July 20, 2012 at 12:00 pm EDT | by Stephen Fallon
America’s healthcare act schizophrenia

Earlier this month, the Republican-controlled House of Representatives voted once again to repeal the Affordable Care Act. House Speaker John Boehner (R-Ohio) said the Act is “making our economy worse, driving up the cost of healthcare and making it harder for small business to hire workers.” He has plenty of Americans behind him in that belief. A majority of Americans want the Act repealed, though 82 percent support the Act’s new rule that bans insurance companies from denying coverage to people with pre-existing conditions. Our nation has developed Care Act schizophrenia.

When the Supreme Court ruled on the Affordable Care Act a couple of weeks ago, I found myself in the perfect laboratory of national opinions, surrounded by families, businesspeople, and gay flight attendants all passing through Atlanta’s Hartsfield-Jackson airport. As CNN announced the breaking news that the Supreme Court had left the Affordable Care Act standing, passengers waiting for flights started speaking out:

“There goes the middle class,” groused a guy behind me.

“Now we know what we need to do—get that guy out of office,” snorted a woman sitting with her elderly mother.

“This is why our forefathers left England. It’s Socialism!” insisted a history-challenged senior.

Right now, more Americans have come around to accept gay marriage than are in favor of the Affordable Care Act. What’s behind this virulent hatred of a national healthcare program? Ignorance.

Now, I’m not saying that there aren’t legitimate concerns about the ACA in its current form. We can have a good debate about the details of its roll out. But first let’s put some common arguments to rest.

  • “The U.S. has the best healthcare in the world.”  Not if you agree that healthcare should prevent untimely deaths. The U.S. is in eighth to last place in the industrialized world when it comes to life expectancy. The only relatively developed nations we outlive are the Czech Republic, Estonia, Hungary, Mexico, Poland, Slovakia and Turkey. We rank dead last among highly industrialized nations. Not exactly what you would expect for the third wealthiest country in the world with the “best” healthcare.
  • “We just can’t afford universal healthcare.” We’re already paying the price tag for universal healthcare, just not getting its benefits. The U.S. pays two-and-one-half times per person as much for healthcare as the average for all other industrialized nations. Pre-existing condition exclusions blocked many Americans from getting health insurance, and high premiums still block others. So many of the 50 million uninsured Americans use the emergency room as their primary healthcare provider.

The average emergency room visit costs $1,318, or $1,565 for patients over age 45. Worse, by the time uninsured people get to the ER, their conditions are much more costly to treat. For example, we spend more than any country in the world on hospital admissions for preventable diabetes. When patients can’t pay, you and I are already picking up the tab through increased insurance premiums, and increased taxes as hospitals write off their losses.

  • “Well, we don’t want to be like Canada, with its rationed healthcare, or socialist like France!” Agreed, we’re an innovative capitalist country. But since we’re paying more and getting less for our healthcare dollar, just saying “no” to “socialist ObamaCare” isn’t good enough. Let’s borrow a better business model from one of the industrialized nations that has a successful healthcare system without resorting to universal healthcare. Have you got a country in mind?  If you do, you must have gone back in time, because ever since Israel changed its system in 1995, we’re the only nation in the industrialized world that does not have universal healthcare.

That’s right, it’s not just Canada and France that have universal healthcare, but also Australia, Austria, Bahrain, Belgium, Brunei, Cyprus, Denmark, Finland, Germany, Greece, Hong Kong, Iceland, Ireland, Italy, Japan, Kuwait, Luxemburg, New Zealand, the Netherlands, Norway, Portugal, Singapore, South Korea, Spain, Sweden, Switzerland, the United Arab Emirates, and the United Kingdom. And they all pay less per person, and all live longer, on average, than we do.

Not a single American I’ve spoken to who is opposed to the Affordable Care Act knew this most basic fact.

The truth is, we can’t afford not to have universal healthcare. Among those employed, medical expenses are the No. 1 cause of household bankruptcies in the U.S. You can sock away savings all of your life, but when genetics, age, bad habits or bad luck bring a major medical issue to your home, too often all financial reserves are lost.

So go ahead and call universal healthcare “socialism.” I believe government has two core functions: to defend the nation’s people against enemy attack and defend citizens from unnecessary death. No town buys its own tank and jet fighter for a possible war, and very few households could save up enough for a medical catastrophe. This is why societies have governments in the first place, not just socialist governments.

Take it from Mitt Romney, who supported an individual mandate to establish universal healthcare in 2006, “Folks, if you can afford health care, then, gosh, you’d better go get it. Otherwise you’re just passing on your expenses to someone else. That’s not Republican, that’s not Democratic, that’s not Libertarian. That’s just wrong.” Sticking stubbornly to our broken, privatized model is just plain wrong.

Stephen Fallon is president of Skills4, a healthcare consulting firm that provides services to CDC and HRSA funded providers, primarily gay- or minority-based agencies and clinics. Reach him via skills4.org.

  • To add another point to your excellent summary of why universal health care coverage for every American is the only effective solution for our health care schizophrenia…We need to decouple health insurance from employment. It makes no sense for people to have access to semi-affordable health insurance only through employers’ group plans (or individual plans that are usually quite expensive). As soon as someone gets too sick to work, there goes his or her insurance–and the downward economic and medical spiral toward disaster begins. Medicare for all paid for through taxes–think of all the money you save from deductibles and co-pays!–and if you want supplemental coverage, you can pay out of pocket for it. But no American should ever face financial ruin, or untimely death, because of a medical crisis. It really is a crazy system we have.

  • Once again the myth of poor US life expectancy gets repeated in support of socialized medicine. The statistic is grossly misleading and produced by a study that punishes any country without soup to nuts socialized medicine. First, the statistics include deaths resulting from automobile accidents and violent crime, both of which the US has in excess but neither of which are a reflection on the quality of health care. If we remove these two causes of death from the statistics the US moves from #19 to #1 in life expectancy in the industrialized world. This makes sense when you also consider nearly 50,000 Canadians sought treatment outside their socialized system – the vast majority coming to the US. If the US has such horrible services and embarrassing results, why do so many foreigners flock here for treatment?

    The infant mortality statistics (thankfully not repeated here) are equally misleading.

    As for universal health care, I agree that the US can and should achieve it. But please look to models like Switzerland and not the single payers of which there are 3 – Canada, Cuba and North Korea. Surely we can do better than that. And please let’s use real facts upon which to base our policy debate.

  • Not to be picky, but is schizophrenic really the correct term to use to describe this? :/

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