Improving Health Care in America Means Abandoning the Status Quo

By Michael Pearlman, 6-14-09

With only a week left to train for a 30-k trail race I registered for back in January, I hit the dirt for a run on Saturday. Aerobic exercise activities like running and cycling are critical to my mental well-being; the natural anti-depressant that helps keep me (relatively) sane. Whenever I get discouraged about my level of fitness and endurance on these trail runs, I remind myself how fortunate I am to be able to run at all.

In 2004, I broke two bones in my leg in a spectacular crash during a ski race, shattering my tibia and snapping clean through my fibula at the top of my ski boot. Thanks to the skills of a talented team of orthopedic surgeons in Jackson Hole who performed emergency surgery and through follow-up treatment that included both traditional and holistic healing methods, I made a full recovery. The injury sapped my spirit and left me on crutches for 3 months.  These days I run with a titanium rod in my left leg that extends from my ankle to just below my knee. While my hardware can cause me to suffer slight pain during long-distance adventures, it could be worse. A friend who suffered a similar leg injury wound up with one leg longer than the other.

I was also fortunate in other ways-I was covered by health insurance when my accident occurred. Even with insurance, the surgery and physical therapy that helped me recover was financially devastating, leaving me wading through piles of bills, unexpected extra charges and drawn-out negotiations with my insurance company. I learned about “reasonable and acceptable” charges and discovered that insurance companies don’t always agree with doctors about treatments. A bone-growth stimulator that my doctor recommended was apparently an “experimental” treatment that wouldn’t be covered, for example. Only through my doctor’s promises that he would cover the cost of the device was I even willing to use it. Acupuncture treatments using electrical stimulation were effective in accelerating the healing process, but also not covered by insurance. I paid for those treatments out of my own pocket and believe they were worth every penny.

In terms of health care needs, I consider myself one of the lucky ones, so far. I try to eat right and maintain a healthy lifestyle and rarely get sick. I don’t have to see a doctor regularly for treatment of chronic diseases and don’t take any prescription medications. Of course, perfect health can vanish in an instant and there’s millions of Americans who have learned that health care and medication costs can eat up a significant chunk of their monthly budget. Medical bankruptcies are on the rise in this country and will continue to increase under our current health care system.

Over the next few months, the Obama Administration is going to wade headlong into what is sure to be a bitter debate about how to address the spiraling costs of health care in this country. Medical care costs for uninsured Americans are incredibly high and create a burden on providers, so it seems to make sense for the United States to offer universal coverage. The devil, of course, is in the details and there are some people and groups who are certain to fare better than others under any changes made to the current system. While I’d rather not absorb the health care costs of uninsured patients who don’t take care of themselves, but the truth is that we’re already paying for these patients’ care in the form of higher private insurance premiums.

My late father was a surgeon and didn’t believe in socialized medicine, saying that it compromised patient care. That was first and foremost in his mind and is still in the minds of many American doctors whose primary concerns are healing and treatment. American healthcare is buried in bureaucracy already and there seems to be no escape. Insurance companies are often in the driver’s seat in making medical decisions and people are suffering from those decisions. The reality is that any true health care reform will affect the bottom line of drug companies, doctors and insurers. How can we make sure that the money spent on health care reform goes to the right place? If the U.S. can learn from the systems of other countries, why can’t we improve on it? Investing in education and prevention is a good start, but how can we improve the lives and treatment options for those who are already sick?

The arguments are going to continue for months, the lines in the sand divided by political affiliation and by whose campaign is most influenced by contributions from health care lobbyists. The wealthy in the United States already have access to the best medical care in the world. It’s the middle class and those living with minimal savings who have the most to gain from health care reform. Our current system is broken, but will we, as a country, have the courage to make the difficult choices to give the uninsured a fighting chance at better medical care? One size fits all medicine is not the answer and neither is duplicating European and Canadian health care models. But until our country finds a way to provide the economically disadvantaged reasonable medical care, the rest of us, healthy or sick, will bear the cost of their care.

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