In all of the back-and-forth armchair quarterbacking about last week’s healthcare ruling I have yet to see anyone mention the attitude problem:
Americans are unreasonable in our demands on the healthcare system.
The real problem isn’t a government stalemate or greedy insurance companies or the cost of a pill. The heart of the problem is that we expect medical miracles and we’re not willing to pay for them.
Healthcare has two easy solutions.
1. Raise taxes and provide free world-class healthcare for everyone.
2. Forget free healthcare, cut taxes, cut insurance rates and accept that if you can’t pay your doctor, you’re not going to get treated.
We are unwilling to do either. We want everyone to be able to get a kidney transplant, whether they can afford it or not and whether they have health insurance or not. At the same time, we want budgets balanced, taxes cut, and insurance costs to stay low.
We can’t have it both ways. Both the left and the right agree that the Affordable Care Act is a patch for the system. It doesn’t solve the underlying problem, which is rising costs and rising expectations.
As hospital workers already know, the hospital isn’t charging you $12 for an aspirin just to gouge you. The $12 aspirin reflects the cost of running the entire hospital – including the woman who just got treated in the ER for free because she has no coverage at all. We’re not willing to let her die, but we’re not really all that willing to pay for her either.
The $12 aspirin also reflects the cost of the hospital’s new robotic surgery assistant that cost $20 million. That robot may improve your surgical outcome, but it costs money. We demand improved surgical outcomes but we’re irate about that $12 aspirin.
And your surgeon spent 8 (or 12) years in higher education at a top-notch public university, which has had major funding cuts, meaning his tuition has gone through the roof. He’s the best surgeon in the state but he’s got $300,000 in student loans so he’s looking for a job with a decent salary. We want the best surgeon, but not the $12 aspirin that trickles down to pay his salary.
We want our taxes cut so we demand spending reductions to balance public budgets, then we get angry about the rising cost of college tuition and angrier about the rising cost of healthcare and demand the government do something – like cut our taxes.
Our bodies were designed to give out by age 40 and we don’t accept that anymore. We expect to hit 80 in excellent health but that takes more than just clean water and a lack of sabertooth tigers – it takes doctors, smallpox vaccines, robotic surgical assistants, chemists, DNA mapping, microscopic analysis, labwork, pharmacists, electronic health records, medical transcription, coding, laparoscopic surgery, Natural Language Processing and a dizzying array of drugs.
All of that comes with a financial cost. The funny thing is that we accept rising costs in other areas with rising service. Your FIOS costs a lot more in 2012 than your dial-up connection did in 2001 but it’s infinitely faster, so you probably don’t even think about it. Your cable bill is higher than it was 10 years ago, but you get 500 channels instead of 40 so it’s okay. In 1990, the average cost of a new car was about $16,000. Today, it’s $30,000 but that car has front and side airbags, good fuel efficiency and iPhone hookups so you accept that it’s just better.
We also see those as luxuries – if we don’t want more channels at a higher cost, we can always give up cable. But we don’t see healthcare that way. We see the rising cost, but not the rising levels of service or our rising expectations for each procedure and for the entire system. Or we accept the rising costs for ourselves, but we don’t want to subsidize all those uninsured people, but we don’t want them left untreated either. And regardless, we don’t see it as a luxury.
If you’re supposed to grind to a halt at 40 and you’re still dancing at 80, everything in between is a medical miracle and those miracles aren’t free.
Good health may be priceless, but it costs a fortune. The sooner we accept that, the happier we’ll be.
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