Last night I watched a powerful documentary chronicling about the plight of four of the 47 million uninsured Americans. P.O.V.’s “Critical Condition” by Roger Weisberg follows four individuals through their experience of getting sick and attempting to secure medical care without insurance.
“What happens if you fall sick and are one of 47 million people in America without health insurance? Critical Condition puts a human face on the nation’s growing health care crisis by capturing the harrowing struggles of four critically ill Americans who discover that being uninsured can cost them their jobs, health, home, savings, and even their lives.”
“Critical Condition” does a good job of pointing out the problems of the American health care system, but does not offer any solutions. Carlos Benitez has a severe back deformity that causes severe pain. A surgery costs about $200,000 and even if Mr. Benitez has the surgery he has 10% chance of dying. In Mexico, the same surgery costs $40,000. Mr. Benitez is a chef at a French restaurant and cannot afford the surgery. Should the government pay for this risky surgery? In the end, UCLA offers to do the surgery for free and the surgery is successful.
Who should pay for this surgery? Mr. Benitez cannot afford it. Should taxpayers pay? In this case, this is a high risk, expensive surgery. Does the benefit of covering this surgery outweigh the cost?
A more depressing case is that of Joe Stornaiuolo. Mr. Stornaiuolo was a doorman for 15 years who got sick, and because of his illness lost his job. Because he lost his job, he lost his health insurance. Because he lost his health insurance, he could not pay for the medical care he needs. Mr. Stornaiuolo’s chronic liver disease could be managed with a regimen of prescription drugs. Since Mr. Stornaiuolo can’t afford these drugs, however, his sickness spirals out of control eventually leading to hospitalization, long term nursing home stay, and his eventual demise.
For Mr. Stornaiuolo having health insurance would likely have saved money for the medical suppliers. If insurance would pay for his pharmaceuticals, this would have significantly decreased the chance he needed to be hospitalized. Since he can not afford to pay for his hospitalization, the cost of inpatient care will be passed on to those who do have insurance in the form of higher fees. This is one case where giving Mr. Stornaiuolo health insurance could have actually saved money.
Whether you have insurance or not, getting sick is horrible. The Critical Condition documentary shows three key issues with medical care in America. First, medical care is expensive. We can reduce the cost of medical care by loosening patent laws and allowing pharmaceutical imports from other countries. We can also get rid of medical licensing. Despite these efforts, medical care will likely remain expensive in the future.
The second problem is that some most individuals do not have enough money to pay for this medical care. The way to fix this problem is with some type of redistribution of income. This involves taxing wealthy individuals in order to either have a government run healthcare system (which I oppose) or giving vouchers to poor individuals to purchase their own private health insurance.
Finally, competition in the insurance market is not always a good thing. Competition leads to higher quality service and technological innovation, but it also gives insurance companies an incentive to drop patients after they develop an illness. This is exactly the opposite of what insurance is supposed to do. A minimum package of benefits may solve this problem, but could also increase the price of health insurance and thus increasing the number of uninsured. There are no easy answers.
Illness is a horrible thing. Yet I challenge myself and all my readers to make an effort to improve the health care system in whatever ways they can.
- Thank you to Jessica Lee and Irene Villasenor for sending me a copy of this documentary.