Over the last few months, there’s been plenty of talk about the state of health care in America. In June, Michael Moore came out with his damning documentary “Sicko,” which portrayed the struggle of many Americans to obtain basic care. Then came “Hillarycare” – Hillary Clinton’s attempt to redeem herself for the fiasco of her 1996 plan – and her Democratic rivals’ responses.
Few deny that America’s health system is facing a crisis. Fifty million Americans are without health insurance, 9 million of whom are children. In 2000, the World Health Organization ranked the United States 37th on its list of countries with the best health care systems. Countries who ranked higher include Colombia, Morocco and Ukraine.
The reasons we should care about our health system may seem obvious: access to and quality of health care are literally life and death issues. So how have we come to this point? And why does change seem so far away?
The most obvious answer can be found in the demographics of who has health insurance and who doesn’t – of who can hire a world-class surgeon to reconstruct their nose and who has to let problems fester until they land them in an emergency room. Indeed, the United States health care system gives some Americans the best care in the world. And so, for the rich and powerful in our country, reform can seem threatening.
The breakdown of who is served by our health system and who is not also means that this crisis is deceptively invisible. Occasionally a tragic story surfaces about an uninsured patient’s needless demise. In February, 12-year-old Deamonte Driver died in Maryland, after bacteria from an abscess in his tooth spread to his brain. An $80 tooth extraction could have saved him – had his family had access to dental insurance.
But most of the time, the victims of this crisis suffer quietly, out of the public eye. They make difficult choices between bad options. Often, health concerns compound other anxieties about finding a place to live or supporting a family or getting training to advance their careers. Disease is devastating to everyone, but when a dreaded diagnosis comes, how much greater the mental and physical toll on the uninsured and under-insured.
There’s more at stake here, though, than individual suffering and collective guilt. The way that our country cares for the health of its people has implications for the health of our democracy. “In health there is freedom,” wrote the Swiss philosopher Henri Frederic Amiel. “Health is the first of all liberties.” If America aspires to be the land of opportunity, none of our citizens should be skimping on needed treatment or dying from toothaches.