It was published as a human interest story in the newspaper. You know … the type that’s supposed to make you feel good about the generosity, warmth and kind-heartedness of your neighbors and your community. It’s a story that unfortunately is repeated with greater frequency these days. A young child is diagnosed with leukemia and needs a bone marrow transplant. The parents of the child are either uninsured or under-insured; and the community rises to the occasion with a benefit pancake breakfast, spaghetti supper, or other type of fundraiser to assist the family with its medical expenses. As I said, it’s meant to be a story that makes you feel good about the generosity of your community; but all it does is make me mad. How can this happen in a country that touts itself as having the best health care system in the world? How can simply getting sick become a one-way ticket to unending debt and poverty? Not long ago a story in the Washington Post caught my eye. With the headline “Sick and Broke” it reported the results of a large scale study by researchers at Harvard University who interviewed more than 1,700 families that were in bankruptcy courts across the country. Their findings were that close to half of these families reported that illness and medical bills drove them into bankruptcy. And the biggest surprise of all was that three-quarters of these medically bankrupt families had health insurance. Their conclusion was that a middle class lifestyle; a good education and a decent job will not necessarily safeguard you from these unfortunate events. Many of the families interviewed were precisely in this position … until illness struck. Elizabeth Warren, a Harvard law professor noted that the problem was not in our nation’s bankruptcy laws, but rather with our health care finance system and our endless debate about reforming it. I may just be getting soft-headed, but I can’t believe that we have evolved to the point as a nation where an upstanding citizen can do everything right, i.e., raise their kids, stay out of trouble, pay their taxes, be a good neighbor, save for retirement; only to have it all disappear due to illness. I’m sorry – if that’s the case then system is definitely broke! We all know that in today’s world you need a good health insurance policy. But as I thought about it in a greater context I wondered why we don’t have insurance for many other essential services. Why don’t we have police and fire insurance? When you call 911 to report your car stolen, a break-in, or a kitchen fire, why don’t they ask you whether you have the necessary insurance? No insurance – no service; right? While those who know me best know that I am and have always been a capitalist at heart, the truth is that not all services should be subject to the inequities of the marketplace. This is especially true for what we collectively define as essential services. We believe that some services are so essential to our collective well being that we provide them to all citizens regardless of their ability to pay. Services such as national defense, police protection, public education and fire protection are obvious examples. Because we define these types of services as essential to our collective well being, we finance them through our taxes and provide them to all. Unfortunately, while the overwhelming majority of industrialized countries long ago placed the provision of health care in this category of essential services, we have yet to do so in the U.S. The consequence is a competitive and dizzying marketplace of health insurance and health care providers; the most expensive health care system in the world; an ever-increasing number of uninsured Americans; a new term in our vocabulary called “medical-bankruptcy;” and a growing number of well-meaning, community fundraising pancake breakfasts and spaghetti suppers. I sincerely hope that the next time you read or hear about a similar fundraiser in your town you get a little madder too! (Dr. Geller is president of Geller & Associates; a rural research and consulting firm based in Mankato, Minn. He can be reached at geller@hickorytech.net)
