Monday, February 11, 2008

Mirror Mirror Of Our Health

I am Italian, so I have direct experience with socialized medicine, and I do not understand why Americans are so repulsed by the concept. Perhaps it has to do with how they were brainwashed to associate any word that starts with the letters *social* with communism and repression. In any case, I would never trade Italy's socialized healthcare for America's.

In Italy, I never had to fear that I would have nowhere to go in times of need. When I went to the doctor, he took time for a thorough visit, instead of rushing me through as happens here in the U.S. I had the utmost confidence in the opinion of the doctors and the professors that visited me. And healthcare never cost me a penny, except for a small co-pay for visits and medicines.

The system is paid for by tax dollars, so everybody contributes in proportion to their income (which is a form of providing “for the least of them”). Private insurance provides supplemental healthcare for those who can afford it. It is a fact of life that money buys power, and Italy is no different in that sense. But those who choose to buy private insurance are not exempt from paying taxes for healthcare.

I know that all is not well with the way healthcare works in Italy. There are structural delays, not enough hospital beds in certain areas, waiting lists for non-life critical care (in the case of transplants or other critical care, some Italians go to private clinics or abroad, so they do not have to wait). It is not a perfect system, but fears of rationing are greatly exaggerated. (The U.S. healthcare system is not perfect either, and stealth-rationing occurs in the form of those who are not insured and cannot afford to pay.)

Things changed when I moved to America.

I have never felt as depressed, angry, and helpless as when I was sick after coming to America. I had no health insurance and my wife was a temp. We did not have health insurance not because we thought we did not need it or because we wanted to spend money irresponsibly. We did not have health insurance because we could not afford it. We went without health insurance for 5 of the first 7 years in our marriage (which, to an extent, suffered because of it). The one time I had to go to the emergency room, for something that luckily was not serious and which took one hour to investigate, I had to pay $350 out of pocket (in 1993), on wages of $750 a month. I am glad to report that I have had a good job and good health insurance for many years now, but rest assured that I understand the plight of those who don’t, in a country that relies on people being covered by insurance companies.

So now you understand why, when you say that almost everyone has access to healthcare, my nerves are raw. Everybody has access to healthcare, but too many are uninsured and choose not to use it or get stuck with a bill they cannot afford. Either way, the monetary and psychological costs of people who should see a doctor or go to a hospital, but cannot afford to and choose not to, is incalculable, not the mention the public health risks for the rest of the population.

From my standpoint, Americans have an overinflated and unjustified sense of pride in their healthcare system. This is the fault of free-market insurance advocates and of those who believe them when they say that taxes are already high enough and that socialized medicine would make matters worse. To them I say this: I agree that taxes are high enough (for the middle-class), but you don't need to raise taxes on everyone, only on the wealthy, and/or you can shift your national priorities, so that instead of waging war because you can, you wage it because you have to. And instead of inflating military budgets, you can shift funds to services that make people lives' better, instead of destroying them. That is what civilized nations do. And in so doing, they probably need less money for defense (fewer enemies) and have more money for everything else. Instead, in America I pay a lot of taxes, AND I have to BUY my own health insurance.

A country that spends so much money on defense (twice as much as the European Union combined and more than ten times as China) but does not have universal healthcare is not a shining example to the world. A country that cuts taxes for the very wealthy and does allows loopholes for corporations to escape taxes, while anyone has to go without healthcare is not the beacon of freedom, democracy and justice that it would have its citizens and the rest of the world believe. It is certainly not a model to follow or to export to the rest of the world, and its conviction in its superiority flies in the face of all evidence to the contrary. On healthcare, America needs to stop asking the mirror to confirm its belief in its superiority and take a good look around. It might learn something healthy.

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