Why Health Care is Organized Crime

The real reason why health care reform has stalled is because too many people are getting rich.

She had been ignoring signs of cancer for months. A relative of mine (I’ll call her “Mary”) had no health insurance. Self-employed, she made too much money to qualify for public health programs for the poor, but she did not make enough money to pay for private insurance.

When debilitating pain rendered her unable to work, she finally consulted a well-regarded private surgeon. The diagnosis: She had eight months to live if she did not have a cancerous organ removed. To schedule the surgery, the doctor needed $8,000 in cash. Upfront.

Two months later, the doctor’s office called to follow up. “Have you decided what you’re going to do?” the billing office asked.

Mary rolled her eyes.

Yes, she had decided what she was going to do. For her and many Americans without health insurance, that meant driving to the nearest emergency room where, by law, patients can’t be turned away. It meant holding her ground against doctors who tried to send her home, until one finally agreed to perform the surgery.

It was a humiliating process, but the government eventually picked up the tab.

I’ve been thinking about Mary a lot this summer as I’ve watched the bizarre and sinister turn that the debate over universal health care has taken in the U.S. It’s been a surreal spectacle: Hordes of Republican-backed activists, eyes-bulging, picket sign-wielding, shouting down public officials at town hall meetings to discuss the plans to provide health insurance for every American.

“Keep your effing doctors!” the crowds are screaming. “I don’t want the government involved in my stinking health care!”

The hatred and passion is real, and given all the people I know who are affected by this problem, it feels personal.

The irony is that the government is paying for their stinking doctors—only at a much higher moral and financial cost. Taxpayers have shelled out more than $150,000 and counting for Mary’s care—all for a cancer that could have easily been prevented and treated with a routine doctor’s visit.

Truth is, America is a wealthy country and can afford to pay for health care. The sad fact is that the inefficiencies and vagaries of the current system are the stuff that American-style capitalism thrives on. The status quo is making a lot of people rich; the doctors, the drug companies, the lawyers, the lobbyists are all getting paid.

My neighbor Mark puts it best: “The problem with our health care system is that it’s organized crime.” Indeed, medical scans that would cost Mary $1,350 out of pocket, companies are billing the government for $3,000. Two anti-nausea pills alone cost $400; a post-chemotherapy injection to boost blood cells runs the government $7,000 a pop.

Many of the drug companies are based here in the U.S., and they get away with charging these exorbitant prices for their products because they can. In places such as Canada and Europe where there is a public health care system, the government is able to negotiate lower costs for the same drugs.

Not so here in the U.S., where the hodgepodge health care system is like the Wild Wild West, creating boom times for the U.S. pharmaceutical industry.

This mob is armed with fancy degrees, big suits and bigger expense accounts. They are the lobbyists shaking down insurance companies to the tune of $1.5 million per day to persuade Congress to scuttle Obama’s efforts to fix the health care system.

They are the trial lawyers, whose ambulance-chasing drives up the costs of practicing medicine so much that a private doctor literally cannot afford to perform a surgery on a dying woman, lest they be subjected to lawsuits if something goes wrong.

The very night that the ailing health care lion Massachusetts Sen. Ted Kennedy died, the Democratic operative and physician Howard Dean conceded the fight against these legal henchmen at a rowdy public health care forum in Virginia. Dean said the proposal in Congress doesn't include tort (legal) reform because "this bill has enough enemies. The people who wrote it did not want to take on the trial lawyers in addition to everyone else."

Vito Corleone would be so proud.

And of course, as we are seeing from these raucous town hall meetings, the slickest gangsters are the conservative operatives who prey on the fears of ordinary Americans. They are stoking racial fears about President Obama’s big government and managed the neat trick of convincing working class white people to take to the streets to defend a system that only makes them sicker and the health care mafia richer.

That’s America.

Five months after her initial diagnosis, Mary managed to get publicly funded health insurance meant for the poor. (How did she do it? Don’t ask.) A doctor-friend told me getting public funding to cover costs for a catastrophic illness always works out better than the alternative; had Mary had private insurance, paying the deductibles for post-surgery cancer treatments would have likely left her bankrupt and probably homeless. The choice was between bad and worse.

Unfortunately in America, these are your choices if you decide you want to live.

Natalie Hopkinson is associate editor of The Root. A version of this essay first appeared in the BBC Focus on Africa magazine.