We've Been Trapped Inside a Bad Health Care System So Long, We Don't Even Know How Much We're Missing

By Sara Robinson, Campaign for America's Future. Posted June 26, 2009.

That disability rate affects the country's economic competitiveness. Americans just don't have the time or money to spend on a proper recovery after a major event, or get the full course of treatment that a chronic condition requires to be truly well-managed. Fearing for our income or our jobs, we hurry back to work too soon. Our insurance doesn't cover necessary follow-up therapies, so things may not heal thoroughly or properly. We can't afford the drugs, so we cut the pills in half, or stop taking them entirely.

The result is that too many of us end up far more impaired than we need to be -- and may, in fact, never be quite right again. Deferred maintenance -- which is what this is -- takes a ferocious toll on the American workforce, which is now being forced to compete with workers around the world who get better care, make better recoveries, and are able to return to work at full strength.

My neighbors start small businesses. Americans routinely stay chained to jobs they hate because they can't afford to lose coverage. Canada has an exuberant entrepreneurial culture, fueled by favorable tax structures for small business and a preference for Main Streets over malls. Canadians may bet the house and the kids' college funds on a new venture; but they never think twice about whether or not they can afford to leave BigCo because they'll lose their insurance, or what will happen to the new business if they get hit by a delivery truck, or how they'll afford some kind of minimal coverage for their new employees. Unburdened by health care costs or concerns, their ventures are far more likely to thrive.

My neighbors go back to school. Low-cost government-subsidized universities combined with assured health care make it easy for people to make mid-course career adjustments, pursue their passions, and expand their horizons. The upshot is a better-educated, more capable workforce that's constantly improving its skills.

My neighbors quit jobs they hate. "Take this job and shove it" is a lot easier -- and sweeter -- when your boss isn't holding an almighty health care card over your head. Bosses know this, too, and working conditions are often better as a result.

My neighbors stay home with their kids. They can afford to do that, because they're not wholly dependent on whichever breadwinner can manage to find a job with a decent health care plan.

My neighbors invest. They've got stable household budgets that aren't being thrown off by surprise health events. Because Canada doesn't have a mortgage interest deduction, most Canadians reduce interest costs by taking out 10- or 15-year mortgages. The payments really squeeze the family budget for that decade -- but by their 40s a lot of them own their homes outright, something most Americans will never achieve. Home ownership, college savings and retirement funds are all big-money investments that you simply can't commit to if you're liable to be hit with five-figure medical bills at any moment.

My neighbors travel. Americans don't get vacation time; and when they do get it, they tend to stay in-country. A lot of Canadians take three weeks off in the winter to go somewhere fabulous and warm (understandable, given the climate). The sheer variety of these escapes boggles me yet: They fly off to build schools in Guatemala, or take holiday jobs in New Zealand, or learn French in Morocco. Even the guy who paints my house can afford to do this, because he's not spending half his annual income on health care premiums. That $15K-a-year savings will buy a whole lot of margaritas in Cancun.

The result is a population with broad global awareness, and extensive global ties -- a necessary thing for a country whose economy depends completely on trade. And it may be an important factor in keeping Canada progressive. According to Diana Kerry, who ran her brother John's overseas campaign in 2004, Americans who own passports vote Democratic three to one. So travel makes you liberal. Who knew?

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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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