August 09, 2005

Moving Back to America: Health Care

In a few months, I’ll move back to the United States after five years of living abroad. I can’t wait to be home again and to be closer to family and friends. However, there are some annoying administrative details to sort out, the worst of which is researching health care plans for my wife and me. The process is only slightly more enjoyable than a Chlamydia test.

In England, we were covered by National Insurance. While hospitals are dreary and long delays for non-urgent care are common, the system is universal and it works better than ours—the average life expectancy in England is 78.5, slightly higher than America’s 77.2. 

In France, the system is more expensive for the state, but it is luxurious for the ill. (France spends 10.1% of its GDP on health care compared to 7.7% for the UK.) Quality of care is excellent in France. Prescription drugs are readily available at low cost. You choose your doctor, and it costs only 1 € per visit. Almost all of your medical expenses are reimbursed by the government. And the results are there: life-expectancy in France is 79.4.

I have long expected it would be difficult to readjust to the parlous US health care system. But after looking into it for only two days, I’m already depressed.

The bureaucracy of it all is so boring and irritating. HMO, PPO, HSA—I have no idea what these things are, but I know I better learn quick. I’m worried about high deductibles and loopholes which will mean we are not fully covered. I’m worried that if I end up starting my own small business, I’ll start every month $1,000 in the red to cover health care just for my own family. Even I work for someone else, the cost is enormous—in the five years I have been away, US employee health care costs have more than doubled. And we’re spending 15% of our GDP on this atrocious system—more than any other developed country, and more than we spend on defense, let alone counter-terrorism.

So why isn’t this a major political issue?  I know that it’s not a priority for the Republican Party, but where are the newspaper editorials and letters to the editor? Are Howard Dean and Harry Reid talking about health care every day? If so, I’m not hearing about it. Why aren’t people protesting in the streets? Let’s get angry, people! I’m already sick of the health care system and I’m not even back yet. I know I'm not alone.

By Will Friedman in Health Care | Permalink  | 


I think that perhaps people believe that the whole thing is so massive and complex that they can't do anything about it. Even Bush chose to tackle Social Security rather than delve into Medicare (which, as I understand it, is 10-fold the problem that Social Security is).

Our health Care system is just wrong and backward and chaotic. It needs to be wiped out and rewritten from the ground up.

(sidenote: I am working presently on a small project for a massive local Hospital, and have found out that in addition to paying the salary of some heinously incompetant and recalcitrant archivists, if I should be so unlucky to be admitted to this hospital for an ailment, I will be paying for the *required* photography [and scanning and filing, and salaries of the photographers] of every piece of furniture and small objects d'art the Hospital buys for all of its thousands of lobbies, etc. That would explain the $85 pen on the itemized bills!!)


Posted by: dks | Aug 10, 2005 7:42:34 PM

You have my sympathies about the medical system here. I would love to have the option of a national health care system. My wife and I have been through the health care machinery and it is hellish, to put it mildly. Good luck!

Posted by: SheaNC | Aug 11, 2005 9:18:44 PM

Thanks SheaNC.

dks is right: the system needs to be completely reconceived, and yet starting from scratch is imposing. It’s hard, too, to make major changes, as we saw during the Clinton era; especially when so many big interests are quite happy with the status quo. Maybe the solution would be to start with a piece of it, like prescription drugs for example, and fix that part before dealing with the rest. It’s the cost of prescription drugs that have the most negative impact on my own extended family.

Frankly, I can’t claim to know how a solution would work—I just know our system stinks, especially compared to other Western countries’.

Posted by: Overseas Will | Aug 17, 2005 5:07:37 AM

Here's the really scary thing about our Health Care system: It can only get worse. With the baby boomers aging, their collective hospital costs will continue to rise. Another problem is the exhorbitant amount of money needed to cover the cost of malpractice suits. Fellow liberals may not like to hear it, but it IS a problem. I consider mysef a liberal, but I place a higher priority on guaranteed health care for all than on allowing unlimited punitive damages in malpractice suits. One reason the idea of nationalized health care scares those in the federal government is their desire to avoid covering the cost of medical liabilty cases from HMOs - which would require raising taxes. Liberals must also frame the Health Care issue in MORAL terms in order to win real consideration. It is hypocritical of conservatives to preach about the right to life for unborn children, then take away that right from sick adults (and their already-born children) who can't afford to pay for health care. Maybe the way to win this fight is to convince Christian conservatives that, for once, they should support the Democrats. Why? Because their not-so-Christian allies in the Republican Party are defying Christ's order to sacrifice personal wealth for the good of others. Isn't "Do unto others" a basic Christian principle? It isn't hard to figure out how to frame nationalizing health care in terms of this tenet - the fabulously wealthy pay higher taxes, and these funds pay for health care for thousands of sick Americans. Do unto others.

Posted by: Ryan | Aug 17, 2005 6:30:17 AM

Very good points, Ryan. And I would add: while it's true that our aging population will make health care even more expensive, the birth rate in the US is higher than most European countries. That's another reason that it's inexcusable that European health care systems are so much more efficient than our own.

Posted by: Overseas Will | Aug 17, 2005 6:39:57 AM

If only, as Ryan reminds us, Christians really practiced what their God preached. One of Jesus's main messages of course was helping the poor and eschewing all wealth to follow God. Er, Sorry. That message hasn't worked since the early Christian hierarchy discovered Roman money. Imagine if the far right in this country were barefoot and espousing charity, rather than richly-clad, spewing nonsense and intolerance.

Dude, happy as I am to have you guys in the country again, I can't imagine why you're moving back here!!

Posted by: dks | Aug 18, 2005 4:36:55 PM


The draw of being closer to family and friends is quite strong. And, I am homesick for the States. I have never felt my American identity so strongly as when I have been living abroad.

So I bitch a lot - and I will bitch some more, but it's because I care enough to complain. After all, you don't complain about the snoring of the neighbor's wife/ complain about your own! :)

(Or in our house, she complains about mine! Or maybe a better example would be a cat...)

Posted by: Overseas Will | Aug 19, 2005 2:45:10 PM

awww yeah!!

You know that I totally know how you feel.

"To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but morally treasonable to the American Public."
-President Theodore Roosevelt

Posted by: dks | Aug 19, 2005 7:36:35 PM

2005-08-09 Moving back to America: Health Care.
I have read this article somewhere else.
Was it "the Economist"?
Why is the article not credited to its original publisher?
If it is, where can I find it?

Posted by: Kirkby Stephen | Aug 28, 2005 6:57:35 AM

Hello Kirkby,

That is very flattering! But, this is an original article.

Posted by: Overseas Will | Sep 9, 2005 5:59:16 AM

I am on anti-depressants and sometimes require therapy for depression. I have gone through unbelievable hassles just to obtain a minimal quality of care. I've had to beg for free samples, buy medicine tablets individually b/c of the cost, send paperwork to my ins. to prove I "needed" the medicine even though I had a valid prescription and gone through hellish withdrawal symptoms when I wasn't able to obtain any medicine. Sometimes it's hard to remember that the system is wrong and that I shouldn't be punished for my health probs. I'm considering moving to Canada or the UK because of this. Right now I'm on COBRA and I'm paying $367/mo. premium and $100 in Rx co-pays a month and I have a $500 deductible for physical therapy. Help!

Posted by: Maggie | Aug 23, 2006 2:53:07 PM

The comments to this entry are closed.


TrackBack URL for this entry: