I Don't Feel Well

I'm going try to be brief, since I'm a living human being, with a certain number of health problems, who's continuing to age and deteriorate as I approach antiquity. This fall, besides the usual respiratory infections, it's been a severe cervical radiculopathy, which was almost certain to need spinal surgery, according to most of the first five or six specialists I went to. The surgery would run anywhere from $30,000 to $200,000, depending on which procedure I chose. (Each of the specialists, by the way, charged between $300 and $600 per consultation. Almost all were out of network, with limited insurance reimbursement.)

But, since each highly reputable specialist recommended conflicting procedures (with many even recommending procedures to conflicting vertebral levels of the spine), I continued to investigate, trying to find some consensus. In delaying, I suffered substantial and possibly irreversible damage to some of the nerves serving my left arm (of course, there was disagreement in interpreting exactly which nerves were being damaged). More interesting though, is that, as time has continued to go on, tests have since shown that my arm strength is now improving, and some of the nerve damage is reversing. Which has led another slew of five or six specialists to recommend avoiding surgery, one of them calling those who once recommended it "psychotic." (An amusing side-note: each spine specialist I've visited has told me the same joke, albeit using slightly different numerical figures: ask five spine surgeons, get six opinions. Ha ha ha.)

Each of the more recent specialists I've seen has also charged $300 to $600 per consultation, almost all out of network, with limited reimbursement. The procedures I had to undergo to relieve the incapacitating pain I was in back in August (steroid injections into my spine, via the neck, with slight risk of stroke, thank you very much) cost about $3000 each. I've had three of those. But do the math. Any way you slice it, my visits to over a dozen practitioners, along with all the scans and procedures, which might have seemed excessive as it was going on, cost between $10,000 and $20,000. That's a huge savings over what surgery would have run.

The point of this post, though, isn't my personal travails. First, it's to illustrate how one person, who might seem, at a quick glance, to be getting "more than his share" of services, actually saved his insurance carrier between $10,000 and $185,000 in charges by lengthening the period of investigation, and by undergoing repeated, costly testing. That might seem counterintuitive to some of the health care "reformers" currently wielding axes.

Second, it's to bring attention to the sad fact that the United States of America is the only industrialized nation on planet Earth that doesn't provide some form of "Universal" health care coverage to its citizens - and that it seems about to cement its status as such for some time to come. The only one on Earth. (In case it matters to anyone, "universal" health care coverage is provided in a number of developing countries, as well.) I'd ask, "What is the world coming to?", except the rest of the world seems, in this regard, to be making sense. It's the United States that apparently suffers from some form of developmental retardation.

There are probably ten billion ways to be appalled and angered by that set of very generalized facts. The most appalling, to me, is that the blame lies so squarely with the many American citizens who are adamant about keeping things here so backward, all in the belief that they're somehow keeping things here "better." I've heard all the arguments against (and the comments section will be open for all those who want to state them again). But they're all misguided, in one way or another. I could have seen just as many specialists in other countries, and gotten equally qualified opinions (in fact, disc replacement surgery was done first, is more advanced, and more successful, in Germany; bone marrow transplantation, another procedure I'm acquainted with, was pioneered and perfected elsewhere, as well), and it would have cost me less. For those who want to scream, "But your taxes would be higher!", it still would have cost me less, inclusive of taxes, as it costs everyone who pays those taxes less, and costs those entire nations less, for their medical care than we pay here. If your line is, "But you would have had to wait weeks for each appointment!", newsflash: I had to wait weeks for each appointment here. Also, if I'd wanted, I could have paid to go outside the "universal" network in any number of other countries, too. Private care is still available to those who want to pay for it, in almost all places. All the "universal" net means is that there's a bottom below which an unfortunate person desperately needing medical care can't fall. If you're against that, well...then you're against a minimum level of human decency I consider imperative.

In fact, I'd argue that, after providing national security and maintaining domestic order, healthcare insurance coverage is the most basic, essential protection government should be obligated to provide - as every other industrialized nation on Earth apparently understands. It's primacy trumps a minimum wage and child labor laws. $7.25 per hour, or even twice that amount, is useless to anyone with the most meager of medical expenses. And a seriously ill child who can't afford medical care derives no benefit from child labor laws, because that child is already dead.

But I'm using rational argument again, and that seems to have lost all currency here.

It's not about advocacy for me anymore. It's about mourning. It's a sad time in our two hundred thirty-three year old story (for those of you unacquainted with history or my sarcasm, the number is there to illustrate how comparatively young our little collective is). There are so many here who seem to insist upon doing, and giving, and having, so little.

For those who find the thoughts confusing, here's an illustration:

Nations without government sanctioned/sponsored "Universal" health care:

The United States of America

Nations with:

Norway, since 1912, Single Payer
New Zealand, since 1938, Two Tier
Japan, since 1938, Single Payer
Germany, since 1941, Insurance Mandate
Belgium, since 1945, Insurance Mandate
United Kingdom, since 1948, Single Payer
Kuwait, since 1950, Single Payer
Sweden, since 1955, Single Payer
Bahrain, since 1957, Single Payer
Brunei, since 1958, Single Payer
Canada, since 1966, Single Payer
Netherlands, since 1966, Two-Tier
Austria, since 1967, Insurance Mandate
United Arab Emirates, since 1971, Single Payer
Finland, since 1972, Single Payer
Slovenia, since 1972, Single Payer
Denmark, since 1973, Two-Tier
Luxembourg, since 1973, Insurance Mandate
France, since 1974, Two-Tier
Australia, since 1975, Two Tier
Ireland, since 1977, Two-Tier
Italy, since 1978, Single Payer
Portugal, since 1979, Single Payer
Cyprus, since 1980, Single Payer
Greece, since 1983, Insurance Mandate
Spain, since 1986, Single Payer
South Korea, since 1988, Insurance Mandate
Iceland, since 1990, Single Payer
Hong Kong, since 1993, Two-Tier
Singapore, since 1993, Two-Tier
Switzerland, since 1994, Insurance Mandate
Israel, since 1995, Two-Tier

Shocking. They all do it, but apparently we can't. They all want to, but it seems not enough of us do.

For those who oppose it, I hope the victory makes you proud. One day, when you're sick and in need of help, pride might be all you have left.


Evan Handler's latest book, "It's Only Temporary: The Good News and the Bad News of Being Alive," tells the story of the twenty years since his unexpected recovery from acute myeloid leukemia (an illness that doesn't look anything like it looked in the movie "Funny People").