Ambivalence on Health Care

My wife and I had to take our baby girl to the emergency room because she had a high fever, some diarrhea, and we worried she’d get dehydrated. We were there a few hours, during which time she was checked on several times by very conscientious doctors, who spent a total of maybe 30 minutes of total person-hours on her care. The bill? Over $10,000. We have health insurance through my job, but we continue to get seemingly-random requests for co-payment. Every few months it seems they want another $50.

In places like Japan, Canada, and much of Europe, it is thought to be rather curious that Americans have such resistance to universal health insurance coverage. This incident provides a clue as to why it is so. For those lucky enough to have health insurance, the outcome we observe seems pointlessly mediocre. This is the land of customer service. Yet most experiences with health care delivery tend to involve long lines, ample doses of frustration, Byzantine rules and regulations, and a complete lack of alternatives. I thought markets were about free choices and clear prices. Asking how much a medical procedure costs is itself an exercise in futility. It depends on your coverage, because different deals have been made with different parties. Health insurance seems to have wrought a system that is complex and delivers rather poor overall results. There are over 100,000 deaths in American hospitals per year due to infections contracted in those hospitals; experts estimate two-thirds of those deaths could be wiped out by instituting simple procedures involving hygiene, such as hand-washing.

Unbelievable. Can you imagine any other business that is not affected by thousands of needless deaths? If one restaurant has an outbreak of E coli, it gets shut down. But not for hospitals.

I’m not an expert in health care. But it seems to me that the health insurance system effectively shields the industry from the competition in price and quality that every other business faces, to the detriment of consumers, and indeed, to all of us, because the care we get is overpriced and of poor quality. While many helpful people work in health care, people who genuinely care about helping people, the overall experience tends to be poor. When we were in the emergency room, were taken to an uncomfortable, poorly heated, poorly lit facility with little privacy. Nearby are several drug addicts in various stages of overdose. We would much prefer to see a doctor, as our situation is hardly a complex medical issue, just a simple matter that could be handled by a general practitioner, even a nurse, and an IV. But it’s pretty hard to see a doctor on the weekend, so one is left with the ER.

Where this all leaves me personally is with the same ambivalent attitude toward health insurance that I think is shared by many other Americans. I’m very thankful that the system is there for me if I were to have a truly catastrophic accident. But in almost every interaction I’ve had with it, I’ve been left with the feeling that there’s got to be a better way. While I don’t know exactly what that way is, it seems clear that the insurance system that we have isn’t working very well, even for those that have good insurance plans. So while I support Obama’s plan, and indeed it seems to be the outcome of a thoughtful analysis by a person who cares deeply about the country, I doubt that it will give us high-quality health care at an affordable price.