Guaranteed Healthcare

Our health care system is in critical condition.

It is difficult if not impossible for Americans in less than optimal health and even many healthy ones, to find affordable, individual coverage. Health-related costs are the leading cause for personal bankruptcy in the United States.

This morning NPR told the stories of two patients with multiple sclerosis, Linda Oatley lives in Buckland England, Jeffrey Rubin lives in Philadelphia, Pennsylvania.

Linda, like all residents of the United Kingdom, is covered under one form or another of the NHS. She was diagnosed with multiple sclerosis in 1999, but unlike her brethrem in the United States, she did not have to file for bankruptcy or lose her home because she had the misfortune to get sick.

Imagine if we had this in the United States.

Oatley pays the equivalent of $30 a week for her physical therapy sessions at the center. And it's a donation, not a fee. The Chilterns MS Centre is run by a charity, with some government funding.

But Oatley has never seen a bill for the rest of her medical care, such as her prescription drugs, doctors' appointments, MRIs and lab tests. That care is paid for by Britain's National Health Service. It's a government-run system, funded by income taxes, that provides health care to all residents.

No waiting, contrary to the ugly lies spread by those who want to maintain the ghastly status quo.

"I felt these odd sensations, in both legs actually," she recalls. "This is weird, but it felt warm on the inside, and when I would take a bath or a shower, the hot water felt cold and the cold water felt hot."

She made an appointment with her general practitioner, who promptly referred her to a specialist.

"He recommended, that very day, an MRI scan, a pulmonary function test, an X-ray and a blood test," she says. "And so all that was done that afternoon, and I went back the very next week for the results."

The tests showed multiple sclerosis, a chronic, degenerative disease that affects the central nervous system.

And Linda got her medications too!

When Oatley was first diagnosed, there were several new drugs available in the United States that were thought to slow or stop the disease, at a cost of thousands of dollars per month.

But in the United Kingdom, the National Health Service was waiting for more data on the effectiveness of the medications. So Oatley paid for one of the drugs, Copaxone, herself at first. Then the NHS approved the drug for her type of MS.

At that point, the NHS gave her Copaxone free and delivered her prescription to her home every month.

"And they gave me my money back," she adds. "So they reimbursed me the 5,000 pounds I had spent. How cool is that? I thought I'd died and gone to heaven."

Medically, she's happy with what she's getting now: twice-yearly appointments with a neurologist and prescription drugs delivered free to her home.

And if she has a flare-up, she can go to the doctor without a wait.

Let's return to our friend in Philadelphia, a citizen of the richest nation on the planet. What sort of healthcare does he receive?

In the United States if you have limited or no health insurance you have to wait more than two years before Medicare will pay for treatment. When Congress expanded Social Security and Medicare to the disabled in 1973, they put a two-year waiting period onto Medicare to keep costs down.

Compare Linda's life to that of Jeffrey Rubin.

Rubin's medicines are lined up on a high shelf in his kitchen.

He takes about nine medications for his disease. Every day he injects Copaxone, which slows down the course of the disease. It costs about $2,000 a month. He takes a twice-a-day pill for his back. That prescription costs more than $200 a month. A drug for migraines costs $400 a month. A lot of the medicines make him feel even more tired, so he takes one to help keep him awake — that costs $1,000 for a month's supply.

So what do you think has happened to Jeffrey, a citizen of the richest country on the planet where healthcare is a privilege not a right?

Because he got sick, he lost his job and his private, for-profit health insurance.

He eventually lost his job, and he couldn't pay for his health insurance on his own.

He recalls thinking, "I don't have the money. I'm already paying, of course, my mortgage, utilities. What am I going to do? I don't know what to do now. Everything just came closing down."

. . . He asked for money from his elderly parents and borrowed money from friends. Neighbors and strangers dropped off food. His doctors gave him drug samples, but not enough. He came up with strategies to make his drugs last longer, but that worried him.

"If I don't take all my medications, who knows what's going to happen?" Several studies have shown that stress can make MS worse.

And finally, he declared bankruptcy.

After a fight with the Social Security Administration and a letter from one of his senators, Rubin finally qualified for government disability payments from Social Security. But he still isn't eligible for government health insurance through Medicare.

Rubin is one of 250,000 people with disabling conditions such as MS, cancer or schizophrenia who are stuck in this waiting period without insurance, according to an estimate from the Commonwealth Fund.

Recently, Kristin Rubin got a job with the charter school the kids attend, and the family now has health insurance through her job. But the insurance comes with co-payments, and since Jeff gets a lot of care, the co-payments add up.

He admits he once contemplated suicide — as a way to ease the financial burden on his wife.

So, returning to the question in the title, where would you rather be sick in the United States or the United Kingdom? It's not even close.