In an ideal world, money would not be the deciding factor in who can get access to healthcare. But I have come to accept that we do not live in an ideal world. I’m reminded of this when reading news articles about taxes, hearing politicians talk about budget cuts, and even while discussing ways to improve healthcare with coworkers at the hospital. As a nation, we would like to have a healthcare system that we could rely on without the threat of medical bankruptcy, but we fear that this would be undoable without raising taxes to an unacceptable level.
This is the viewpoint I try to keep in mind while thinking of how change could be achieved. A single-payer system, which could provide universal healthcare by having the government pay for medical expenses from a fund collected by taxes, may seem like an unfeasible idea from a financial perspective. After all, if healthcare is free, wouldn’t people start using it more and make costs go up?
In my experience, having access to healthcare at the first sign of trouble would do the opposite. A stay at a hospital costs many times more than paying for an outpatient visit. As I see patients come in, I can’t help but wonder if their condition would have progressed far enough to require hospitalization if they had gotten help earlier. In many cases, a hospital visit may have been avoided if they had gotten appropriate care and medication when they first noticed a problem.
Cost plays a significant part in postponing care and not taking vital medications. Too many people are forced to choose between taking care of their health and paying for housing, food, and other essentials. This may save money up front, but in the long run it costs much more to treat a poorly managed chronic disease or an acute illness that becomes life-threatening.
Take the example of a person with diabetes who skimps on insulin because it costs too much. Even with insurance, the price of insulin may be too high to be feasible with a high deductible. It costs up to $300 a vial in the U.S., and several vials may be needed per month. In countries with single-payer healthcare that can negotiate drug prices with manufacturers, it is cheaper – about $50 in Canada. According to data from the American Diabetes Association, the average price of a hospital admission for diabetic ketoacidosis, which is a life-threatening condition that occurs when sugar levels get dangerously high, is $26,566.
It would be much cheaper to cover insulin than pay for a hospitalization, especially if the government is able to negotiate drug prices with pharmaceutical companies. Though it may seem like only the person getting hospitalized suffers the financial fallout, ultimately it increases costs for all of us. The hospital bill of a patient unable to pay it will be paid for either by increasing prices for all other patients or with our taxes. If the cost comes around to all of us in the end, wouldn’t it make more sense to pay for the insulin in the first place?
In the pursuit of saving money on healthcare, we may even prevent some human suffering. It is much more comfortable to have a disease treated before it progresses to the point of requiring hospitalization. It is unfortunate that in a country that sees itself as the best in the world, people are unable to access care until it becomes an emergency. This leads to unnecessary suffering, bankruptcies, and even deaths. As people lose their jobs and insurance with COVID-19, this problem will only get worse.
It is time for a better system in which everyone is able to afford healthcare, regardless of what they can pay.
Zoryana Bilohan is a registered nurse from Bristol.