The United States is a conundrum in many ways but, to me, their healthcare policies are one of the most obvious. Just imagine, living in a nation that is so wealthy, so powerful, and so proud to call itself the greatest nation on Earth and, yet, for some reason, they can’t get their heads into providing basic medical protection to all citizens. Virtually every nation listed in the top ten for livability has universal health care but the United States doesn't. Nationalism, individualism and consumerism are raised to heroic proportions but a high level of social responsibility is, seemingly, anti-American. In the presence of such abundance what possible justification can there be for ignoring people who get sick or hurt?
Obama fought hard to bring in the Affordable Health Care Act but, by the time the bill passed, so many compromises had been reached it was hardly worth the effort. As well, since the bill's passage constitutional challenges have been launched, (the Supreme Court has chosen to hear a case which may kill Obamacare altogether), huge amounts of money have been spent criticizing the day-to-day viability of the program, and almost every power player in the Republican Party, who now control both the Senate and the House, has promised to deactivate the program. Obviously this attempt to care for those who can't care for themselves is on shaky ground.
How can the richest country on Earth expect everyone to be totally responsible for their own well being when good health is such a highly random event - particularly in children? Adults may make lifestyle choices putting their health at risk, even some forms of employment are harmful but given this reality how you respond to a risky lifestyle impacts each individual differently. Some live long vibrant lives in spite of their choices while others can be disabled by the most innocuous of situations. Only a few deserve their injury or illness, not enough to be statistically significant, and certainly not enough to create a model for a health care system. On the other hand, government ideologies preclude regulating the compensation of medical professionals thereby allowing America to have one of the most expensive systems in the world.
Our health is vital to every aspect of our moment-to-moment lives, and to live without the ability to get qualified help in an emergency must create a high level of anxiety. How do you live with ongoing or increasing symptoms you can’t afford to get diagnosed, or a deadly disease which you have no resources to treat – or, if you do choose to treat a debilitating disease, live with the knowledge it would bankrupt your entire family?
The American justification for having no universal healthcare is, supposedly, that it’s run by the government and is, therefore, socialist, (it’s referred to as socialized medicine). When you add to this the popular perspective that all government enterprises are over-bureaucratized and wasteful of resources, while private industry runs everything efficiently and humanely, a psychological barrier to universal healthcare is programmed in.
Of course, by unequivocally believing that private industry provides more for less, the American people may possibly be under the influence of the constant, sometimes intense, promotional campaigns paid for by industry. Advocating for specific policies in support of your industry, unlike universal healthcare, is a fundamental freedom in the United States, which gives the medical community every right to contribute multi-millions of dollars toward lobbying politicians while, simultaneously, portraying a host of negative scenarios about "socialized medicine" to the general population. And In a culture where "spin" has been raised to an art form determining whose story is the real one is not an easy task.
Indeed, can a level playing field exist between citizens and special interests when, officially, over 12,000 registered lobbyists are spending around 29 million dollars per year in Washington DC and, unofficially, Opensecrets.org puts the estimate of money spent to influence policy closer to 3 billion dollars? It’s a wide-ranging figure at the very least. With 435 elected members in the House of Representatives and 100 in the Senate – multi-billions of dollars per year is a lot of money being used to influence 535 people – although, as Opensecrets.org also noted, in 2012 incumbent House members spent an average of over 3 million dollars each to get re-elected. Politics in the United States is, without a doubt, very expensive.
Strategically, of course, it’s not necessary for lobbyists to get all politicians onside. You only have to influence 50% plus one to win a vote in both Houses - less if you are trying to prevent a bill from passing. To stop a bill you only have to influence 50% plus one in one House because legislation has to be passed in both Houses, then approved by the President, to become law.
Admittedly, expressions of influence are seldom this blatantly transparent. More subtle results may be achieved by altering a bill's detailed technical language or through amendments attached during the committee process. Remember, lobby groups are spending billions and hiring the best and brightest minds in the country. Legislation that says all the right things, while doing little of it, is not that difficult to craft.
If their entire federal process represents good government to you than you and I don’t have the same priorities and, I hope, those who continue to suggest that all other governments should be more like America’s never get their way. Thank Heaven their State governments have a lot more residual powers than most federal systems to offset some of this influence.
A couple days after I began writing this piece my wife and I were in the mountains near our home, gathering firewood, and I managed to drop a Douglas Fir on my head. In forty years of running chainsaw, both professionally and domestically, it was a first. I didn’t lose consciousness but I was dazed and bleeding so my wife administered first aid, gathered up our tools and drove my truck, and me, down into our little town where I was dropped off at the door of the local medical center, (while she went looking for the ever elusive parking space).
Immediately I was placed on a gurney in the emergency ward and a nurse began cleaning the gash on my head to have a better look. Shortly thereafter a doctor came by and said my wound went right to the skull and I also had a severe concussion (which is probably why I kept falling over whenever I tried standing up for any length of time). He also wanted an x-ray of my upper spine. Within and hour I had the x-ray followed by ten stitches and, still, the doctor wasn’t satisfied. The x-rays showed nothing - but my neck was sore so he decided to send me to the regional hospital for a scan. It was a tremendous inconvenience that included a three hour ambulance trip and further hours waiting in a crowded emergency ward - to get the scan - and then more hours to get someone to read it, but at two o’clock in the morning a doctor wandered over and informed me that I had a broken neck. A vertebra was cracked in two places, one of them right through and, if subjected to more strenuous activity, (my rural lifestyle) it could separate.
I spent the rest of the night in the regional hospital and the next day I was visited by a neurologist who suggested that if the break was properly protected it could heal on its own. I would be required to spend twenty-four hours a day in a neck brace for some months and undergo follow up physiotherapy. If we didn’t have a full coverage medical plan (Thank you Canada.) I would have tried to patch up my head at home and tough out the neck pain by telling myself that it was just jammed when that sneaky limb swung around and whacked the top of my skull. Such a rationalization could have been life threatening.
When this happened had I been living in the United States, (which I did for a few years), I would either have enjoyed good coverage paid for at great expense from a medical insurance provider, and subject to a myriad of terms, conditions, deductibles and spending limits, all outlined in a complex and detailed signed agreement… or I would have nothing. The Canadian system is far from perfect and studies show that superior models exist that we can learn from. Particularly in their ability to reduce wait times and place superior technology, and administrative procedures, in the hands of health care providers - but our system is still world class, and the fact that it exists at all is a testament to this country and the value we place on providing the comfort and security each of us needs to live the best life we possibly can.
Americans seem fond of portraying Canadians as kind of generally laid back and easy going (as in lacking ambition) and, comparatively speaking, this may be true. However, it behooves them to take a closer look. Perhaps this relative difference in our cultures may rely, in part, on our ability to avoid one of life's most singularly frightening anxieties.