Sunday, November 4, 2018

Is There a Need for Universal Healthcare?

     I can't remember when, but I saw a post on IG saying something along the lines of "I believe in your right to insurance, but I don't believe it's your right to make me pay for it." I don't agree with this principle in concept or practice, and here's why: as a group, doctors already make an oath to - essentially - heal those that need it. So regardless of anybody else's opinion, they've essentially committed themselves to a line of action - if someone needs it, they'll fix it (this is pretty much what the emergency department is for - urgent care that requires treatment). Furthermore, they cannot turn folks away whether they are rich, homeless, or anything in between. This creates a situation where "consumers" receive a service regardless of their ability to pay (I put "consumers" in quotes because I think it's a really callous way of viewing people), creating some debt. How's this debt covered?
     Well, either the staff provide the service without charge (which they usually don't, nor would I expect them to) or everyone else gets a little bit added to the top of their bill to take care of it. Situation remedied, right? Completely. If you can't tell, though, that means we are all (already) collectively paying for that service (emergency services). As the saying goes, though, an ounce of prevention is worth a pound of cure. Let's take it literally (just for the sake of the blog, there's literally no economic or medical data I am citing for this) and say that $1 in preventive care is worth $16 (16 oz. to a pound) in later, emergency costs. For 137 million emergency department visits in 2015, that cost ends up being quite hefty. Let's say the average visit costs $1,000 for scans and other treatment for some simple math - this ends up being $137,000,000,000, or 137 BILLION dollars. According to the CDC, 14% of emergency department visits (in 2012) were by people with no insurance. If the percent from 2012 applied to the number and cost of visits in 2015, then 19.18 billion dollars (14% of 137 billion dollars)  worth of care is administered to those without insurance - which is a figure that must be bore by some other entity. Lastly, if we take this figure and take 1/16th of it as the hypothetical figure for preventive care, the cost would end up being 1.2 billion dollars. So, the health care system (and by extension, all its customers) could save some ~18 billion dollars by focusing treatment on preventive care rather than emergency services. Now, is my number off? Yes, most certainly. I (admittedly) oversimplified the issue and am missing a host of considerations.
     HOWEVER, the point still stands, and hopefully you understand these ideas better:

  • Everyone ends up paying for everyone else's health because hospitals cannot refuse to administer emergency services. Hopefully, you're made of the moral substance that says this is the right thing to do. If you're not, then this really isn't for you, but you don't get to go around pretending like you care about anyone else. You don't, because denying anyone emergency services is cruel and about as far from caring as you can get.
  • It is more expensive to treat health when it gets to the point of being an emergency (scans, surgeries, etc. etc.) than it is to enact preventive measures (medicine, lifestyle changes, etc. etc.).
  • If we are all going to pay for it when people end up being in poor health, then we might as well be cheap about it by ensuring universal access to healthcare that is preventive so as to ensure as many health problems as possible are dealt with as early as possible (before they snowball into major health issues).
  • It might be counter-intuitive, but by being willing to look out for everyone else, you also serve yourself by reducing your financial burden.

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