The veil of pretense was snatched long ago. So, politicians dare not brazenly declare that the U.S. has the greatest health care in the world. The system is broken. Neither Republicans nor Democrats have a remedy. It is a perverted Robin Hood system, where the rich are robbed to serve the poor poorly.
The exorbitant insurance premiums are unaffordable for many, and for others, it is as if it were a crime to be better off. Imagine being in rude health, not really requiring health care year upon year and still paying 500 or more monthly for very basic insurance. Despite having coverage, a health crisis can become financially catastrophic. A physician diligently paying insurance premiums is no less prone to the vagaries of insurance companies, being denied good health care or any at all, made to jump through hoops and then being left out in the cold.
The U.S. spends more on health care than any other country in the world and still does poorly, even compared to some Third World countries. The futile attempts at course correction over many decades have led to the conclusion as an article of faith that the system is unfixable. So, Congress adds to it or subtracts, applying Band-Aids to suit political interests, while the majority of citizens find it unaffordable.
A Gordian knot
Health care is a Gordian knot created by unnecessary politicization and sloganeering entrenched as dogma. That mindset obstructs solution. Even in the proudly capitalist U.S., everything is not and cannot be run like a free market economy. Running health care as a shop of goods and wares was doomed to fail.
Whenever the system came close to belly up, out came the fixes, e.g., health insurance, Medicaid, Medicare, HMOs, and more recently, Obamacare. The capitalistic component spreading its tentacles in search of profits usurp any intended benefits of such interventions.
Who would care for a judiciary recruited and run on the basis of a free market? Imagine judges making rulings for financial gain. Yet, in the current system, doctors and hospitals do more than necessary, or harm the patients with treatments that pay more. We further limit the system awkwardly by compelling health care providers to become glued to computer screens.
Health insurance companies maximize profits by denying lifesaving care, while their executives rake in eye-watering compensations for performance at the stock market. The industry leaders appear in league with those popes who sold salvation, even the papacy.
What if the military were run on similar principles as health care? Denied essential equipment because “it” was “not covered”; the soldiers left to the whims of powerful entities who took the lion’s share of the defense spending and effected swift retribution upon officers who dared point out the brokenness of the system? Would one entrust the nation’s defense or lives of the soldiers to such a system? Yet, we entrust the entire nation to one such.
Global comparisons
When our northern neighbors have a system that has withstood the test of time, why not borrow the bits that could work for us? Canadians are healthier, happier, leaner, and live longer. The other critique, “wait times,” are better than no health care at all.
Why not look to Europe, including Switzerland, that has universal health care, nonprofit insurance providers, citizens with freedom of choice, and the quality of care is high. To Germany, that prescribes luxuries (by our standards) such as health retreats, while spending less than the U.S. on health care.
The London 2012 Olympics proudly celebrated the United Kingdom’s free, publicly funded NHS system during its opening ceremonies. During Paris 2024, athletes of the richest country in the world, the U.S., eagerly availed free health services including dental, visual, and gynecological, that are cost prohibitive back home.
Long ago, a colleague proudly declared that the U.S. takes stuff from the rest of the world and makes it better, e.g., pizza. That is the spirit necessary to revamp health care, not foolish political slogans.
The path forward
To compel lawmakers to do the right thing, Congress should be law bound to have the same health care benefits as the average American and at the same price. That may precipitate the emergence of ways and means.
A fair health tax can ensure universal health care and curtail the insurance industry. Such a tax may prove less burdensome than the ever-increasing premiums. The health insurance industry could be made more accountable and nonprofit. Just like religion, the judicial system, and national defense, health care must be placed largely above politics. It is essential to national interest, progress, and prosperity.
Shah-Naz H. Khan is a neurosurgeon.
