Come On, Washington… How Hard Can This Be?
For decades, Congress and various presidential administrations have been engaged in a stupid "health care reform" debate fueled by stupid "health care experts."
The American health care system needs just one change: We need to make sure Americans aren't turned out of their homes and made into beggars by their medical bills.
We're a rich country. We're a generous country. When people get sick or injured, they shouldn't lose the house. The boat? Maybe. But not the house.
The simplest way to keep medical care from causing impoverishment is a "10% Rule." Calculate after-tax household income (including all government benefits) and when medical bills exceed 10% of income, we as a country step in and help out.
Actually, we're damn close to having this system already. According to figures from the U.S. Department of Health and Human Services, only 11% of health care expenses are paid directly by patients out of pocket.
We just have to ensure the 11% is coming out of the right pockets (such as mine). I'm an affluent old guy on Medicare. Therefore, I'm ripping off everybody in the country who's under 65.
A 10% hit on my income would be unpleasant... but not catastrophic. Less pheasant hunting in South Dakota and more shooting crows in my backyard.
Well, shooting crows provides plenty of good sport (if not much good eating).
This is the "KISS" approach (keep it simple, stupid).
But nothing will make the health care experts or politicians who listen to them "KISS" and make up... hence decades of stupid health care reform debate.
The stupidest thing about the debate is that the U.S. health care system doesn't need "reforming." We have the best doctors, nurses, hospitals, and hospital staffs in the world.
I found this out 50 years ago when I was a hippie on a motorcycle. (Do not ride a Triumph Bonneville at 90 mph after you've taken LSD.)
I've found it out again now that I'm a 70-year-old who still drinks and smokes cigars and whose idea of regular exercise is getting out of bed at 3 a.m. to take a leak.
Yeah, yeah, the "health care experts" say American health care is not the best. The World Health Organization (WHO) claims that France has the globe's No. 1 health care system.
If I think I'm having a heart attack, I'd better get to Paris. Some pate de foie gras, a chunk of brie, and a bottle of Dom Perignon, and I'll be fine.
To give you an idea of how much expertise these experts have, the WHO ranks the American health care system 37th, behind Oman (No. 8), Colombia (No. 22), Cyprus (No. 24), and Morocco (No. 29).
Oman... Seriously, the WHO says the Sultanate of Oman has the world's eighth-best health care system. One fact: Female genital mutilation is legal in Oman.
And Morocco is ranked well above the U.S. You've probably noticed that when rich people from every corner of the Earth get sick, they don't fly to the Mayo Clinic in Minnesota. No, they fly to Marrakesh: "Eat two hashish brownies and call me in the morning."
"But," say the experts, "if you're not rich, you don't get treated in America." That's a lie. That's also illegal.
American hospitals are required by federal law to admit every person needing medical attention. It doesn't matter if you're so broke that you married your girlfriend for the rice.
This is a result of the "Emergency Medical Treatment and Labor Act" of 1986. (Passed – health care experts take note – during the "heartless" Reagan administration.)
The law applies to every hospital that receives federal funding or payments... which is all of them (except maybe a few privately operated emergency buttocks enhancement clinics). So the health care experts can shut up about availability of treatment.
Here's something else they can shut up about: health care insurance.
If Dad keels over, you don't call Blue Cross, you call an ambulance. Why do all the Democrats, too many of the Republicans, and the big green eyeshades at the Congressional Budget Office keep going on about health care insurance instead of health care?
We have health care in America. No, we don't have the body mass index of the Danes. No, we don't live as long as the Japanese. But we're a big, crazy, hard-working, hard-playing country, living high on the hog. We love eating, drinking, fussing and fighting, driving too fast, and... "Hold my beer and watch this!"
Considering the way we Americans behave, America's health care system does a miraculous job. "But, oh, oh, oh," say the experts and the politicians, "the American health care system is so expensive."
And it is: $3.2 trillion a year, 17.4% of gross domestic product (GDP). That's $9,990 per person.
But let me ask you a question: Do you want your health care done on the cheap?
Some things you buy by price, some things you don't.
The safety and security of my family, for example.
If I hear burglars breaking into my house in the middle of the night, there's a way to handle this situation that's a bargain – a toll-free call to 911.
But I live way out in the country, miles from the nearest police station. There's another way to handle this situation that's less of a bargain.
While my wife calls 911, I take my shotgun out of the closet and go to the top of the stairs. The sound of me racking a round into the chamber of my 12-gauge pump should make the burglars skedaddle.
But if it doesn't make the burglars skedaddle...
Am I going to stand at the top of the stairs carefully calculating the costs of replacing the front door, re-glazing the doorframe sidelights, patching the 00 buckshot holes in the front hall walls, and paying the legal fees of the lawyer I'll have to hire to defend me on manslaughter charges?
No. I'm going to pull the trigger.
So, Congress and Mr. President, just pull the trigger on health care and shut up and go back to bed.
Regards,
P.J. O'Rourke