We've Been Trapped Inside a Bad Health Care System So Long, We Don't Even Know How Much We're Missing
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Sometimes, when you're up to your chin in alligators, it's hard to focus on the fact that there's a big, broad, alligator-free world waiting somewhere out there, beyond the edge of the swamp.
In this case, it's hard for most Americans to even imagine that nobody in the rest of the developed world lives this way. We've been living inside the restrictions and making the trade-offs required to hang onto our all-important health care coverage for so long that we don't even realize that we're cutting those deals, or what we're giving up, or how thoroughly those choices have come to dominate and limit our lives.
If you're an American under 40, you can't remember a time that the health care system didn't work this way -- or that keeping coverage wasn't a dominant factor in making your life choices. If you're older than that, the memory of another, happier era beyond the swamp is dim, and fading fast.
This was one of the things that struck me hardest when I arrived in Canada five years ago. The swamp-blindness was so dark and deep that it took a while to adjust to a world without alligators. It's almost impossible to describe to folks back home how different life is when health insurance simply doesn't factor at all into how you choose to live your life. There's almost no language for it. Rather than even attempt it, I sometimes just ask my American friends and relatives to open up their imaginations, and answer the question for themselves:
I've seen people reduced to tears of rage and frustration by these questions. When you really stop and think about it -- pause for a few minutes to take it all in, past, present, and future -- it becomes clear that the full absurdity and the sheer enormity of the sacrifices we have to make for an almighty health care card are the greatest obstacle to life, liberty and the pursuit of happiness that most of us are burdened with today.
Polls say most Americans who have health care are satisfied with it. But nobody ever asks them if they're satisfied with what they've had to do to get it, keep it, or afford it.
What would you do differently? I watch my Canadian neighbors live their lives, and the world beyond the swamp comes into sharp and stunning focus.
My neighbors go to the doctor when they need to -- and often, when they don't. If they're just feeling funky for a day or two, they go. If the splinter is too big to handle with a needle, they go. Anything goes a little bit sideways -- they go.
By American standards, they're probably overusing the system. (My husband once asked an employee who was nursing a cough, "Have you seen a doctor about that?" The guy just looked at him, confused. Of course he'd seen a doctor. Up here, only an American would ask such a stupid question.)
But the upshot is that the small symptoms of really big things -- little lumps, creeping blood pressure, wounds that don't heal right, coughs that don't go away -- are caught and diagnosed early in a GP's office, instead of months or years down the road in a full-blown crisis at the ER, which is now the American way. And this is central to cost containment: getting emergent problems calmly headed off right away in a $30 office visit is a lot more cost-effective than having to deal with the full catastrophe later on in a $3,000 emergency-room drama scene. And it allows people to maintain their good health through the years, instead of delaying treatment until it's too late to recover it and permanent damage is done.
My neighbors heal, recover, and go on with their lives. The U.S. disability rate last year was 19.1 percent, and rising fast. In Canada, it's 14.3 percent -- and Statistics Canada believes that the only reason their stats are creeping up these days is that people who once hid their disabilities are now more willing to admit them.
See more stories tagged with: health, education, insurance, health care, canada, savings, age, public option
Sara Robinson is a Fellow at the Campaign for America's Future, and a consulting partner with the Cognitive Policy Works in Seattle. One of the few trained social futurists in North America, she has blogged on authoritarian and extremist movements at Orcinus since 2006, and is a founding member of Group News Blog.
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