why our healthcare is perpetually broken

It doesn’t matter how fit or young or healthy you are, when you get a bad case of food poisoning, you will quite clearly be reminded of the fact that you’re a mere mortal. And then the hospital bill will remind you that getting sick in the United States is a rather expensive affair. Back in January of this year, a tainted pizza picked a fight with my stomach and until I got to the emergency room, it was winning. After a shot of something to stop what were the most immediate and painful symptoms, and two quick blood tests, I was sent home to recover for a few days. So how much did three hours at a hospital, one of which was spent waiting for treatment, cost?

Just a little over $4,000 with the hospital charging about $3,000 of it and the doctor asking for the remainder. Lucky me though, I can buy insurance so I’m only on the hook for… oh, $2,000 because that’s my deductible. I could try and get better insurance, but even for a healthy non-smoker under 30, a $1,000 deductible is the smallest you’re likely to get and it will cost as much as it would to lease a new economy car. But remember, we’re lucky to have the medical system that we do, otherwise, we’d have to ensure socialistic rationing nightmares.

Certainly, paying between $2,000 and $4,000 for an emergency room visit is worth it not have any government agencies involved in deciding what care you should receive. The decision will be made by a case manager at an insurance company who will determine what care to authorize based on your plan, and if your doctor dares to prescribe a pill that’s too expensive for their tastes, they’ll simply refuse to cover it for you. And certainly, it is their right as private parties not to cover you, and we certainly couldn’t expect the public to pick up the tab for random freeloaders who think they have the right to get sick and expect medical care.

If they don’t want to have medical debt or need treatment, they shouldn’t get sick in the first place because you can prevent getting sick from anything as long as you really put your mind to it, right? So say a college student living mostly on loans is driven to the ER with food poisoning after eating something shady to save a few bucks on food and winds up with a $4,000 medical bill. Can we, with a straight face, insist that this is fair to everyone involved? Do we just say that the student can sue whoever sold her the food that sent her to the hospital and that some very basic, straightforward treatment should really cost thousands and thousands of dollars?

Suing the place that sold the questionable food is an expensive and lengthy ordeal that’s hardly guaranteed to work out in the end, and the health inspector is likely to only give the establishment a slap on the wrist unless there’s a huge flood of lawsuits coming their way and the kitchen is literally crawling with roaches. Meanwhile, the student is looking at incurring medical debts that could stick around for years unless she’s under a terrific plan through her parents. Sure there’s a maze of forms from charities and government funds that she may try to navigate to get more of her care covered but they take a healthcare professional to fill out properly and to be frank, having someone jump through so many hoops for what should be a very simple and inexpensive round of treatment is ridiculous.

The healthcare system in the United States can only be described as dysfunctional because it’s guided by conflicting principles, confusing regulations, and its pricing and cost structures are the definition of absurdity. On the one hand, we say that we need to help those who are sick since many of those who are, didn’t decide that today would be a perfect day to get into a traffic accident, or be diagnosed with life- threatening illnesses, or even have food poisoning. And yet, we’re constantly afraid of “freeloaders” who dare to expect the hospital’s resources to be used to help them when they get sick and have no insurance.

And the confusion goes even deeper. We get riled up at the idea of governments deciding who gets care and who doesn’t, but seem perfectly fine with insurance companies who try to make a profit by not covering care in the role of the “Death Panels,” a role they’ve occupied for years. Why? Because it’s less direct? Because it’s a more digestible idea we can hinge on money rather than think about its ethics? And why does basic care cost so much?

We know that waste is a big part of the problem as are fraud and litigation, but between all of those things combined, we still have more than a trillion dollars worth of medical care left unexplained. Even the fact that Americans have been eating themselves to death for the past two decades and the same punditry that preaches personal responsibility in healthcare grabs their torches and pitchforks when someone suggests a few more salads to the 66% of the country that needs to lose weight to live a longer life, doesn’t account for all of it.

And this is the real problem with every major healthcare bill considered since the 1990s. Instead of trying to sort out our philosophical contradictions and to get to the bottom of why medical care is so expensive in the United States, it offers little more than overcomplicated band aids. As healthcare costs grow, politicians either twiddle their thumbs or regurgitate stale, predictable talking points. But hey, they get medical care paid by our taxes. Why should they care about this? It’s not like they’ll have to pay $2,000 after eating a bad pizza.

We’re not talking about healthcare being free of course, that’s impossible because someone will always have to pay the doctors and cover the cost of operating the hospital and its equipment. But at the same time, what a libertarian would describe as a “free market solution” doesn’t apply here because when you need emergency medical help, you don’t have time to shop around to find the right hospital. I know of no one who makes totally rational, logical decisions when he or she is really sick and even if he or she did, emergency room visits tend to be equally expensive wherever you go. Likewise, it seems crudely selfish to declare that anyone not happy with the runaway costs of healthcare in the U.S. is a freeloading socialist whiner who expects to be taken care of by everyone else.

The issue is not black and white, and no “illegals and welfare queens” is not the answer to every question about the cost of medical care out there. And until we can actually put all the facts and all the options on the table, and consider them without radical partisan insipidity, we’ll have a healthcare system that functions despite its best efforts to collapse under its own weight, trudging onwards with no guidance and an impassioned, tangled mess of contradictory principles instead of a standard or goal.