Guest Blog: In Pursuit of Happiness? Health Care in the 21st-Century U.S.

This article is co-authored by Dr. Kristen Marie Burkholder, Dr. James Cane-Carrasco, Dr. Douglas Catterall, Elizabeth Powers, Rev. Scott Scrivner, and Dr. Tony Wohlers. For the authors’ longer study of the American health care system, click here.

On March 23^rd, 2010 President Obama signed into law a sweeping reform of the U.S. health care system.  Since that time some have taken action to repeal these reforms, others have indicated support for extending them.  Much of the talk opposing or supporting reform has been remarkably free of the perspective of those who would benefit most from it: the uninsured, the underinsured, and those who may soon enter their ranks. We are writing to address an injustice that the citizens of the United States, the country of our birth or adoption, are inflicting upon themselves.

Let’s first show the health care system working at its best.  Recently, a colleague of ours became ill and physicians suspected the worst: a brain tumor that might be near or actually embedded in her speech center.  Our colleague received incredible support from family and friends and our employer offers first-rate health insurance, giving her a choice of clinics, hospitals, and specialists.  She chose MD Anderson in Houston whose physicians and staff provided her with the excellent care. Happily, the neurosurgeon who operated on her found no tumor and she has returned to work.  However, this best-case scenario could have turned out differently. Our current health insurance provider, Blue Cross/Blue, Shield., covered the roughly $58,000 cost of our colleague’s treatment. But, with our previous health provider, MD Anderson would have been an out-of-network, leaving our colleague with more of the costs.

Peeking behind these numbers reveals some other stories that challenge us all as residents of the U.S.  First, while far from the most expensive procedure one could have, the cost of our colleague’s treatment would not have been in financial reach of most of us to pay out of pocket.  According to recent Census Bureau data from the recession period, 50.7 million people living in the U.S. have no health insurance. Most of these people without insurance cannot pay for anything but the most basic health care and would certainly not have received the care that our colleague did.

Now, let’s take this a step further.  Generally, the uninsured resort to costly emergency room visits for medical conditions that might otherwise have been treated months or years earlier. Too many of them will not make it to the emergency room at all, or, if they do, will arrive too late for adequate treatment. In a recently published paper, Harvard Medical School researchers stated that as many as 44, 789 people die each year for lack of access to health care. This means that more than 120 Americans will have died twenty-four hours from now, and 3,732 by this time next month for want of health care access.

This state of affairs flies in the face of the words that Thomas Jefferson and other early founders of our republic championed.  They spoke of “life, liberty, and the pursuit of happiness” as essential rights. Would they recognize the spirit of that phrase in the health care profile of the U.S. today?  They would find a country that devotes at least 16 percent of all its goods and service to health care, and 50 percent more per capita than any other country in the world. For these substantial expenditures the United States manages to provide health care to only 85.3 percent of its populace.  Among the United States’ OECD peers, the founders would encounter very different circumstances.  All OECD countries, except Mexico and Turkey, offer universal or near universal healthcare coverage, while paying far less to achieve it.  Most of these countries have much better results to show for their health care outlays.  In the OECD’s 2009 data for life expectancy, the United States ranked 24^th out of 30 countries.

These facts present a sobering reality that no amount of bluster about the U.S. health care system, a system that chiefly excels at boutique health care, being the best in the world can erase. The facts beg an equally sobering question to be asked and answered by everyone in the U.S.: is a health care world in which each of us can pursue only that happiness to which our individual circumstances entitle us the one we as a society want?

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