The American Health Care Dilemma

A Suggested Resolution

That the U.S. is a nation divided is a statement few knowledgeable individuals would challenge. These divisions have been exacerbated, to some degree, by the impending 2020 election wherein Americans will go to the polls to elect their next President and a cadre of senators, congressmen and a multitude of lesser known local politicians.

These divisions include race, ethnicity, religion, the distribution of wealth and the provision of medical services. The Latin motto that appears on American currency and elsewhere, “e plurubus unum” (out of many, one) is clearly no longer applicable, if it ever was.

As the pre-election process proceeds, the nation is divided between those who advocate the free enterprise model and those who believe the state should play a bigger role in the provision of health care. Several Democratic Presidential hopefuls have risked being labelled socialists as they advocate single payer health care or, at the very least, a bigger role in the provision of health care by the federal government. As Senator Bernie Sanders correctly points out, America is the only industrialized nation that does not have some form of universal health care for its citizens. For example, the four Scandinavian nations have had state sponsored medical care for several decades. Skeptics should also take note of the fact that in virtually every survey dealing with the level of happiness of its citizens, the nations that come out on top are all Scandinavian.

As a Canadian, I have lived most of my life under a health care regimen wherein most of my health care expenses have been covered by Canada’s medicare program. Canadians can thank the late Tommy Douglas, the former Premier of the province of Saskatchewan, who carried out a lengthy battle with the medical profession before ultimately introducing a government sponsored medical insurance program which was later adopted by the Canadian federal government.

Many critics of the Canadian model (mostly well to do Americans) claim Canadians are subject to long wait times before gaining access to most of their health care needs.

If you are a wealthy Canadian and want immediate access to medical care, you can simply travel south of the 49th parallel and pay the applicable fee. From a personal perspective, I would rather wait a few weeks for an elective procedure than risk bankruptcy or have to take out a second mortgage in order to pay my medical expenses. It is also important to recognize that in Canada, no patient requiring immediate care is subject to a long wait period.

Many Americans have been “brainwashed” by those who caution them on the evils of “socialized medicine.” Such an approach is a step toward socialism they warn and this will ultimately result in the government gaining more control over their lives. My God, how long before communism becomes the dominant form of government in America?

Yes, there are people in both the U.S. and Canada who have sufficient resources to pay for the cost of their own medical care. Conversely, there are many Americans for whom a major medical expense can be catastrophic.

The publication Law Dictionary estimates that 40 to 50 million Americans have no health insurance.

As referred to above, one of the most divisive issues in American society today centers on whether health care should remain a component of the private sector or become a responsibility of the federal government.

Perhaps there is a compromise position that would be acceptable to both sides of this issue. Perhaps the solution could involve a “means test” wherein families with a certain annual income would be ineligible for access to the government sponsored program.

In effect, a two tier system. It would not be difficult to review every family’s income during the previous year to ascertain whether or not a family was eligible for participation in the government program. Also, people who have comprehensive health care insurance provided by their employer could be ineligible for the government sponsored program.

There is another model that also incorporates fairness which might be labelled “ Graduated Eligibility.” In this model, if an individual (or family unit) had an annual income below a certain level they would be eligible for comprehensive coverage whereas those with annual incomes exceeding a specific amount would not be entitled to a government sponsored program. People between these two extremes would be eligible for varying amounts of coverage.

What should the family threshold income be to be ineligible for participation in the government sponsored program? I would suggest an annual family income in excess of $250,000 would be reasonable. But this is a question that would likely be highly debatable.

Despite the impassioned pleas of people like Senator Bernie Sanders, perhaps the American people are not quite ready to embrace a universal health care program. If this is the case, then a means test could be a step in the right direction.

Are you listening Bernie?

Barry Mayhew is a recently retired business executive. He has a doctorate in Strategic Planning. Throughout his nearly 50 year working career he has held senior positions in the airline and forest products industries and spent many years as a management consultant. He and his wife live in Victoria, B.C. Read other articles by Barry.