook a few months back:

  1. If food prices had risen at the same rate as medical inflation since the 1930s, one dozen eggs would [have] cost $80.20 [in 2007]
  2. Health care spending in the US represents over 17% of the GDP (the third highest percent of GDP spent on healthcare in the world)

The reality is that our healthcare spending significantly outranks Canada, The United Kingdom, Switzerland and Sweden; all of which boast longer average life expectancies than here in the US.  I know what you are thinking: “I’d have to wait six months for my MRI in Canada!”  Yes, you might have to wait, but the universal coverage provided for Canadian citizens ensures their ability to access medical care.  By contrast, there were roughly 84 million United States citizens who were uninsured or underinsured in 2012.  How long does this population wait before they get care?  Who ends up paying when they do get care?  How does this affect the overall cost of healthcare?  This is just the tip of the iceberg of the rising cost of healthcare.

We have decided as a society that we will not refuse care to individuals who present to the emergency room; this means that we’ve decided that everyone should receive a base level of care.  If we are willing to pay for others’ visits to the emergency room, why wouldn’t we want to design a system that would minimize the cost of providing care?  I think that we can all agree that paying for stitches is preferable to paying for an inMarch 27 Micahfection or even an amputation.  Furthermore, proactively providing care will decrease utilization of services.  We are so focused on the next great surgery or pill that can cure a disease that our healthcare system has not fully embraced community health and wellness or preventive medicine.  I’m not surprised.  Healthcare exists in a mix of public and private markets and there’s no money to be made by keeping people out of the hospital.  And that’s the real key. To fix the healthcare system, we need to focus on reducing cost while maintaining clinical quality, not increasing profit or finding the next great profitable service.  Leaving 48 million people uninsured will always cost more than pooling resources to insure them.

I have done a wonderful job in the first 31 years of life of surrounding myself with like-minded individuals who tend to view this issue the same way that I do.  During the past six months, I have tried to listen to and understand opposing points of view.  I’ve heard the phrase “free market” tossed around as a possible answer to our current healthcare crisis and I cannot see how this is a plausible response.  I’m not an economist, but my basic understanding of a free market implies that individuals have a choice when selecting the item or service they are purchasing (It should be noted that I did not choose to contract diabetes).  While choices do exist in healthcare, most people who use the system do not have the expertise to decide what course of medical treatment is best for them.  More importantly, most people don’t know if a high deductible plan is better for them than a high premium plan.  Is it better to get the gold plan on the exchange or the bronze?  Do I need good coverage for procedures or care that I am unlikely to use?  The unknown involved with procuring health care coverage and services makes it impossible for everyone to predict what they will need.

I’ve always heard that there is no such thing as a free lunch.  I wish someone would tell the pharmaceutical companies that.  I am in the wonderful position of having studied and worked in a field that is at the forefront of political and social discourse.  It’s a subject that currently rivals religion on the list of polarizing topics.  If you don’t believe me, just come over for Thanksgiving next year and sit between me and my orthopedic surgeon uncle (a man whom I enjoy talking to and truly respect).

The reality of our current situation is that we have followed an unsustainable course that has led us to a point of crisis.  It is wasteful to spend so much energy vilifying an opposing view without focusing on a viable solution.  We must take steps to fix the system; meaning that we must reduce spending while providing a premier level of care.  Although the Affordable Care Act falls short on many fronts, it is a step towards cost containment, expansion of coverage, and dare I say it: universal coverage.

Mark Demers

Want to talk about sex, politics, spirituality? So do I. I grew up in a religious home in the 1950’s and 1960’s. Our country was reeling from assassinations and the devastation of the Viet Nam War. Looking for something beautiful, I got a degree in music, married the love of my life and had children. Looking for God, I then went to seminary. Looking for something that might transform the world, I became a local church pastor. Now, I’m always looking for people who want to talk about important things. I cherish conversations with emerging leaders, people who are antsy to try an idea they believe would change the world for the better. I’d would love to hear from you.