Earlier this week, we ran a Q&A with Julie Salamon, author of the new book Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God, and Diversity on Steroids. Given the richness of her book and the primacy of healthcare as a topic of interest, we’ve asked Julie to guest post here, and she has obliged.
(Disclosure: Julie once reviewed a book of mine; and yes, if it had been a bad review I would have remembered …)
Common Sense Health Care
A guest post by Julie Salamon
Last week a young friend, an international student at N.Y.U., received an upsetting call from a bill collection agency. She was told she owed a $1,089.50 balance on an emergency room visit, the part her insurance didn’t cover.
She had a high fever at night. The resident advisor in her dorm took her to the N.Y.U. emergency room, which accepts her student insurance. After a long wait, a doctor saw her, gave her Tylenol, and sent her home.
I called the insurance company, which had no record of any claim being filed or turned over to the collection company. On hearing this, the collection company told us “to sit tight” while the two companies deal with it.
“What does it mean, to sit tight?” the foreign student asked. “To do nothing,” I said. “To wait.”
“Crazy system,” she said.
As problems go, the $1089.50-plus tab for a quick fix was microscopic in the face of the $2.3 trillion spent on health care in the U.S. last year — about 16 percent of the GDP compared with 7 percent in 1965. But it was a big bill for my young friend.
Sitting tight in our crazy health care system doesn’t cut it anymore. A useful June election tracking poll from the Henry J. Kaiser Foundation reports that 25 percent of Americans see paying for health care costs as a serious problem — for them.
Our market economy approach to medicine has to change. There is “a fundamental illogic to trying to contain costs in a market-based system,” writes Dr. Marcia Angell in a thoughtful article about health reform in the April 21 issue of The American Prospect.
Dr. Angell, a senior lecturer at Harvard Medical School and a former editor-in-chief of The New England Journal of Medicine, was called “an unlikely muckraker” by The New York Times in 2004, when she published a powerful expose of the drug companies.
Her position on health reform appeals not to corporate interests but to common sense and the desire for good medical care, making it appear radical:
“The only workable solution is a single-payer system (there, I said it), in which everyone is provided with whatever care he or she needs regardless of age and medical condition,” she writes. “There would no longer be a private insurance industry, which adds little of value yet skims a substantial fraction of the health-care dollar right off the top.
“Employers, too, would no longer be involved in health care,” she continues. “Care would be provided in nonprofit facilities. The most progressive way to fund such a system would be through an earmarked income tax, which would be more than offset by eliminating premiums and out-of-pocket expenses.”
Until then, will state and federal lawmakers be willing to rein in a system that dishes out Tylenol at $1,089.50 a pop?