Guardian UK: American healthcare is in truth already rationed

American healthcare is in truth already rationed
Growing up sick in the US, and being treated by a humane NHS here, has shown me that Britain's system is far better

Bee Lavender
guardian.co.uk, Sunday 16 August 2009


I grew up in the US with a series of mysterious health problems, not least two different kinds of cancer. Everything in my life – education, choice of career, job mobility, decisions to marry or divorce, where I lived, who I knew, what I wrote or talked about – all of it – was determined by the paramount need to maintain health insurance.

In the United States there is no basic protection for working people. My fully employed, doubly insured parents were pushed to the brink of bankruptcy four times before my 15th birthday. I exceeded the "lifetime maximum" coverage before I was old enough to vote. My family paid huge sums for insurance, then 20% of the cost for treatments, without assistance from any public entity.

And I never received more than essential services, on large wards, in grim hospitals. My most significant childhood memory is knowing exactly how much I cost, and regretting the expense. I can tell you that it costs at least $200 to ride in an ambulance regardless of distress or distance. The price goes up for every lifesaving procedure ­ performed during that journey. Extrapolate from that the normal charge for every test, procedure, blood draw, and dose of radiation – the costs of staying alive can be extreme. One day in the hospital can easily total more than an average person earns in a year.

The truth is, healthcare is already rationed in the states – by individuals struggling to afford even basic cover, by companies negotiating (or refusing) benefits, by government agencies trying to balance budgets. For many years I lived in a state where the legislature ranked and rated, by price, procedures people on aid could receive, and refused to cover anything deemed too expensive. Even if, as the papers frequently reported, it meant letting adorable little children die. But since it is America, you can shop around. Just across the border in a different state, the legislature decreed that pre-existing conditions could not be excluded or made the subject of increased charges under insurance plans, leading me and many others to migrate a few miles to get a better deal. ...............(more)

The complete piece is at: http://www.guardian.co.uk/commentisfree/2009/aug/16/nhs-us-healthcare

It's a shame that the people who need to read it the most won't bother.