MOST COUNTRIES ARE PROUD TO HAVE A HEALTH care system. It’s an organized way of helping the sick and infirm—a mark of genuine civilization. Not so here, alas, where the health system is rapidly becoming a health hazard. After decades of privatizing, profiteering, and insurance company–driven bureaucratization, Florence Nightingale has morphed into Vampira.
Health care costs are sucking the blood out of the economy, for one thing. Consider poor General Motors, once America’s flagship corporation and now sinking under the weight of its employee health benefits—which account for at least $1,500 of the sticker price of each new vehicle. As GM contemplates mass layoffs, other companies thrash around frantically trying to shed their insurance-needy American employees. They downsize and outsource—anything to escape the burden of health costs. Hence, in no small part, the “jobless recovery” of the early 2000s. Companies don’t want to assume responsibility for their workers’ medical bills and—this being the global temple of free enterprise—neither does the government.
Then there are the US health system’s toxic effects on individuals, and I’m not referring to Vioxx or the approximately 200,000 people who die each year as a result of “medical mistakes.” Harvard’s Elizabeth Warren has shown that more than half of all bankruptcies are triggered by medical costs, and it’s easy enough to see how. If you lose your job—through, say, downsizing or outsourcing—you lose your health insurance, and the uninsured routinely pay more than the insured. As for emergency rooms, which the hard-hearted or incurious imagine absorbing all the poor and uninsured—well, the average visit to an ER now costs a little over $1,000, which is a high price to pay for an asthma attack or an infant’s fever.
Certainly the health system makes plenty of people rich—Big Pharma’s overlords, for example, and insurance company CEOs—but it makes a lot more people poor—indirectly, by inhibiting job growth, and directly, by grinding individuals down to bankruptcy (which, thanks to the 2005 federal bankruptcy law, offers no fresh start to the debt-ridden). Add to this the well-known fact that poverty is a risk factor for dozens of diseases—from asthma to AIDS, from depression to diabetes—and, well, I rest my case.
When doctors notice a tissue growing nonstop—as US medical costs are doing—and in the process draining nutrients from the body as a whole, they insist on prompt excision, that is, cutting the thing out before it kills. So, too, one might think, economists should be calling for the immediate destruction of the American health care system. Stamp it out and drive a stake through its heart! Since Americans will still need health care, the solution is obvious: if we can’t outsource our illnesses—and there is so far no technology for transferring one’s cancer or atrial fibrillation to a starving African or Asian—we can at least outsource our health care.
It’s already happening, in fact, though only in a helterskelter way. An estimated two million Americans cross the borders annually to purchase their prescription meds in Mexico or Canada. US X-rays are increasingly interpreted by radiologists in India. Patients are being globalized, too, as hundreds of thousands of them from all parts of the world flock to Manila, Singapore, Bangalore, and other centers of low-cost, high-quality care. Some hospitals in India lure the rich with airport-to-hospital-bed car service and postsurgical yoga holidays, and I can foresee cheap, Motel 6–style hospitals springing up in Tijuana for the American working class.
All right, it’s painful to admit that the nation that produced Jonas Salk, pacemakers, and MRIs can’t do health care anymore. But there are other things we don’t do here much anymore, like manufacturing. In the case of health care, it wasn’t the science that foiled us (though, with more schools teaching only biblically approved versions of biology, that may soon be a problem too). No, we Americans just couldn’t figure out the technology for distributing health care to the people who need it. We left the whole business to business, and business screwed it up.
The abolition of the American health care system will lead to some difficult readjustments, of course. Our doctors, nurses, and technicians, who are among the best trained in the world, will have to seek work in the emerging Asian centers of medical tourism. As for the insurance company functionaries whose sole business it is to turn down your claims, they may be bit harder to reemploy, since they have no counterpart in any civilized, health-providing nation.