Now and Later

My son is “jacked”, or so I am told. My first image is of a car half way through a tire change. I quickly understand, however, that they reference his physique. He’s in good health, works out religiously with his girlfriend, eats “healthy” (as compared with me, certainly), and takes physical risks (sports, weight lifting and such) without much concern. He is 25 and part of an army of young Americans fit or unfit, roughly between the ages of 20 and 35 (between leaving their childhood home and starting their own home with children), who are careening toward a precipice blinded by their own temporary good fortune. They are, for the most part, oblivious to the social and economic meltdown which is health care in the United States. Yet this problem will impact them so directly and in so many ways that their ambivalence leaves them akin to free-range chickens.

America has evolved its health care differently than every other advanced economy in the world. This was a complex evolution with many factors impacting the current state. Some common factors, however, have affected every economy over the past century; such as exponential population growth, exponential advancements in medical science, exponential dissemination of information, and exponential means of communication. With those common underlying dynamics, why is the US model so different… and so inefficient?

One major reason was the outcome of the 2nd World War, later combined with a manic fear of collectivism during the Cold War. With the exception of Canada (and to a lesser extent Australia) the US immerged from WWII without devastation. To the contrary, the Country was in better shape than it had been during the prior decade. Further, there was a righteousness that came from victory that persists to this very day. It was perceived, in many ways correctly, as a victory of Free Enterprise, but to question such became unpatriotic (or deemed treasonous as what occurred in the mid-50s, or by such sages as Sarah Palin today).

Where the rest of the world after the War saw major portions of their populations in devastation and without means, the concept of universal health care was both a necessity and consistent with a world view of fallibility. Those countries in Western Europe and the Far East had the ability to conceive a collective approach to health care without deeming such as undemocratic. They intentionally or not were able to view universal health care as liberating. Ironically, the United States, an integral player in the reconstruction of Western Europe and Japan, helped construct the bureaucracies to support universal health care. Canada, the noted exception, attempted an expanded free-market approach to health care, but facilitated by their parliamentary form of government later found it unworkable abandoned it for the British model.

The for-profit health care system in post-war America meshed nicely with rapidly expanding free-enterprise. The combination of strong organized labor, combined with a shortage of workers, which persisted from 1948 to 1972, health care (via insurance) became a form of invisible compensation. This was an historical accident without precedent (on a large scale), and without any logical argument for its efficiency. Quite the contrary, given the aforementioned dynamics of population, medical science, information, and communication, this system has proven itself to be extraordinarily inefficient. However, for the most part two generations have lived through it and now too many believe that employer covered health care is a natural state of affairs.

The Republicans in Congress, who argue for the status quo like junkyard dogs at the fence, find sympathetic ears by those employed individuals who can’t see their benefits as an actual use of compensation (i.e., something they’re buying). These so-called Conservative politicians wrap patriotism with the most egregious lies about the quality of our health care, exacting support for their position. You cannot have the “greatest health care system in the world” (as Speaker Boehner and Majority Leader Cantor have said countless times) and be 24th in the world for adult mortality and 26th in infant mortality. These politicians are actually fighting for those on the receiving end of the $1.6 trillion transfer that takes place each year - 2 to 4 times that of all other modern nations on a per capita basis. Tragically, the nation eats what it’s being fed. Obama, unable to compete, ends up creating a politically expedient health law which - once he agreed to drop a public option - only entrenches the for-profit system. There’s not much light poking through the clouds.

The young adults in the US today are playing on the tracks and they can’t see the train coming. Before this American health care system becomes unsustainable too many will find themselves and their children under cared for, their lifestyles compromised by huge health care costs, their parents destitute or without legacy, their mobility compromised, their ability to take risk reduced, and their responsibility for the previous generation a near impossible social burden. None of that even includes the anxiety and diminished quality of life that comes from the fear of uncertainty at the most basic of levels - survival. Right now they have little fear; they unconsciously plan on living forever, just as they are doing right now. If they only knew…