By Evan Falchuk
It’s been all over Facebook and Twitter the last couple of days. People updating their status with this message:
No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.
It strikes me as odd. I mean, who can disagree with these statements? And for what policy proposal are they meant to encourage support?
How about just changing it to “no one should die, and no one should go broke”? I’d be in favor of that, too.
But think about what the Facebook slogan is saying.
- No one should die because they cannot afford health care. Let’s say I have a terminal disease and I want an experimental treatment in Europe that costs $500,000 and has a 50% chance of curing me. If I have the money in the bank, I’m going to get the treatment. Should the government or an insurance company be required to pay for it if I can’t? Does your answer change if it only has a 1% chance of curing me? What if I have half the money? “No one should die,” right?
- No one should go broke because they get sick. Let’s say I don’t own health insurance even though I can afford it. I smoke, don’t exercise and am overweight. One day, I have a heart attack and my treatment costs $50,000. I can’t afford it, although if I had an insurance policy, almost all of it would have been covered. I’m broke. Should the government just pay for my care? If “no one should go broke,” then the answer is yes.
As I’ve noted before, when we talk about reform, we are really talking about dozens of different issues. Is reform about covering the uninsured, or competition in the insurance market? It is about a “public option “, or changing reimbursements to doctors? Is it about longer life expectancies or insurance cooperatives? Is it about medical malpractice, or comparative effectiveness? Is it about healthier lifestyles, or cutting the cost of prescription drugs? Is it about taxes on employee benefits or administrative waste? Is it about the cost of end-of-life care or the federal deficit? Is it about new health care IT, or the profits of private insurers?
It’s about all these things, and many more. Which presents a problem for reformers – how to package this in a way that makes sense? So far, it hasn’t gone well.
So I understand the appeal of the Facebook slogan. It’s like a virtual bumper sticker. It reduces all these issues to a simplistic slogan that suggests you are morally suspect if you disagree. But it’s too bad.
There are real issues at stake in health care, and a real need for reform. We ought to be having a more thoughtful and extensive discussion.
Thanks for the post. About 8 of my friends posted that as their Facebook status. Every one of them resulted in a lively debate in the comments section of their status. So while I understand that some may be wary of a robotically repeated meme with no real substance, think of it as a bumper sticker capable of prompting engagement and discussion. I think it worked pretty well on that level.
The cheap way to beat any premise is to carry it ad absurdum.
If you’ve got money in the bank and you want to go to Europe for treatment, that’s your choice. The discussion in the US is about best practices. No one is advocating paying for anything that’s not an accepted treatment in the US.
If you’re a fat, lazy smoker who can afford insurance and you have a heart attack will the ambulance driver refuse to transport? No, an emergency room will try to save you and every cost that ticks away on the meter will be paid by an insurance company or government subsidy. The point is, we do pay for it now. If there’s a single payer system the fat, lazy smoker will pay his own way through taxes, unless the fat, lazy smoker is also a tax cheat.
I’m so tired of hearing the same old argument about healthcare. I’m am an unemployed,relatively healthy person (with a pre-existing condition)who is currently unable to afford health insurance.
It doesn’t matter if I have a 1% or 50% chance of being cured for my condition. If I need the healthcare and want to have a procedure done to cure my pre-existing condition, I should be able to get it done in the U.S. and the healthcare should be affordable.
If I had assets, I shouldn’t have to hock them in order to get healthcare and my condition fixed.
Too often people forget that the healthcare conversation and debate has been ongoing since the 1970s. This isn’t new and it’s not going to go away. The longer we wait to make a decision, the more expensive it will be come to implement.
More people will die, more children will become parentless, more families will go into financial ruin, fewer taxes will be paid to support the economy, fewer consumers won’t spend money in the economy because they will be forced to choose between eating, the roof over their heads or paying for prescriptions and procedures.
Waiting is procrastination, the thoughtful discussion has been going on for over 40 years and is already taking place through HR 3200 with amendments and modifications on the way. No one said that this bill was the end all. We have to start somewhere.
It’s now time for a decision.
And I might add, it looks like your post regarding whether the Facebook meme was of any value is also generating discussion! Cheers!
Hi Rebecca, yes, it seems to have done just that!
Thanks for your comments!
Evan
So, Amanda, you are saying even if a very expensive treatment only has a 1% chance of success the government should pay for it? What if you are 90 years old and want a heart transplant? Where does it end. Just because you want something does not mean it should be given to you. Healthcare resources are finite no matter who pays for it.
[...] 5. I was surprised to hear the President give more than just a nod to the Facebook health care status update meme. I mean he quoted it directly: “in the United States of America, no one should go broke because they get sick.” This must be the first time a President has ever quoted something from Facebook in an address to Congress – it’s some kind of a milestone for social media. Thoughts on that meme are here. [...]
[...] 5. I was surprised to hear the President give more than just a nod to the Facebook health care status update meme. I mean he quoted it directly: “in the United States of America, no one should go broke because they get sick.” This must be the first time a President has ever quoted something from Facebook in an address to Congress – it’s some kind of a milestone for social media. Thoughts on that meme are here. [...]
None of these choices are going to be easy ones, and I have no idea who’s going to make them … but I’m grateful that Evan is willing to acknowledge that the health reform debate can’t be dumbed down into sound bites without changing its nature from something real and complex into something simple but imaginary.
[...] Evan Falchuk makes a nice commentary on his blog on the latest facebook health reform memes “No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.” [...]
[...] of reform is terribly disconnected from the reality of the proposals. Maybe this is a good storyline for getting a law passed, but it’s not a recipe for righting what is wrong in our [...]
[...] the problem with health care in America is we keep getting lured into assumptions that money is the right metric to measure the quality of medical [...]
nice to read about this that facebook users write these messages
funny to read that