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This past week brought with it a grim pandemic milestone. November 17th marked a full year since the first case of COVID-19 was identified in China. In the months since, more than 57 million have been infected globally and more than 1.3 million have died. The United States claims more than 11.7 million of these infections and over 250,000 deaths. Beyond the tragic toll the pandemic has taken on human life, it has brought social, political, and economic consequences. It has also clearly illuminated the moral failure of the health care system in the United States.
Far too frequently, we allow our sense of American exceptionalism to cloud our ability to impartially examine our successes and failures as a country. We do this with many policies and practices, and health care is no different. Take, for example, the fact that the richest country in the world was so ill prepared for the possibility of a pandemic that some frontline healthcare professionals were forced to wear trash bags for protection and dangerously reuse single-use personal protective equipment. Remember that we tolerate price gouges in treatment that outpace inflation with only minor gains in quality of care. Recall that we still accept a health care system that cripples livelihoods with debt as ethical.
We place profit above social benefit in few other sectors as much as we do health care. Social cost and social benefit are tricky terms in economics – they are complex calculations that fluctuate depending on how we collectively determine the value of the environment, human life, and other variables. These terms attempt to “price in” impacts of consumption that are typically not reflected in standard pricing. Just like the clear social costs of climate change are not appropriately incorporated into the cost of burning fossil fuels, the social benefits of health care are not adequately weighed in its pricing.
In a pandemic, your neighbor’s access to health care matters just as much as yours. When any individual can be a vector for viral transmission, ideally, all should be able to access comprehensive care quickly and without fear of cost. This is true even in the absence of a deadly virus. One could argue that the financial burden health care places even on the well-insured in the United States takes an economic toll on overall productivity.
It might be said that the U.S. is in a much better place to deal with the pandemic than it was several months ago. Masks and face shields are in greater supply, health care providers are better equipped with resources and knowledge of how to treat the coronavirus, and substantial progress has been made in vaccine development. These successes are worthy of some degree of praise, but they do not erase failures.
The United States was always going to struggle with this pandemic more than other countries because of its toxic emphasis on individualism over collective good. Make no mistake, I value my freedoms just as much as anyone else, but when the burden of wearing a mask is too much for some, we are not just in a crisis of health but a crisis of community. A simple piece of cloth is one of the most important – and cheapest – tools we have in combatting the coronavirus. The Institute for Health Metrics and Evaluation reports that 68% of Americans wear masks regularly. We can do much, much better. If that number increases to 95%, the IHME projects around 65,000 fewer coronavirus deaths in the U.S. through march compared to current projections.
While I have neither the time nor the space in the form of a blog post to comprehensively discuss the U.S. health care system, I hope I can at least engage in a constructive examination and leave a few questions to consider. The government-backed Operation Warp Speed is on track to yield safe and effective vaccines on an unprecedented timeline. Does this negate the idea that increased government involvement would stifle innovation in health care? Drug prices continue to outpace inflation with only modest improvements in health outcomes. Would less stringent intellectual property protections increase competition and remedy monopolistic drug markets? Preventative health care can often be cheaper in the long run than more reactive approaches to care. In a system where consumers do not bear costs, will they seek more preventive care or will they adopt poor health habits, knowing someone else will always pay the bill?
Draw conclusions how you may, but I believe the current system of health care in the United States is immensely bloated and inefficient, overspends on care relative to outcomes, and allows insurers to line their pockets as middlemen. As a country, we are failing our citizens by seeking immense and often uncontrolled levels of profit off of their illness, ailment, and misfortune. Other countries have demonstrated, through various different models of care, methods to control costs and increase quality of outcomes. We can and must do so much better.
Ben Barberie is a McConnell Scholar in the class of 2021. He is studying political science and economics at the University of Louisville.