03 November 2012

Election issues: Health care

Health care is a hot-button issue which most people, rather than examining rationally and analytically, react to emotionally. This state of affairs helps no one and ensures that we will make the wrong decisions. I will not tell you whom you should vote for nor where you should come down on health care, but I really must tell you a little of what I know about the issue.

I grew up in Argentina, which has a mixed health care system: public hospitals which take any and everyone and charge nothing, but which most Argentines consider sub-par and not clean enough. In addition there is health care insurance provided through the employer, much as in the US. Most people were traditionally covered in that manner, though now it is questionable if even half have such coverage. These people have access to more desirable hospitals, named clínicas. If you are wealthy you can pay for the best private hospitals and have access to health care equal to the best anywhere in the world. The inequalities of such a system are glaring, but let me tell you a story about my family.

When my wife and I were relatively recently married and our first son was 18 months old, I took advantage of two months' accumulated vacation to spend an extended time in Argentina with them. My parents met us at the Buenos Aires airport and we set out by car to La Falda, in the Córdoba province hill country, some 800 kilometers away. As we neared Rosario (a little over a third of the way), our son developed a high fever. Since we had lived in Rosario and knew it well, we stopped at a public hospital. It did not match US standards of visible "cleanliness", but you can be sure there was no methycillin-resistant staphylococcus aureous (MERSA) there. They diagnosed him accurately very quickly, gave him the correct prescription, handed us the medicine (no hunting for an open pharmacy), and charged us nothing even though he was not a citizen of Argentina or even a resident. When we got to my parent's house my son was feeling much better. As we gave him his medicine that night, he said his first word: Gracias, which means "thank you." In two days he was back to normal. This would never happen in the USA.

Bear with me for just one more story. After this very selfsame son of ours graduated from college, he married a wonderful British girl in England (where they now live). Since the wedding day was 21 December, we stayed for Christmas and my father- and mother-in-law came from Argentina. My mother-in-law developed a potentially serious eye ailment the day before Christmas. On Christmas day I took her to a beautiful hospital in a village in West Sussex, where they took her information, diagnosed her eye disease, and handed her a eye pomade. My mother-in-law is a nurse and she knew exactly what her eye infection was and she knew they had given her the right medicine. They did not charge her a penny. The referred her to an eye hospital in Brighton and told her to go the next day, which she did. They looked her over and made sure things were going well and she cured quickly. Again, they charged her nothing. This would never happen in the USA.

One more thing you need to know which may surprise you. The British National Health Service was created by the Conservative Party. During WWII many people were evacuated from London to the countryside. The government set up field hospitals to care for the displaced people. After the war, the government found itself paying for health care for the population, so they made the system official. Now the system is in financial trouble because the Labour Party (primarily) has been taking away national funding for the system. They argue that rich shires should pay for health care so West Sussex and Oxfordshire have had their national health care monies curtailed severely. That wonderful hospital I took my mother-in-law to has been closed as a result. That makes me sick. My son and daughter-in-law seriously considered moving to the US. However, after adding up all the various factors, they have decided to make a permanent life in England. One of the main factors in their decision is the inordinate cost of health care in this country.

We have the most expensive health care system in the world by a factor of 10 in the US, but of all the industrialized countries, we have the lowest quality of health care by all accounts. This is a scandal. We must address it as a nation and do so informed and dispassionately.

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