The DSA has been ranked as having the worst healthcare system in the civilized world, whatever “civilized” means. But it doesn’t have to be the worst, does it?
Dead yet?
According to the World Health Organization, the Commonwealth Fund, and even the generally conservative CEO World, the DSA ranks well below the mean on average age of death. Here’s a snapshot from the Commonwealth Fund’s assessment of that particular piece of information:
People here die sooner (by a lot), and pay more (by a lot) for care than any other country in the world. Maternal mortality rates are among the highest in the world, ranked alongside the poorest countries on the planet and three times the rate of Canada and all the countries of Western Europe.
Last I checked, Canada was a few inches — sorry, centimetres — from the border, but the differences are staggering.
Physicians and patients fight with insurance companies more in the DSA than anywhere else, except for Switzerland, where the system is universal, but more in the hands of the private sector than other developed countries.
But you knew all that already, or something like it. And yet, people in the DSA do not treat this death rattle as a hill to die on, for some reason, which is why I asked at the beginning of this article whether you were already dead and you’re done with hills.
If so, that would explain a lot of things.
When you research the four general categories of healthcare in the world, you’ll see that three of them are forms of universal health. The DSA ranks last of the “developed” countries of the world because it clings to the most monopolistic, capitalistic, profit-at-the-expense-of-health version, colloquially known as “Every Man For Himself.” And it’s expensive as hell.
In the “Out-of-Pocket Model,” countries are too poor, too new, or too corrupt to have established any healthcare system at all. Predictably, most of these countries are poor and hundreds of millions of people go their whole life (short as it may be) without seeing a doctor. However, the DSA has that same form of healthcare for 15% of its adult population.
In the “Beveridge Model,” health care is provided and financed by the government through tax payments. These higher tax payments, of course, not only replace current out-of-pocket costs, substantial insurance premiums paid by business (small and large alike), and every other cost associated with seeing a doctor, but actually reduce the cost in the long run. The people, as represented by a non-corrupt government, are in a better negotiating stance to lower costs than the insurance companies, which still call every legitimate claim as a “loss.”
(Note: that terminology alone should provide insight to motives of the insurance industry. Do not believe those happy commercials kids on swings, seventysomethings at farmer’s markets, and soothing voiceovers telling you how safe they’ll make you under their plan. When they don’t pay, it’s a win for them. When they do, it’s a loss. Their words, not mine.)
In the “Bismarck Model,” everyone is covered through a labyrinthine set of nonprofits called “sickness funds.” These funds that pay for healthcare are financed jointly by employers and employees through payroll deduction. These “sickness funds” do not show a profit (they’re not supposed to) and are tightly regulated to the extreme, which provides cost control for the users.
Finally, we have the “National Health Insurance Model.” The doctors and providers are in the private sector, but their fees are paid with higher taxes (like the Beveridge Model) and the patient never has to worry about payment to any doctor in the country. This is, by far, the most popular model among constituents. It is a “single-payer” system (in which the federal government is the payer) and has great negotiation power with the pharmaceutical and medical industries. Canada’s system, for example, has negotiated such low prices from pharmaceutical companies that DSA citizens have spurned their own drug stores to buy pills north of the border. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated. In other words, not everything is covered, but what is covered is completely paid.
Because there’s no need for marketing, no financial motive to deny claims and no profit, the “National Health Insurance Model” tends to be cheaper and much simpler administratively than American-style for-profit insurance.
The DSA is unlike every other country because it maintains so many separate systems for separate classes of people. Out of pocket, Medicare, Medicaid, Obamacare, Employer-paid health insurance — all these are present in the DSA. All the other countries have settled on one model for everybody. This is not only much simpler than the DSA system; it’s fairer and cheaper.
Fairer, cheaper, and more effective, too. Despite spending nearly twice as much per capita on healthcare compared to similarly large and wealthy nations, the DSA has a lower life expectancy than peer nations and the gap has grown for some measures since the COVID-19 pandemic.
Yes, there are downsides to universal healthcare. Of course there are downsides to systems in which people are encouraged to take care of their health before they have to go to an emergency room. Waits are long. Elective surgeries aren’t covered. And everyone has heard the tall tales spread about somebody else’s Aunt Marge who moved to Saskatoon and had to wait six years to get her broken leg set by a doctor. No really. That happened. I read it on Facebook.
Having to wait and getting healthcare is better than not having to wait and not being able to afford healthcare until you’re dead, after which you get that whopping $255 check from Social Security for your funeral. But only if your child or spouse applies for it.
Which brings us back to the original question, especially for artists and other independent contractors: are you dead? For small businesses and nonprofit arts organizations who won’t have to pay through the proverbial nose to get better healthcare for all their people: would you prefer going broke? If not, then where the hell are you?
Why do you accept a system that is intended to kill you earlier and in more pain than any other civilized country? Why do you insist on paying more than twice as much as anyone else when you do get sick than anyone else?
Good health is the right of every individual in the world — except, evidently, the residents of the DSA (what happened to “life, liberty, and the pursuit of happiness?”) and the poorest rural governments. In the DSA, it’s especially awful for anyone with the bad taste of being born non-White. Sorry about that, Black people, but these White elitists promise it will be the last indignity you’ll ever suffer. Ever. Scout’s honor. /sThe new country of Pacifica plans to institute universal healthcare. Yes, taxes will be higher. But no one will be one paycheck from bankruptcy or foreclosure due to bad health. No one will be forced to choose between rent and medication. No one will have to pay the exorbitant eight-to-nine figure annual salaries of insurance racketeer executives, let alone its filthy-rich CEOs firing their claims adjusters for granting “losses.” No one will have to pay for healthcare marketing. And the nation, as a whole, can negotiate a better price from pharmaceutical companies (as Canada has) than a series of competitive money-grubbing insurance companies. Isn’t that worth fighting for?
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