How Much Am I Worth?

I recently wrote about medical treatments I would be receiving. I said I was grateful to live near a first-class medical center and to have medicare to pay for it all. I lamented that so many others do not.

I finished those treatments and got the bill. Or, actually, I did not get a bill. Instead, I got statements from medicare and my medigap insurer about how much was charged by the hospital and doctors and how much they were paid. My share of the payments was zero.

So, that’s great, right? Well, I suppose. For me.

As I write this, the nation has once again reached its debt ceiling. Now Congress will fight over raising it. Fiscal conservatives will demand spending cuts, targeting programs like medicare. I don’t agree with their tactics—and certainly not their rhetoric and factual distortions—but we need more rational discussion about how we raise money (taxes) and how we spend it.

My treatments were billed by the hospital and doctors at over $500,000. Under medicare, the providers got paid about five percent of what they charged. (My private medigap insurance paid another one percent.) They accepted that. As I said, I owe nothing.

Great program, right? A ninety-five percent discount. Let’s do that for everyone. By that reckoning Medicare For All would be dirt cheap.

Of course, it wouldn’t be. Our national system of healthcare providers may be charging too much, but they could not take a ninety-five percent haircut and stay in business. In a health system that covered everyone, reimbursements would have to be greater, which would raise the cost to government, which would have to raise taxes to pay for the added cost, or cut services.

You can’t get anything repaired today for less than market rates, not well anyway, and not for long. Plumbing, electricity, roofs, kidneys, lungs, hearts. When it comes time for a new water heater, we have to make choices. If our budget is tight, something less important might have to wait.

The same is true of healthcare. We see that reality in every country that has free healthcare for its citizens. As The Rolling Stones said, “You can’t always get what you want...”

As our population ages, we are spending more and more of our healthcare dollars on old folks like me. The question is obvious: are we worth it?

Even in a country as prosperous as ours, we don’t have boundless resources. We have to make choices about where to invest. In a child of five with many years ahead of her, or in a man of seventy five, who is coming to the end of the line?

Every human life is worth something. None is worthless. But is each one worth the same investment from the public treasury?

When put in those terms, the question answers itself.