Preamble: In this post, we attempt to explain what’s gone awry with American health care— and a way to fix it—in human terms. It is meant to be a non-partisan discussion, so please keep that in mind when commenting. The views laid out here are my own and do not represent those of any organization.
It’s Saturday morning, and you’re shopping for a raygun. How did you get here? I’ll explain.
It’s the future, and the world has been invaded by aliens. The good news is the aliens are tiny and have no interest in taking over, or even eating people. The bad news is they really love to eat houses. That’s because the aliens are extraterrestrial termites.
They’re everywhere. You never know when you’re going to have to patch a hole in your porch, or discover that your nightstand has been half-eaten. Wood, brick, concrete, steel—if it’s part of a house, they’ll chew it up.
That’s why you’re at RayGun World this morning. Early on, people simply chopped off the alien-infested parts of their houses. But eventually scientists invented raygun technology. Their special beams zap the various breeds of alien termites back to their home planet, and simultaneously repair any chewed-up parts of your house.
You have decided to lease a raygun for yourself after witnessing your neighbor’s house collapse entirely because — unbeknownst to him — the alien termites had been chewing on the basement for years.
The RayGun World saleswoman greets you with a wide smile as you walk in. The first thing she asks you is if you have Extraterrestrial Termite Insurance?
You tell her that you have standard E.T. coverage, through your job.
“Wonderful!” she exclaims. “If you didn’t, you’d have to pay full price. Come with me, and I’ll show you the rayguns available in your country.”
You walk down the aisle past a whole bunch of sleek, shiny rayguns. Each is labeled with its corresponding country where it can be used. You pass the sophisticated, regal-looking U.K. ray guns ($4,003 per year), which looks like a termite-killing Rolls Royce.
I got my rayguns from drawings by the talented Joel Kimmel: http://joelkimmel.com/
Next to it sits the gleaming Swedish rayguns ($5,228), which look like rocketships. Germany’s raygun ($5,267) is equally inspiring, as is Japan’s ($4,150). Your gaze lingers on a row of Nicaraguan rayguns ($1,000), which look like converted cowboy revolvers, and the saleswoman makes a face that you interpret as, “Who would ever use one of those, right?”
Finally, you reach the wall with U.S. rayguns. They’re… well. You’re not impressed. It looks like a dirty toy: small, dull, and a little used. There’s no price tag.
The saleswoman begins assuring you that this raygun is 80% as good as any of the fancy European or Japanese ones—but you interrupt her. “American rayguns are supposed to be the best in the world! What’s with this one?”
“Well, America does make the world’s best raygun, in my opinion,” she motions to a glass case behind the counter containing a raygun that makes the other ones look like super soakers. It has a price tag of $30,000. “But standard ET Insurance is not going to cover the cost.”
You grimace. “How much is the regular one?”
She smiles. “With ET Insurance, you only have to pay $50.”
Wow, you think. That’s practically free. Who cares about Europe and Japan! Fifty dollars to fight the termites? “Sure,” you hear yourself telling her.
“I’ll take it.”
Pleased, she excuses herself to go run your credit card.
While she’s gone, you pull out your phone to look up the actual cost of the raygun you just bought. Just out of curiosity.
To your surprise, it costs $9,900.
The saleswoman returns with your receipt, and you’re upset. “Why didn’t you tell me,” you demand, “that this lame raygun costs twice as much as the others?!”
She smiles while raising her hands like it’s a stick-up. “I don’t set the prices—this is just how much the standard American raygun costs,” she says. “If you didn’t have E.T. Insurance already, it would cost you ten grand yes. But that just shows how great of a deal you are getting!”
You’re annoyed. “A great deal would be twice as good of a raygun,” you mumble as you take your receipt. Maybe blasting some termites will make you feel better.
On the way home, you run your hand across the smooth curves of your ray gun and smile. No matter what, you’re glad to have it.
But then, to your dismay, another thought hits you:
How much am I paying for insurance?
Atthis point I have to tell you something. This isn’t actually a story about aliens and rayguns. It’s really about health care.
Like our fictitious war against termites, health care is a war on sickness. We of course hope that our bodies don’t get invaded by disease or break down. But when they do, we fight and repair, fight and repair.
But despite our country having developed many of the world’s greatest advances in medicine and medical education, the average American’s annual health care is twice as expensive and significantly less effective as our developed-world neighbors.