Universal Health Care Myths

Universal Health Care Myth #1: Paying For The Other Guy

The most common complaint I hear about any proposed system of universal health care is, essentially, "I don't want to pay for some guy's medical bills who has lung cancer because he smoked for 20 years. *I* don't smoke, so why should I pay for *HIM*?"

This argument sounds compelling, and might be in a zero sum two player game, but in the scope and context of a nationwide health care program with 300M+ participants, it becomes nonsensical.

When we look at a population of that many individuals, we see a normal distribution in health - and more specifically, health costs. There are a few individuals out on both ends; the people who are both lucky *and* careful, and have extremely low health costs for their entire lives, and those that are unlucky or extremely careless, and have HUGE health care costs over their lifetimes. It's worth noting that mostly the truly expensive ones are unlucky, not careless. People with chronic illnesses ( such as my sister with epilepsy ) cost the system far more than most drug addicts or alcoholics, because the cost is both high and ongoing. She didn't make bad choices that put her there - she was born that way.

Now, the rest of society falls in the bell curve. The vast majority of people have very similar lifestyles and lifetime health costs, and the vast majority of people will be contributing the vast majority of the money.

Now, to further muddy the water. The vast majority of people who live careless, unhealthy lives will live shorter lives, in general; the majority of people who live careful, healthy lives will live longer. The older people get, in general, the higher their lifetime health costs. Thus, it's not entirely clear that people who live healthy lifestyles have a lower lifetime health cost. You just can't make those kinds of assumptions without long term studies.

Finally, when we research the issue, we discover that *most* people don't live as healthy a life as they think they do.

So, in the end, we discover that, while there are necessarily variances in lifetime health costs, the shared risk reduces costs for everyone - that's the foundation of insurance to begin with. In the final analysis, most people will pay for most people. The rest is just like property, road, and school taxes. Sure, there are outliers, but they're not particularly relevant in this context - that's why they're called outliers.

Universal Healthcare Myth #2: The High Cost of "Socialized Medicine"

I can't count the number of times I've hear people bandy around mind boggling numbers concerning the costs of "socialized medicine". The subtext - and sometimes the actual statements - indicate that this cost, this massive amount of dollars, is somehow a 'new cost', that it's an additional burden on the public. Fortunately, this simply isn't the case.

Every claim of the costs of universal health care is based on estimates derived from current costs plus expected increases in costs. The people of the United States of America *WILL PAY THAT BILL* no matter what action Congress takes, either to insurance companies or to the government in the form of taxes.

There are complexities, to be sure. The extension of coverage to people who do not now have it will increase costs, but the fact that those people will no longer have to go to the emergency room for things like the flu (where they cannot be denied treatment) will reduce costs. Extending preventive care to those people will probably reduce longer-term costs, as well.

The way our system works today is the reason we pay more per-person for health care than any other western nation, both as a percentage of GDP and in actual monetary value. Our system does have some shiny spots - particularly in cardiac outcomes and certain cancers - but several other western countries that finance medical research have similar segments where cutting edge treatments are available there. The wealthy frequently cross national borders for various treatments, in both directions. Overall, however, most other western countries have better overall healthcare outcomes, and pay much less than we do for them. In addition, most European countries have longer life expectancies and lower all-cause death rates.

The benefits of universal health care, in all probability, extend far beyond simply controlling costs and improving overall health care. For example, the American Journal of Medicine says that more than 3 of 5 personal bankruptcies in the US are directly attributable to medical debt. The reduction of the stress of dealing with medical bills and worrying about how to pay them will undoubtedly improve healthcare and healthcare outcomes.

There are two things that everyone needs to understand about health care costs and predictions. First: We're debating about HOW we'll pay those bills, not *whether* they will be paid. That money *will be spent*, and it will be spent by the US taxpayer, period. Second: The only way to get our health care costs under control is through government intervention. All of our peers in the western world realized this long ago. 'Competition' among health insurance providers has brought us to this place - the highest per-capita health care cost in the world, and sub-par care for much of our population. The Insurance companies are making their profits (ranging from 2 to 40% of company revenues!!) while hospitals are cutting raises, reducing staff, and jumping through hoops to cut costs because half of their patients can't pay. Insurance companies apply massive downward price pressure to medical providers while adopting 'first-pass deny' policies and jacking up premiums.