Factual Alternatives

It seems apparent to me that very little in life will ever be considered ideal or perfect--especially in matters of public policy.  This is why I believe the practical approach to discussing policy is not strictly talking about the pros or cons of one particular policy, but rather considering all available alternatives.

I give as my first example the question of healthcare.  Just yesterday a conservative voiced his concern that if we had government healthcare (as nearly every other developed country has), we would be subjected to "death panels" and he cited the case of Charlie Gard to support his claim.  Now, discussing the finer points of that case could be a discussion on its own, so I set that aside.  Let us assume, for the sake of argument, that the prospect of changing to single payer invariably comes with death panels.  That is to say, the courts of the land will be given authority to terminate care for a patient due to whatever reason it seems to find reasonable to do so.  In particular, if the cost of care is too great, or if the perceived chances of survival are too small.  So, I will concede that point and just assume that "death panels" come with the package of single-payer nationwide health coverage (although, at this point I would like to point out that I'd have much to say on that matter, again for another discussion).

So let us consider the alternatives.  One alternative is our current system.  Our current system is very complicated.  Those who are employed full-time have health insurance through their employer.  Some employer-sponsored plans are very good and some are very expensive with minimal coverage.  My plan happens to be a very good plan, with a low deductible and high coverage benefits.  Some plans have deductibles of $5,000 or perhaps more.  This means that a patient must incur over $5,000 in medical costs in a year before the insurance even comes into effect.  This cost is prohibitive for many families.  Now, on to people who are not employed or who are only employed part-time (or are contracted or otherwise not considered employees with benefits).  These people must be insured through private insurance.  If a person is relatively young and healthy, ey may not have much difficulty finding an affordable private insurance plan.  However, if ey has cancer or diabetes or some other chronic illness, no private insurance company will write a policy for em.  Ey would need to go through a state-sponsored health insurance plan with very high premiums.  This may not be affordable.

So let us consider two people and what might likely happen to each in each situation.  The first person has type 1 diabetes.  This is a condition in which eir pancreas does not produce sufficient insulin to react to the sugars in eir blood stream.  Fortunately, progress is being made in preventing or treating this condition.  But, for the time being, people with type 1 diabetes need to check their blood sugar regularly and inject insulin according to their intake of carbohydrates.  So this person, in a single-payer country, would simply go to the pharmacy at regular intervals and pick up eir insulin and blood testing strips.  These have already been paid for by tax money, so they would be made available to the patient without any extra charge.  The patient is never without the medical aid ey needs to treat eir condition appropriately.

Now consider what might happen to this patient in the US.  If ey is employed, eir insurance plan may or may not cover diabetic supplies (some plans do not, since these are costly and regularly required supplies).  If ey is unemployed or only employed part-time, ey will need to find eir own insurance plan or pay all of eir own medical costs out of pocket.  Because of the Affordable Care Act, insurance companies would not be allowed to turn the patient away for having a pre-existing condition.  However, if the GOP healthcare bill passes, this regulation would be revoked and we would be back to where we were prior to the enactment of the ACA, where no private health insurance company would take the patient because of eir pre-existing condition.  Which would leave em stuck buying eir own supplies.  The amount of insulin and test strips that a diabetic person needs are extremely expensive.  Ey may be required to take on a second (or third) job simply to cover the costs of eir medical bills.  More likely, ey may just end up not treating the problem at all and living with dangerously high blood sugar levels.  Ey could develop all of the problems that come with high blood sugar, including kidney failure, blindness, amputated feet, and many other health problems.  Eir life would be drastically shortened without the regular supplies ey needs to keep eir blood sugar levels in the normal range.

Now let us consider another person.  This person has suffered some major trauma and is now in a vegetable state.  Ey cannot react with eir environment in any meaningful way.  Ey can be kept alive through life support.  The doctors attending the patient have determined, to the best of their knowledge, the patient will not recover from this condition.  In a country with social medical care, it may be determined (by the doctors or the courts or whatever entity) that the cost of keeping the person alive is not justified and that the life support should be discontinued.  This may be against the wishes of the next of kin of the patient.  This is what may be considered a "death panel"--a person or group of people making a decision which results in the death of a patient.

What would be different with this patient in the US?  Again, it depends on how wealthy the patient (or the patient's family) is.  If the patient did not have health insurance (or had a poor plan), ey may not ever have made it to the hospital to get on life support in the first place.  Or, the hospital may have decided to pull the patient off life support when it became clear to them that the patient (or his family) would be unable to pay for the cost of the treatments.  In any of these cases, the patient is in exactly the same position as in the socialist medical care case.  The only case which may be different is if the patient is wealthy and is able to remain on life support for an extended time.  In the best case scenario, the doctors may be proven wrong and the patient makes a full recovery and regains cognizance.  Again, this would only happen if the patient was on a very good insurance plan or had a virtually unlimited supply of money to pay for the coverage.  This represents a very small percentage of the population.

From what I have read and what I have heard from people who live in other countries, it would seem to me that the only way in which our healthcare system is superior is that wealthy people can get any treatment they seek/need.  But, for the average person, it seems to me that switching to single-payer healthcare would be beneficial.  Ordinary people wouldn't have to stress about whether they're going to be able to afford the healthcare they or their family members need.  They would have the peace of mind knowing that they can get the care they need regardless of their economic status.  This is why I support switching to a socialized medical plan.