On Healthcare: a letter to America

Dear Americans, what are you doing to yourselves?

“Into the Water” (partial view), Sonia Alins.

In 2000, the World Health Organization released a report ranking the health systems of its 191 member states. The United States ranked number 37.

I live in a small Southern European country in the lower half of the less prosperous of the Eurozone, called Portugal. We are the 45th richest country in the world by GDP. The US is the richest. And yet, our healthcare system was ranked number 12 in WHO’s report, beating the US by 25 spots on this list.

How was that possible?

The healthcare debate in the US is a tragic example of how propaganda can lead the people to think and act against their own interests. Americans have been exposed to a decades-long campaign against “socialized medicine”, an expression propagated in the aftermath of WWII to establish a pejorative association between public healthcare and the rising threat of communism. This misleading campaign played a major role in averting President Harry Truman’s proposal to institute a national healthcare system in the late 1940’s, following President Franklin D. Roosevelt’s similar purpose of making this policy a reality in America.

Perhaps the greatest poison to be introduced in the hearts of Americans in this process was a specific type of self-centered individualism — “it’s every man for himself” mentality. When it comes to considering healthcare you fail to see that a public system should exist to protect society as a whole. Instead, you think of it in an egocentric perspective:

— I work. I pay. I have the right to healthcare. My (probably lazy) neighbor doesn’t work. My neighbor doesn’t pay. Why should he benefit from the healthcare system that I’m paying?

This is the individualistic perspective at work. And because of that, and because you’ve allowed private corporations to take hold of the healthcare system, you are paying more and getting less coverage for your money.

Here’s a different perspective:

— Everybody pays in proportion to their capacities and income. And everybody is covered. Why? Because, except a few very rich people, nobody can afford certain diseases. For example, nobody can afford brain surgery. Or cancer.

The money that you pay for insurance will never be enough to cover your treatment if you have the unfortunate circumstance of facing a terrible medical condition. That’s why medical debt is the number 1 source of personal bankruptcy filings in America.

That is also why healthcare should be open to everyone, and why it should be public. This way, you will be able to focus not on profit, but on sustainability. And because you would increase the user base of the system, the State should be able to negotiate better conditions with private partners such as pharmaceutical companies (in the acquisition of drugs and medical devices), and better agreements with private hospitals and independent doctors collaborating with the public framework.

In a universal healthcare system you don’t pay for your coverage, you pay for everyone’s, and everyone pays for yours. You don’t pay so that you can be covered in case of cancer. You hope you don’t have cancer. But you live in the tranquility of knowing that, if you happen to face such dark circumstances in your life, the system will be there for you, giving you the best chance you can get.

When will Americans understand that they don’t have to live in a 3rd world country when it comes to healthcare. You can do better, and you have the obligation to do better to your own citizens.