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After the Supreme Court’s decision last week to uphold the Affordable Care Act, I am not convinced that the state of health care will actually improve as promised. I am not talking about insuring the previously uninsurable, or keeping a child on their parent’s plan until 26. I am concerned about the overall health care of each American. Here is why I am concerned.
Our family spent 10 years serving as missionaries in Germany. German citizens have two options when it comes to health care insurance. They can participate in the state run health insurance, which the majority does, or buy private insurance, which is more expensive. Since private insurance is more expensive, those having private insurance are the wealthiest of the nation. The poorer and middle class participate in the state’s socialized health care, and the wealthiest carry private insurance.
In 1995 I broke my elbow playing basketball. The fracture was severe, necessitating immediate surgery. In the capital city of Thuringia, Erfurt, there was a university hospital with an excellent sports injury department. I was sent to this hospital for surgery by the professor of the sports injury department, the head surgeon.
After I awoke from surgery, I was in a hospital room all by myself. Other than being very meager, the room was like most hospital rooms in America. After all, I was in the former East Germany and I did not expect the room to be exactly like one in America. A day later another man came to the room after his surgery. Between waking and sleeping the man and I struck up a conversation.
We talked about our families, our occupations and general life stories. I commented on how blessed I felt being operated on by the head surgeon. The man told me the head surgeon would have operated on me naturally. I was a bit confused. What did he mean? He said that because I had private insurance (our insurance was in America and considered private health insurance) the head surgeon would operate on me. What if I would have had the German socialized health insurance? The man replied that a subordinate and not the professor would have operated on me.
The head surgeon operated on me because I had private insurance? Could that be? I received the best care because I had private insurance? I was not sure I could believe the man, because I was used to receiving the best possible person a hospital offered for surgery in America. So I asked the professor when he visited my room. The professor confirmed the man’s statement. My private insurance guaranteed the best possible care during my hospital stay.
Not only did the head surgeon operate on me; I was in a two-person hospital room. I had not thought about my room accommodations, because I have only seen two-person rooms in America. I asked the man staying in my room about the rooms for those without private insurance. Those rooms accommodated up to six people, and, mostly, the rooms were at the maximum capacity. My private insurance granted me a hospital room that afforded the best possible situation for my recovery.
Another disconcerting experience with socialized health care in Germany concerns access to needed surgeries. Frau (Mrs.) Duve, a friend of ours, needed a hip replacement desperately. She could barely walk, and when she did, she hobbled. She was in constant pain. She begged her doctor to allow her to have hip surgery, but was continually denied. Operations, in the German socialized health care, had to be prescribed by the doctor before the surgery could take place. Since Frau Duve was over 70 she was denied the hip surgery and was told to manage the pain through medication. If she would have had private insurance, the surgery would have happened immediately. Instead she was denied surgery based on her age and the assumed productive years of life left to her.
If you think that rationing is not a real possibility in the practical implementation of the Affordable Care Act, I contend that you are deceived. As costs rise and money fails, decisions will be made about cutting costs and rationing will take place. To avoid this possibility, the wealthiest will purchase private insurance, guaranteeing them the best possible care as the rest of us receive second-class health care. In effect, a two-tiered health care system will develop. The wealthy receiving any surgery immediately that their private insurance will pay for, and the rest of us will wait for permission for surgery or be denied based on cost overruns. This will impede the majority of Americans’ individual health care. It will not be better, but worse.
I have experienced socialized health care, and I think it is a bad idea.
Mark,
I am confused. You describe a two tier system in Germany with the wealthiest getting the best care and the middle class and poor getting care but not as good. That is similar to what we have here, but we have a third tier of people who get minimal health care in the form of emergency room visits. Yes, Germany ranks as 24 country for health care even though they pay the third highest rate of health care cost. Not a very good performance. But a whole lot better than paying the very highest health cost and getting only 37th best healthcare in the world (the current US rank).
Before you think I am a liberal about the process and turn off listening, I would like to hear what you think about http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/ It is one of the best article about the problems facing our healthcare system and his proposals are about putting competition back into the system. It is an eye opening article and would like to hear what you think about it.
Ernesto: I do not think Germany’s health care system is similar to ours. I’m sure it happens, but most people in America are able to get the surgeries they need; even those who are uninsured. This is not to imply that the American health care system does not have problems. I believe it does.
I read the article, and you are right. It is an excellent article about true health care reform. There were some minor points of disagreement, but on the bulk of the suggested reform, I am in agreement. Health Savings Accounts, true competition and the abolishing of health insurance as we currently know it, would be a great start to truly reform the American health care system. The author was addressing the problem as a businessman. I think we need our current politicians thinking like him.