In the words of Winston Churchill, “America will always do the right
thing, but only after failing at everything else.” According to Dr. Rachel Adler, associate professor sociology and anthropology, health care is no exception to this assertion. “Our health system in the U.S. is definitely problematic,” she explained. “From my perspective, the for-profit model is at odds with the human rights foundations of what health care should be.”
As part of the Global Public Health course taught this semester, Adler says she and her students examined the pros and cons of health care systems worldwide. Though each is different, the basic principles remain the same and shed light on some of the inadequacies of the U.S. system. First and foremost, she says our view of health care as a privilege and not a basic human right is fundamentally flawed. Referencing a documentary about foreign systems, Alder described how in other capitalist countries that have successfully re-conceptualized health care (Germany, Japan, Taiwon, Great Britain), average citizens think it is inconceivable that a person might get sick and be unable to afford a visit to the doctor. “It was so interesting to look at how other countries thought of it as scandalous to think that that could happen whereas in our country we have millions and millions of people for whom that is their reality every single day,” she said.
A common thread in the design of universal health care systems is that these are financed through tax revenue, with each citizen paying the same amount (Great Britain, for example). Though Adler admits that high taxes for health care most likely would not fly in the U.S., she hopes we can still take a few cues from the other principles governing foreign systems. Most importantly, she advocates the non-profit model.
“Right now, the profit-hungry insurance companies are running the show,” explained Adler. “It is not really in their best interest to pay sick people, because if they pay sick people it is less profit for them. Philosophically, the system is at odds with the goal of providing health care.” Non-profit organizations, on the other hand, are designed so that rather than funneling profit into billion dollar CEO salaries, it goes right back into the company. Thus, it is a matter of maintaining the enterprise rather than obtaining unlimited profits and Adler says that when motive is removed, there is a lot of money to play with, “it can go into extending coverage to those who deserve to be insured or those who have lost their insurance.”
Regarding the House bill, Adler says she is fully in favor of the oft-disputed “public option.” In her opinion, extending Medicare-like coverage to everyone while changing the way money is distributed (shift to non-profit), could reduce costs and improve care. Based on discussions I’ve had with students here at the College, my general impression is that some people are paranoid about the prospect of “big government” health care, complete with long waits and bureaucrats mandating what care you can and can not receive.
Adler, however, pointed out the fact that insurance companies are currently doing those very things. “Insurance companies run the show, telling physicians what they can and cannot do, what tests they will and will not pay for and which hospitals patients can and cannot go to,” she said. “All the things people are afraid big government will do.” To drive home her point, she gave the examples of the postal service and Amtrak as two nationalized, government-owned corporations (socialist even!) that people do not seem to have a problem with not view as radical.
So, what does Adler say about Christie and the future of health care reform? It’s probably not a good thing. Throughout the campaign, Corzine accused Christie of supporting “swiss cheese plans” (limited coverage) that would cut out funding for mammograms and autism consultations. “From a public health perspective, those prevention and screening mechanisms are a necessity,” said Adler. “If you talk about Cadillac plan being someone paying a little extra luxurious perks in the system, like the option of a private hospital room or fancy meal plans, that is fine, but when you are talking about mammograms and basic stuff, no way! Everyone needs to have access to that.”
Moreover, Christie has stated he is not in favor of the public option and if a provision is added to the Senate bill allowing states to opt out, New Jersey may be left behind in the health care overhaul. Looking on the bright side, Adler says if that happens, at least our state will be able to see the great results in other states that opted in and hopefully enact change, better late than never.
Regardless of whether reform passes the Senate, Adler is confident something will happen soon because of the momentum the issue has garnered across the nation. “People need to look beyond themselves and find some compassion,” Adler said. “In the end, lack of health care is bad for our country, bad for public health and bad for the kids, who have no choice in the matter. Something has to change, it just can’t go on like this.”
