Tuesday, 1 October 2013

In Honor of Exchanges

I've just come back from a wonderful expedition through Spain and Morocco, and I have lots to share about that very soon. However, something major has happened today here in the United States of America. Our government has ground to a halt, and, at the same time, we went live with a new, nationwide system of healthcare. This is a very big deal, indeed.

Despite this ridiculous government shutdown business, the United States took major a step toward joining the rest of the civilised world today. I have friends who can now access coverage, and treatment, for anything from chronic, life-threatening illness to minor maladies that would otherwise escalate into a debilitating issues requiring emergency room visits--and potentially permanent disability. People I know who have addiction issues can start to seek help, as mental health services and substance abuse treatment must be covered as "essential health benefits" under insurance plans and publicly funded treatment programs become more widely available under Medicaid. 

All of these changes come as a result of pooling risk, which one could argue we were already doing, albeit in a haphazard, cruel and expensive fashion. Leaving the people who most need medical care out in the cold to favor those who are already better-equipped to deal with emergencies has meant that we all foot the bill for care--at inflated cost--in a strained network of hospitals, left to provide all of us a level of treatment inferior to that of a country that would prioritize early, inexpensive and non-invasive preventative care.

This insurance-based solution is imperfect, but it was implemented in the name of bipartisanship and preserving choice. Our status quo has been shitty and harmful: ongoing market failure to provide adequate and efficient solutions to healthcare needs, because there's no money to be made in providing basic care to the poor. Aside from the moral failures of our previous shambles (I am reluctant to even use the word "system" for something so disconnected, ineffective and unpredictable), what we've been doing in this country with regard to healthcare is expensive--on federal, state and individual levels. We've spent more out of pocket and through our taxes than other countries that allow people to simply walk into nationalized hospitals and receive high-quality care for free.

For all of these reasons, we should resist letting perfect be the enemy of good. We can keep working on a better answer, even as we get more people out of lives of illness and fear by starting on some sort of solution.

One consistent tendency among developing societies is a commitment of resources to gains in health and education. This is us trying to live longer, healthier lives, gain wisdom and really reach farther toward the horizon of our human potential. And that transcends any fitful starts we have on the path.

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