Dont' Get Sick !
A few weeks ago, I needed to see a doctor; nothing serious, but I liked the process. Make an appointment, turn up on time, wait five minutes, see the doctor, get a prescription. Done. Time spent: 30 minutes. Cost?
Zero. This set me thinking about the complexities of the US healthcare system.
And, frankly, I don't get it.
Burst appendix, ambulance, hospital, operation, then three days flat on your back, sharing a ward with three others. Even with insurance, the bill will quietly gobble up the fund you'd been building for your child's university education.
Meanwhile, the surgeon who performed the one-hour procedure will use the proceeds to install a jacuzzi in his chalet in Aspen. Consider it your contribution.
Now the fun starts.
If it isn't an appendix, say it's a heart attack. Serious stuff requiring a medical team to raise you from the dead with all sorts of wires, paddles, and a small fortune in tiny valves. Once done, the maths gets truly biblical.
You will not only fund the jacuzzi but also the extension where he intends to house it. By the time you receive your aftercare, your surgeon will have sold the old chalet and moved further up the mountain to an even bigger one, with better light and a ski-in, ski-out entrance.
You, meanwhile, are doing arithmetic you never wanted to learn at a kitchen table you may soon be selling, along with everything else you own.
It’s time to do the arithmetic for people who are simply trying to stay covered, not including the risk of getting sick.
Someone who earns, say, $80,000 a year, has a wife and two kids, and receives his insurance through his employer. Good benefits, right? Well, not really.
His share of the family premium is somewhere in the mid-to-high teens of thousands of dollars a year! Skirt around this and try to buy the equivalent plan on the open market without an employer to soften the cost, and you're looking at the same figure, sometimes substantially higher.
Remember, that's before he's paid tax and before he's used the insurance for anything. That's just the cover charge, designed simply to let you get sick later. This is America, folks, the land of pre-existing conditions!
So, how on earth does the average family survive this? I have absolutely no idea, and I don't think the average family does either.
In Indonesia, where I live, there is universal healthcare. To participate, the cost to the individual is about $8 per month. That's not eight hundred; it’s eight! In other words, it’s the price of a fancy coffee at a chain café,
Have a heart attack here, and an ambulance will turn up. A team will work through the night, tiny valves or something will be replaced, and whatever else needs doing will be done.
You then spend ten days in post-op care, being fussed over by nurses who call you Bapak. The total bill for all of this is zero. Not subsidised-down-to-nearly-nothing.
Zero.!
Indonesia's population is roughly the size of America's, give or take a few million, and yes, there are plenty of undocumented people here too. However, none of that stopped anyone from deciding that healthcare is something you simply provide, the way you provide roads or rubbish collection.
In other words, it’s not something you means-test a dying man over.
America's neighbour to the north naturally has universal healthcare. Canada has universal healthcare. Granted, its population is only forty-odd million, a smaller test case.
However, apart from curing you for virtually nothing, they'll also cover your child's orthodontic bill, which in America is the kind of expense that has sent more than one couple quietly investigating career paths they'd rather not discuss at dinner parties.
This year, Mexico, you know, that "poor" southern neighbour, so often talked about as the problem rather than the example, signed a decree rolling out universal healthcare for its 120 million citizens.
It's being phased in, not switched on overnight, because that would affect a lot of people and, naturally, these things take time. But the direction is set, the credentials have been issued, and in a few years any Mexican will be able to walk into any public hospital and receive a brain transplant if that’s what’s required. It’s brilliant.
So: Indonesia has it. Canada, bless it, has it. Mexico is building it, right now, this year, one national ID card at a time.
America, the wealthiest country in the history of the species, looks at all of this and simply won't, or can't. I've genuinely stopped being able to tell which.
I guess, then, the operating procedure for dealing with healthcare in the US is quite simple:
Don't get sick!
Paul v Walters is the author of several novels and an anthology of short stories and is fortunate enough to live on the island of Bali. His latest work, RITUAL, was recently launched at the Ubud International Readers and Writers Festival.
