[an error occurred while processing this directive][an error occurred while processing this directive]''I don't know which was worse, being told that I had cancer or finding that I could not get insurance...''(quote from NY Times article referred to in the Sydney Morning Herald)SYDNEY MORNING HERALDGouged and gutted by medical insuranceMark Coultan
April 18, 2007
THE Governor of New Jersey, Jon Corzine, was running late for a meeting last Thursday night when his car, driven by a state police officer, was forced to swerve to avoid another vehicle and hit a guard rail.Corzine, who was in the front passenger seat, suffered multiple fractures - a dozen broken ribs, a fractured collarbone, sternum and lower vertebrae, and a compound fracture to his femur.His driver and an aide sitting in the back were wearing seatbelts. They escaped with relatively minor injuries. Corzine was not wearing a seatbelt, in violation of his own state's laws.
Although he is in a critical condition, he is expected to recover. Rehabilitation is expected to take months. At Cooper University Hospital in Camden, he can expect the best medical care, not just because he is the state governor but because he is rich.
Corzine, who used to be the co-chairman of Goldman Sachs, is reported to be worth about $US 400 million ($480 million). It's unlikely that anyone asked him what his medical insurance was as he arrived in the emergency room, but given his wealth, there's no doubt about his ability to pay his bill.
Unlike the stories you sometimes hear about American medical care, they don't turn away dying people from hospitals. In fact, in New York there is a law that hospitals have to treat people irrespective of their ability to pay.
So almost anyone would probably be treated in much the same way Corzine has been - although when he is discharged and requires months of physiotherapy and follow-up care, the story may be different, because health-care professionals don't have to treat people who can't pay them.
Also, just because a hospital will treat you doesn't mean it won't send you a bill.
Even for a few hours in a hospital, the bill can be very big. A New York state politician did a survey of New York hospitals' costs, finding that one, Mount Sinai, charged $US224,000 for intestinal biopsies, a one-day procedure. That was just the hospital charges; the doctors and anaesthetists billed on top of that.
It's no wonder, then, that the leading cause of personal bankruptcy in the US is unpaid medical costs. There are 47 million people in the US without medical insurance. Insurance normally comes with a job, although there are plenty of employers, particularly small companies, that don't offer it.
You can still get into financial trouble even with a good job. The New York Times recently highlighted the case of Vicki Readling, a self-employed real estate agent who had surgery for breast cancer in 2005. With breast cancer on her medical record, insurance companies did not want to cover her. The only insurance she could find would cost her $US 27,000 a year, with a deductible allowance of $US 5000 a year - an impossibility on her $US60,000 a year income. To save money, she takes her $US 300-a-month medication three or four days a week, instead of daily.
As some Americans penny-pinch to afford health care, the nation as a whole binges. The US spends 16 per cent of its gross domestic product on health, about 50 per cent more than Australia or other industrialised countries, yet its health outcomes are no better, and on some measures slightly worse, than comparable countries.Health care has become so expensive that it is dragging down companies. One of the major problems besetting General Motors and Ford is the cost of the health care they provide present and retired employees.
Not surprisingly, health care is a constant political topic. Several states, including Massachusetts and California, are introducing universal coverage reforms.
The obvious measure - introducing a national, single-payer system similar to Medicare - seems unlikely. There are too many powerful, entrenched and vested interests - doctors, pharmaceutical groups and insurance companies.
When people want to start a scare campaign against a national health system, they cite the Canadian system and its long waiting lists.
It is true that patients in single-payer systems experience long waiting lists, as governments try to restrict the cost of health care. However, with the cost of health care rising rapidly, societies have a choice: either restrict health care on the basis of medical need, which is what a Medicare system attempts to do, or restrict it on the basis of income or employment, which is what happens in the US.
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