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Politics / Health Care

Medical Costs: Survival of the Richest?

by Cara N | August 16 2014

Did you see this recent headline?

Once again, U.S. has most expensive, least effective health care system in survey

16June2014, Washington Post,

The article asserts that while we pay significantly more (see the huge divide between us and second worst Norway) on healthcare, the U.S. system gets the worst ratings for quality.

Why Are American Health Care Costs So High?

How does that make you feel about your tax dollars?

Let’s talk diabetes, a handy example since it’s a disease where treatment is often a matter of life and death.

According to the American Diabetes Association (ADA), in 2012, nearly 10% of the U.S. population had diabetes.

Then consider this quote from the ADA website:

People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes.

Of note: if someone works for minimum wage (Federal: $7.25/hour) full time, that means they make $15,080 before taxes, in the entire year. Our lowest federal tax bracket is 10% for single people, which could mean:

Annual income $13,572

Annual medical expenses $13,700

Even if you’re making more than minimum wage, as are about 94% of all employees paid by the hour, $13,700 adds up quickly.And by “adds up,” I mean requires folks to choose between food and medicine, or to reuse medical supplies against medical advice. Despite the dangers of doing so, some people with insulin-dependent diabetes reuse their syringes because they need to save money.

Other things to consider:

What if there’s more than one person with diabetes in the home?

What if diabetes gets in the way of working full time?

What if there are other diseases in addition to diabetes? (Thyroid problems are a common second diagnosis.)

What if, what if, what if.

It paints a grim picture, doesn’t it?

To add insult to injury (er, disease), in the U.S. your level of wealth impacts the quality of care you get. The top of the line treatments aren’t accessible to everyone. Insurance representatives will tell customers their plan doesn’t cover the “luxury” of say, an insulin pump.And while, yes, and insulin pump does wonderful things, is having to be dependent on insulin, and having to always wear a medical device, and being responsible for all the pieces that go with it, truly a luxury?

In American-Dream-type-thinking, illness is a matter of bad luck and/or laziness. People with this slant have said things like:

Anyone who works hard enough can be financially successful.

–The evidence says no. In fact, a large majority of people believe the American Dream is fallacy. 

It’s not my problem you have a disease, it’s yours.

–But, it could be you. Tomorrow, next year… we all will die of something, after all.

If we force medical suppliers (pharmaceutical companies, device manufacturers, insurance companies, etc.) to work under a fixed profit, the money will no longer drive development and technological advances will stop.

–Fear mongering, not truth. Read about healthcare in Europe, if you’re in doubt.

About that fear mongering, what I mean is the trend in the U.S. to use marketing-type strategies to put a dramatic fire behind your message, whether or not it’s true.Those of us who take the time to read research, digest it, and question it know. There’s so much fact around us buried under political artistry. They take a term, like “socialist,”and make sure it’s front and center. Then they focus our attention on the emotional phrases, like “control your hard-earned money.” They’re successful—think of the immediate, negative imagery tied up in political phrases. (What does “socialist” bring to mind for you? Or “welfare nation”? Or “the party of no”? )

While facts take time to chew and digest, in seconds the scare technique can shut dialogue down. Fear doesn’t foster deep thoughts, it feeds reaction. Of course we’re going to be afraid to hold medical companies accountable to the people whose lives literally depend on them when we’re told it could make them dry up and go away.

We look past the fact that AstraZeneca’s CEO made $5,748,018  in 2012. (Now there’s someone who could afford good diabetes care.)

We look past the fact that equal medical care costs much less in other countries.

While some blame people for being lazy and not earning the tens of thousands they need to live with diabetes, perhaps they should hold up a mirror to that “lazy,” and raise themselves a “hypocritical.” Lazy is spreading the propaganda that comes from political marketing and then voting behind it. Voting against affordable copays (or none!) for your neighbor’s insulin, your cousin’s asthma inhaler, your former classmate’s cancer treatments…

We need to stop hiding behind scare tactics and political party lines and start looking at truth. Remember Erin Brockovich? She showed us one way complete strangers’ decisions can utterly change peoples’ health. Industry has been deemed responsible for some human illnesses. It’s the result of contaminating air, water, and paying to keep the information away from those affected by it.

Tell me again how that person drinking tap water from his sink is at fault? How about you? Do you research the issues most important to you before you vote? Or do you follow the opinions of others? Do you think there are lies lurking in research? Some conspiracy between the left and all legitimate research agencies and scientists out there?

And how about the countries, our peers, that prove us wrong all the time? You know—the ones that provide healthcare to all, have healthier citizens, lower bills, and higher satisfaction levels. Is that myth, too? Or are we ready to move past those politicians, their cheaply tossed words of terror, and see our fellow human beings: the person living with diabetes who will never be able to afford to retire and the one who has to make a choice between a new pair of shoes or her testing strips.

I’m often fascinated/depressed by the comments I see in response to articles like the one mentioned at the beginning of this post. The facts are there—you can verify them yourself. Regardless—the naysayers sign on and pull out their fighting words (opinions), a tactic geared at emotional response. Frequently, their political opposites respond with links to research. It becomes a cesspool of facts and buzz words that swim in the same muck, but miss the point. Divided they make more filth, together they could transform it.

How does the American Dream apply to people with health challenges? When’s the last time someone conquered mounting cancer debt by hard work? How did she surmount everything that comes between actual hard work and profiting directly from it? And after she paid it off, was there enough left for the pursuit of happiness?

Further Reading:

The Economic Burden of Diabetes (Health Affairs, February 2010)

Affording Health Care and Education on the Minimum Wage (Center for Economic and Policy Research (CEPR); March 26, 2012)

5 Facts about the Minimum Wage (Pew Research Center, December 4, 2013)

Your 2013 Federal Taxpayer Receipt (Ever wonder where exactly your federal tax dollars are applied? Plug in your 2013 numbers here and you’ll see.)



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