Americans have been arguing about health care for the last couple of decades, and most of the discourse has not made much sense. It seems that a great many people think that it is possible to give all Americans gold plated health care. They seem to think that countries like Finland or Sweden have unlimited health care for everyone and that socialism or creation of a welfare state is how they did it.
Sad to say, that is not true.
Every country in the world rations health care in some way. Lifetime limits, bureaucratic reviews on procedures and rejections of insurance coverage for medications or procedures deemed too expensive are examples of European health care rationing.
Instead of just throwing money to the health insurance industry Europeans turned to government bureaucracy to deny treatment for individuals and refuse to pay for expensive drugs and procedures. Conservative Republican might not have been far off the mark with their talk of “death panels.” Here is the human tragedy that kind of rationing causes.
In a recent study of health care delivery in European counties, researchers summarized their findings by saying:
“…we find that while there is a strong association between low income and perceived access barriers across countries, within many countries, perceptions of difficulties accessing care are not concentrated uniquely among low-income groups. This implies that factors that affect all income groups, such as poor quality care and long waiting times may serve as important barriers to access in these countries.”
We have rationing here in the United States as well. Americans who do not have much money cannot afford routine treatment, although everyone receives treatment for acute health needs. You may be too poor to pay for labs and cholesterol medications, but when you have a heart attack, you will receive treatment at the emergency room and admission to the hospital. If you are too poor to pay, but not poor enough to receive indigent care, the hospital absorbs the loss and increases prices to cover it.
The solution offered by ObamaCare was simply to open the coffers of the US Treasury to the health insurance industry. Even guaranteed profits for the first three years of ObamaCare backed by the wealth of the United States economy was not enough to satisfy the health care industry. Americans may not have received the health care they thought they were going to get, but the health care industry got exactly what it wanted.
Almost 10 billion dollars when to CEO bonuses in the aftermath of ObamaCare, resulting in an incentive to increase costs instead of lowering them. So much taxpayer money flooded the health industry that an orgy of mergers and acquisitions ensued with power and money accruing to the biggest and most aggressive players.
California tried to create a universal health care plan similar to ObamaCare but price was higher than the entire annual budget for the state of California!
Healthcare in the United States is not going to change dramatically any time soon. Like so many other things no longer once looked after by government or large organizations, we will have to manage our own health care.
This should not be surprising. Institutions that once managed so many parts of our lives have morphed into very different things.
Paternalistic companies no longer mange careers. Younger people may find this hard to believe, but in the 20th century, the company managed careers by determining promotions, requiring trainings, and paying for education. In those days, companies offered on the job training, apprenticeships, and school to work transitions.
The introduction of easy educational debt shifted the cost of education to workers and created more debt than home mortgages or credit card balances.
Companies also offered health insurance. In the early days, the company usually covered the entire cost of premiums as a way to maintain a healthy workforce. As health care premiums increased, the cost has gradually shifted to workers.
These days, with almost half of the labor force working in low paying contingent jobs, employer paid health care is outdated.
The same thing is true of retirement funding.
For most of the 20th century passing probation meant employees would receive a slice of a huge retirement pie. The emergence of 401K plans shifted the burden of retirement funding from corporations and government retirement systems to individuals.
In the wake of the crash of the industrial economy in 2006, the result has been sadly predictable. Most workers have little or no money saved or invested for retirement.
We are still in the mist of this shift towards personal responsibility for personal needs — note the municipal bankruptcies resulting from unfunded retirement mandates — but the writing is on the wall. Health care is no different.
We have to take care of our own health care.
How do we do that?
Obviously, by developing a healthy lifestyle. That means eating nourishing food, getting some degree of exercise, minding our own mental health, staying out of relationships that are bad for us, and avoiding harmful drugs like alcohol and opioids.
But those are day-to-day habits. They may be hard habits to develop and maintain, and a basic understanding of science and biology is important, but we know the path to developing daily habits. On the other hand, managing our health care does not have a clear path. At least not yet.
That is because so few people have figured out how to create an induvial health care system for themselves. How do you get a blood lab done without a doctor to order it? How do you read a lab? Where can you get prescription medication without a doctor?
The basic information is easily available. Companies like Life Screening are a good place to start. They offer screenings for a wide range of physical dysfunctions, but no actual diagnostics. If it has been some time since you lost your health care coverage these services will look for serious problems.
After that, get a blood lab. Sonora Quest offer labs for everything from hormone levels to lipid panels to cancer detection. The prices for each test range from reasonable to outrageous, but like screening companies, there are many companies offering blood labs and competition is already lowering prices.
The results of your blood work will tell you whether the levels detected are high or low. With a little research, you can find out what medications treat your conditions. If you have records of previous blood work and prescriptions, the best bet is to repeat what a doctor has done in the past.
Next, find an online pharmacy, fill out the order form for the prescription drugs you want and if the staff doctor who reviews your lab report agrees you will get your meds in just a few days.
Do not forget herbal and “alternative” sources of health products, but be careful, especially if you do not have a background in science.
One of the wondrous things about the world we live in is the democratization of knowledge. Anyone who has an association with an educational instution has access to academic journals. This includes any employee or student of any college or university. Even membership in public libraries includes access to scholarly journals. Google Scholar is also an excellent source of academic research.
Before even thinking about using something publicized on the internet, Google the name of the product along with “review” or “scam.” If the product you are considering passes muster, search for professional academic research in Google Scholar or the academic databases provided by the educational institution with which you are affiliated.
If you do not understand the science, do not order the product.
This might seem very desperate way to get health care, but it seems to be increasing in popularity.
Recently one of my friends had this to say:
“I can’t believe that I am an American and I can’t get a statin to lower my cholesterol from an America doctor, but Germany has no problem creating a script and filling it more inexpensively that I can get it here.”
Maybe the future will hold the secrets to solving our health problem, but for now increasing numbers of Americans are shouldering the burden of supplying their own health care. That does not seem so startling in the context of managing our own retirement, education, and career, and maybe that is the most startling thing of all.