Everyday—because of the escalating costs of health insurance—the odds increase that if the parent of an ill child leaves or otherwise loses their current job, for whatever reason, his next employer will offer a far more limited choice, if any coverage at all, for health insurance coverage. The parent may feel that it is necessary to stay in a job that he increasingly finds demeaning or unrewarding, simply to ensure the health insurance that protects his child's health.
This leads me to a concept I call the slavery of necessity. As the Lord Chancellor of England pointed out in Vernon v. Bethell, Eden 2, 113, (1762), “Necessitous men are not, truly speaking, free men: but to answer a present emergency, will submit to any terms the crafty may impose upon them.” It is not only the necessity of keeping a dead end job that the lack of national health insurance forces on many Americans. Because of that lack of adequate health insurance coverage, millions of “necessitous” Americans are forced to use the overcrowded emergency rooms of our hospitals as a last resort for care for their families. Besides inflating the cost of healthcare in this country, lack of adequate health insurance costs 18,000 Americans their lives every year. This travesty also marginalizes and dehumanizes all of those Americans who are forced to delay the treatment of themselves or their loved ones illness until they are left with no choice.
The United States spends at least fifty percent more on healthcare than any other Western Democracy, yet we are at or near the bottom of the list in terms of life expectancy and infant mortality.
Healthcare costs, including insurance, have risen at more than twice the rate of inflation over the last fifteen years. The greed of the healthcare industry (insurance, medical, and pharmaceutical), is every bit as economically damaging as Wall Street's speculators. The insurance industry is especially contemptible in this regard, where at least fifteen percent of your insurance payment is taken off the top for operating costs, including paying the underwriters and CEO's.
I do not propose a nationalization of the healthcare system like Great Britain, where the physicians work for the government. I would prefer to not see a system where healthcare is rationed as with American HMO's or the Canadian system. I think we should look to Germany as our model, where the government pays the insurance companies a set fee to cover an individual, and the company improves its income by improving its services while keeping costs down. Or perhaps a single-payer system like France would be best. Or even a double payer like Australia where the government provides the basics and you can buy insurance for things like private rooms.
I would also like to see our system change so doctors and nurses, in exchange for the cost of their education, spend time in the poorer urban and rural areas, with adequate technical support, to improve medical care in those locations. This will help encourage additional qualified individuals to seek out jobs in medicine, who now hesitate to do so because they do not want to go a quarter million dollars into debt.
We can no longer continue to have a nation that is, to paraphrase Lincoln, half necessitous and half free.
For our children's sake, it's time we take a stand.
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