Three cheers, we’ve finally joined the other developed nations


Nobody could have been happier than I was the other day when the U.S. Supreme Court upheld the Affordable Care Act.

We’ve just extended health care coverage to 30 million Americans who could lose their home, their income, their meager savings – everything. The cost of one major illness could be catastrophic.

For nearly a quarter century, I wrote editorials and columns about health care for The Journal Gazette, Fort Wayne’s morning newspaper. One theme I returned to often was our broken health care system.

In America, it costs more to get sick than in any major industrial country. The cost continues yearly to explode. With few exceptions, our outcomes lag behind the others. People in those countries live longer. For generations, we’ve been at the mercy of profit driven industries, from health insurance to drug manufacturers, from the makers of MRI scanners to prima donna specialists. The new health care law changes that.

For nearly all my adult life, I’ve enjoyed the benefits of health care coverage. I don’t know what my family and I would have done with out it. When the bill came from Good Samaritan in Cincinnati for the birth of my daughter Robyn, I could easily pay it. Three years later, when the bill came from St. Elizabeth in Covington, Ky., for John’s birth, I had no problem covering that charge with a check. I happily paid the nominal premiums for health insurance through the schools where I taught.

Even before my kids were born, I developed, as I had often since childhood, a severe case of tonsillitis. The tonsils had to come out. People often said that surgery was tougher on adults. I believe that. Laid up for nearly a week in my 20s, I was only able to eat soup, ice cream and drink tea. I got a couple of James Michener’s novels to read. That is, I read when I wasn’t sleeping and the pain pills had worn off. My health insurance mostly paid the surgeon’s bill and the hospital’s.

In the early days of my editorial writing, I interviewed experts on health care, people from across the political spectrum. I brought up the subject with political leaders, state and national. Mostly, I found, those who defended the American system sold health insurance or had some other vested interest in the status quo.

“We have by far the best health care in the world,” one friend told me. She was a financial adviser who also represented health care insurance companies. She adamantly insisted I was wrong when I pointed out that it was mainly people who could afford to pay, with insurance or otherwise, who had decent care.

Along the way, I studied the history of efforts at reform. Pretty depressing. I became acquainted with what worked and what didn’t work so well in Canada and other countries with national health insurance. With few exceptions, people in those countries got a better deal. Moreover, nobody went without or waited until they were so sick they went to the emergency room. That’s often the case in this country where the emergency room has to treat a person. No secret here, that treatment’s cost is borne by those of us with health insurance. The result is higher premiums.

In late summer 1978, near my birthday, I developed abominable pains that took me to Lutheran Hospital’s emergency room. Nurses there gave me a powerful shot for pain and sent me home. Not long after, I was in Dr. Robert Ball’s office where he explained this major surgery to remove my gall bladder. He was sure right about the major part of it. When I sort of awoke from the surgery, I was delirious with pain. This was years before the surgery became much more targeted on the offending organ and recovery takes fewer days. Mine left a scar across my abdomen. What I didn’t have was a huge bill I couldn’t pay.

When my teenage son ended up in a psychiatric treatment center for depression, the final cost exceeded $30,000 for weeks of care. My health insurance with the newspaper picked up most all of that.

It has always seemed to me that health care is a basic right. This is where the discussion should begin. The day the Supreme Court announced the health care decision, I met over coffee with Professor Dave Johnson. He’s a good friend of mine who teaches nursing at the University of St. Francis here in Fort Wayne.

Dave said he agreed about health care being a basic right. Yet he wanted to know what I thought about people who don’t take care of themselves, who bring their health problems on themselves.

The conversation with Dave called to mind a recent visit to a health care center where I went to have a test for lung efficiency. My wife Toni mentioned to our family doctor during my annual check up that I occasionally seemed out of breath without having exerted myself. Hence, my presence at this center for a breathing test. Turns out, the test showed no problem. Lungs are working fine. A relief for me, even though years ago I was a heavy smoker. As for all those other folks in the waiting room, I guessed most wouldn’t get a clean bill of health.

As I scanned those waiting for their turn at the breathing machine, I saw one person after another who was grossly overweight. A couple had a oxygen tank attached to them. Two needed help getting out of the chair.

What about these folks? They clearly hadn’t taken care of their own health. I hesitate to label anyone irresponsible. Yet they will be treated. And if not private insurance, if not the clinic eating the cost, if not Medicare or Medicaid, somebody will pay. The rest of us can lament their lack of responsibility. But it would take a pretty heartless person to deny them care.

I’m taken back to a line from Philo of Alexandria: “Be kind for everyone is fighting a great battle.”

Making sure that everyone has health care is a society’s way of being kind to everyone. I’ve met plenty of people who would tell you it’s “every man for himself.” I prefer thinking that “we’re all in this together.”

Yes, old single-payer guy that I am, I would have preferred health care reform that’s much like what the Canadians enjoy. Medicare for all would be my watchword. Still, it’s hard to see what’s not to like about the Affordable Care Act. It requires your insurance carrier to let you have the policy despite pre-existing conditions. There will be no lifetime caps. You can stay on your parents’ policy until age 26. And, under the court’s ruling in at least those states that accept the new federal dollars, Medicaid will cover lots more poor people, surely millions more.

I expect this law will be fiddled with, improved and might even help rein in health care costs in this country. I can’t imagine how it will be thrown out under another Congress, under another president. Too many Americans like key features. To be sure, the politics against the now constitutionally scrubbed law remain pretty ugly. Well, I’m reminded that Social Security survived such opposition. So did Medicare. So did Medicaid. The truth is, we’re a better, more civilized, more humane country because of those programs. In time, I’m confident most Americans will find this to be the case with the new health care law. It was long overdue. Long overdue.

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