You can’t put a price on being healthy, says Robert Nielsen as he dives into the economics of healthcare
There are few things in life as important as good health. After all, we need it to live and even the slightest illness has huge effects on our happiness. It is for this reason that we all value healthcare and believe that all people have a right to good health. Unfortunately, this is more of a noble aspiration than a reality.
Despite what we may wish, there are gross inequalities in the health system, meaning that how much money you have helps to determine how long you live. One hundred years ago, your class determined how long you would live. If you had the luck to be born into a wealthy family, then you could look forward to a long and prosperous life where illness could be quickly and efficiently dealt with.
If you had the misfortune to be born in a tenement slum, then you have to face a life of hardship where sickness would be always near your door and your life would be much shorter. Now, even in the 21st century, money may not be able to buy happiness, but it can buy life itself.
A study by Balanda & Wilde entitled “Inequalities in Mortality” found that people from the lowest socio-economic group in Ireland have a mortality rate that is 3.5 times higher than that of the highest social class. According to the Think Tank for Action on Social Change (TASC), unskilled men die six years earlier than professional men.
In her book “Irish Apartheid: Inequalities in the Irish Healthcare System”, Sara Burke estimated that inequality was responsible for an extra 5,400 deaths every year. Inequality is not an academic question, it is literally killing people. So, why is this the case?
The main reason is the two-tier health system we have in Ireland. Healthcare is great if you have enough money, but if you don’t have the money, you are left on a trolley or for months on a waiting list. This is part of a process that puts a monetary price on someone’s life and values making money more than saving lives.
It is argued that privatising healthcare will make it more efficient, but only for those who can afford it. In order to get an operation in Ireland, you must go on a waiting list. That is, unless you have private insurance, in which case you can skip the queue and get treatment ahead of people who have been waiting longer and need the procedure more.
This system is a lot of things, but it is fundamentally dishonest. Healthcare should be based on providing a service to those need who need it most; it is not acceptable for people to skip the queue just because they have more money.
Still, many say that privatised systems are more efficient than the government. Is it not best if we leave things to the free market? That may be the case for many areas of the economy, but not health.
This is because health is not simply another market, but rather much more important and complex. In a normal market, you can shop around to find the best deals, but healthcare is such a complex subject that you need years of education before you can fully understand it.
This means that consumers don’t understand what they need, how to get it or what they are paying for. In essence, the market cannot function. This is why attempts to privatise healthcare in Ireland and America have not lead to lower costs as promised, health companies know that consumers lack information and can get away with charging higher prices.
Private healthcare is not only unjust, it is also inefficient. If healthcare is a major expense, then people will avoid having to incur it. This means that if someone on a low wage feels a pain, they will try to ignore it until it becomes unbearable and trying to make ends meet goes against all medical advice.
The golden rule of medicine is that if something can be detected early enough, it can be dealt with relatively easily and cheaply. But if things are ignored until they become a massive problem, then the costs are unnecessarily far higher. The key to a cost effective health system is preventive medicine, but if these come with a cost then people will try to avoid them where possible.
This is why universal healthcare is widely adopted across Europe. By making preventive medicine cheap and, in some cases, free, people are not discouraged from seeing a doctor and illnesses can be cured before they become a serious problem. Government may not be the most innovative of bodies, but it is good at standardisation and economies of scale.
By including all people in one system, administrative costs are minimised and efficiencies are reaped from the concentration of services. A universal system does not have our current problems of a few enjoying luxury treatment while the rest are stuck on trolleys in crowded hospital corridors. A healthy population is in everyone’s interest; healthy workers are more productive and far better than being stuck on a hospital bed being a burden on the state.
Our private health system is grossly inefficient, though that shouldn’t matter. The obvious nature of its unjust treatment of the poor should be reason alone to change it. There will always be differences between rich and poor in life, but these shouldn’t include in sickness too. Life may be unequal, but that doesn’t mean death should be too.