Posted by: Mark Nielsen | January 20, 2009

Universal Healthcare? A By-the-Numbers Question

As I watched the 2008 presidential campaign, …and dealt with a small health crisis of my own this past summer,… and as I now watch the downfall of Illinois governor Rod Blagojevich (“provider” of  a healthcare safety net for every Illinois child a few years back)… I’ve been trying to get my brain around this sticky problem of how to keep people well, and how to pay for help when they get sick.

Thankfully my own rear end is covered (literally… and trust me, you wouldn’t want to see it un-covered). So is my family’s, by a medical plan through my wife’s employer (a public school district). But I’m acutely aware (pun intended) of the millions of others, including people in my own extended family, who are tightrope-walking that tenuous thread, praying they don’t get sick, or they may go broke.

I’ve always been inclined to mistrust and dislike insurance companies, medical or otherwise. Think about it logically. The whole concept is just weird: paying in advance, for nothing in hand (at the moment), so that they can then make money with my money for a few years. Or lose it, like AIG did. Then maybe, if I follow all the rules, they’ll pay to fix my car, or clean out my clogged arteries when there’s a problem. After I pay the deductible, that is…

I combine the car thing with the medical thing quite intentionally, too, because if you look at it from a technical perspective, a doctor is not much more than a mechanic for our body, or a plumber for our soul-house. The circulatory system is certainly more complex than a power steering system, and the stakes in medicine are literally life-and-death once in awhile. So I’m not saying a doctor or an X-Ray tech shouldn’t get paid. We need quality people, who know their job and do it well, and get paid enough to make all that prior training and hard work worthwhile.

Yet we’ve elevated the medical and pharmaceutical industries to such a high position of perceived importance that we’re now having a hard time paying the fee for what the free market says they deserve. We pay up-front, to prop up an entire industry, one that currently makes up 17% of the entire Gross Domestic Product (according to the National Coalition on Health Care …where there are dozens more startling statistics, if you dare to click through). It’s like we’re being held hostage, just for having bodies that occasionally develop problems.

Here’s how the economic numbers break down: the median income in the U.S. these days is around $42,000. Meanwhile, a typical healthcare plan for a family of four costs $12,000 or more. Do the math. That’s 30% of one’s income for healthcare coverage, based upon some future “what if”.  It’s basically a “wellness tax”, though it’s usually paid to a private company.

For our family, the cost (including Medicare) is around 18% of gross wages. It’s set at that price partly because we’re supporting all the other folks in the system who DO need those expensive MRI’s and specialist consults, and partly due to the possibility (according to some number-cruncher) that eventually we too will need those services (at which point they will cost much more — since inflation when it comes to medical costs is twice the rate of inflation on everything else).

Oh, and by the way, we’re the lucky ones!  I know 18% is not that big a deal compared to what it costs some folks. Our income is significantly higher than that $42K figure above. We don’t get sick all that often, and when we do, it’s not very severe. So we have good genes. And we have dental.

I don’t want to sound ungrateful here, but even  that 18% is not a number I’m comfortable with, when I know how many physicians and pharmaceutical executives are living high on the hog. Not to mention how many car mechanics are among those uninsured or underinsured — the people walking the tightrope, gambling with their health. For me, it’s about basic human values, not numbers. It’s about community, and cooperation, and “Who is my neighbor?”, and “I’ll pay a little more, if you’ll take a little less than this exorbitant asking price.”

In other words, it’s about power: who’s got it, who doesn’t.

Maybe it’s all those lobbyists. Maybe it’s the big-time contractors making beaucoup bucks putting fancy new wings on the already fancy (yet legally not-for-profit? how’s that work?) local hospital. Whoever is coming out a winner in this, I’m tired of looking the other way and accepting it as simply the status quo, the way things work. They have to work better. Soon.

Health Care costs, a simple 3-nation comparison


                                                               U.S.            U.K.            Australia

Cost of hospital bed (per day):             $906            127            139


Intensive care bed                               1616            224            246


Visit to doctor                                           366            49            25


Cost to see specialist                                     768            102            115


Life expectancy                              77.5            78.5            80.5

As “Sicko” director Michael Moore and others have tried to show us, I think there’s much to be learned from how Canada, Cuba, the U.K. and many other nations handle this, if we can just stop crying ” No Socialism!” and start being honest about what works best for the common good.

The Common Good. A fairly old concept that until recently seemed to have gotten lost, among all the 20th century rhetoric about prosperity, progress, technological advancement, competition, freedom, and individual potential. So to solve the healthcare dilemma, we will need a return to a concern for the Common Good, that mutual, team-oriented, cooperative spirit that has the courage to set limits, to remake the rules.

I realize we may not be able to force cooperation, for that flies in the face of what we think of as our “freedom”. But we can’t afford to ignore the problem any longer, or to just kick it out to commitee, or put a few band-aids on it. The system needs a complete overhaul. It needs a Doctor.

Quality. Affordable. Health. Care.

That’s the four corners of the Obama house, each deserving an equal amount of attention, imagination and cooperation in trying to achieve them. And “care” is the cornerstone. We may not yet know all the mechanisms and changes needed to pull this off. But if we decide we don’t care, we’re dead-on-arrival.



  1. nice post

  2. Excellent! I think you hit on one of our country’s biggest dilemmas. The concept of insurance companies really doesn’t make sense. An entity whose overriding purpose is self-perpetuation by making a profit is in direct conflict with goals such as caring and the welfare of others. A company can make no decision, however great the benefit for any human, which would conflict with its overriding purpose. Maybe this realization will gain enough momentum under a new administration. Then we can finally give ourselves the gift of universal healthcare, and I can finally get my lobotomy.

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