I’m not sure there will be much new in this post, but I wanted to reiterate Steve Randy Waldman’s blog post regarding our massive healthcare costs. Waldman’s post, titled “Shame,” responds to Steven Brill’s long article on healthcare costs. Brill’s piece, while long, is very good, though I agree with Matt Yglesisas: the policy solutions he outlines don’t address the main problem.
But, I’m a bigger fan of Waldman’s response, which is pure disgust that we allow hospitals to rip off the most-needy in our society when an unfortunate health incident strikes:
The burden of citizenship is to share in, and hold people to account for, the injustices experienced by our neighbors. Alice was fucking ripped off to the tune of any semblance of economic and financial security she might ever have had at the very moment that her husband was dying of cancer. This is beyond awful. This is mortal sin in any religion worth the name. This is pure evil.
Our problem is not a matter of shitty policy arrangements. We have plenty of those. Whatever. Policy is a third-order pile of bullshit. Our problem is that it is a sick excuse for a society when this sort of ass-rape is relegated by custom and practice into the sphere of the “private”, the sort of bureaucratic struggle one quietly hires professionals to deal with and hides as much as possible from friends and coworkers.
There’s a bit more in his post (it’s not very long) and it’s definitely worth a read. Those hit by a health disaster are, in many cases, massively unlucky. Some may not have eaten healthily or exercised enough and thus have some responsibility for their poor health. But many unhealthy people don’t have huge heart attacks. They’re incredibly lucky and those that do get sick are unlucky. As for those people do live a healthy life and still get sick, they are incredibly unlucky.
So what do we do when all of these unlucky people go to the hospital and get treated? We throw a massive bill at them that wipes out their life savings and can leave debt hanging over their family for years. What type of society are we that allows this to happen? I’m just repeating Waldman here, but it’s worth repeating.
In a midterm for class a week ago, part of an essay I wrote implied that people are inherently selfish and care only about their own ends. It’s been an assumption economists have made for decades and I never really stopped to question it. My professor commented:
[T]he theory that all human beings are selfish is one of those bizarre dogmas that economists and political scientists are finally starting to abandon. There’s just no evidence for it, and all the evidence from behavioral game theory is quite opposed to it. People have a deep sense of fairness, and will take a personal loss to uphold fairness norms.
I’m not sure of the exact evidence he’s referring to it, but I certainly believe it. When I read Waldman’s post, that’s what I thought of. Human beings really aren’t inherently selfish, except it seems in the health care market. Hospitals, doctors, big pharma and every other part of the industry capture huge profits at the expense of the unlucky. And the rest of us? We mostly sit around and watch it happen. We call it a free market and blame unhealthy lifestyles instead of the cash-sucking industry itself. We empathize, but do nothing, caring more about our own time and life. Where’s the fairness here? Is that the type of society we want to be? I certainly don’t think so. It’s about time the rest of us, the lucky ones, start showing our unselfishness and stand up to the healthcare industry.