‘The rights of every man are diminished when the rights of one man are threatened.’ — John F. Kennedy (1917-1963)
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
I have been enjoying the summer months (notwithstanding the heat we escaped by hiding out up north), and I hope my readers are doing the same. Sadly, some irritating and tragic medical events have interrupted my otherwise blissful season. The first issue involved my newly minted grandson, who required a routine ultrasound for a skin mass that was determined to be a benign cyst. This was and should have remained a “nothing burger” until my daughter called to tell us she had been hit with a $937 co-pay for the scan. Being somewhat facile with an ultrasound probe, I found this cost outrageously excessive for such a simple procedure and a young family just starting out.
This situation was soon followed by the medical tribulations of an older close friend on a fixed income who needed medication for a heart condition. Insurance denied this 80-something couple coverage, and she was forced to obtain the drug independently (i.e., a Canadian pharmacy selling medicines from India and the new Amazon pharmacy) at a price she could afford. The stress she sustained over the incident certainly did not improve her condition. She may have wholly forgone the medication without our guidance or paid too much.
Finally, and perhaps most tragically, a British business associate and his spouse were making a passage on their sailboat from the Bahamas to the United States (living my dream). Upon arriving, his American wife learned she had been released from her job. They had been out of communication during the ocean crossing, and the woman’s company terminated her health insurance without notice. She had been locked out of her computer at work, which contained this information and options to obtain other coverage. Tragically, she was soon diagnosed with breast cancer, which now must be faced uninsured. Her British husband, of course, is completely baffled by our American medical system that would treat a tax-paying citizen so harshly.
In all these situations, my wife and I, while trying to be understanding and helpful to these folks, felt incredibly grateful to be a part of the federal healthcare system. Despite its many challenges and failings (as any system conceived and managed by humans would necessarily be), federal medicine takes care of its members. The Department of Defense (DoD) and Veterans Health Administration (VA) learned long ago that the nation’s defense depended on healthy servicemembers, families and veterans. Healthcare in the services is not a “perk.”’ It is a vital component of our military’s strength. Our servicewomen and men better accept the extraordinary risks placed on their minds and bodies because they can depend on federal medicine support. Servicemembers and families do not have to worry about a personal finance-crushing bill arriving in the mail, costly life-saving medications or the sudden “rug-pull” of their coverage. I am justifiably proud of our federal medicine system and feel it should be a model for the nation.
I love this country, and like so many of my readers, I have committed to a life of service in defense of its Constitution that promises freedom and justice. That said, healthcare in this nation is a national disgrace. I am not speaking to the medical innovation from our research institutions or the many healthcare professionals who toil in our broken system daily. I am referring to the human rights violation perpetrated on millions of uninsured Americans who cannot afford essential medical services.
I imagine some readers are eyeball-rolling now, lamenting my perceived hyperbole. Perhaps those readers are correct, and I exaggerate. Then again, I bet most of the folks feeling that way have health insurance and are likely covered by the federal system. I am not suggesting that everyone in this country has the same healthcare standard. I am enough of a supporter of capitalism to recognize that those with resources can get their healthcare when and how they want it. Instead, I am advocating for a national healthcare system that provides a basic standard of care for all its citizens. It is unconscionable that the wealthiest country on the planet that invests the most per capita in healthcare cannot afford to care for all its citizens. According to the Consumer Financial Protection Bureau (April 12, 2023), medical debt (estimated at $88 billion) is the leading cause of personal bankruptcy. These financial failures may not affect us directly, but we all suffer from the drag these insolvencies place on our economy.
“You are a Socialist!” I imagine someone likely has lamented as they throw this editorial aside. Whether we like it or not, when it comes to medicine, we are already all socialists. Moving around this country, I do not see bodies in the streets. No matter how poor, people can seek care in the nation’s overwhelmed public hospital emergency rooms. Who is paying for these folks to receive these emergency services? We are. America already had a socialized healthcare system; it just happens to be the most inefficient (and fabulously expensive) system of the industrialized nations. Those of us with means pay higher local, state, and federal taxes to cover this systemic failure, and countless citizens suffer from the indignity and shame of healthcare-related debt. Furthermore, we are getting inferior value for the tax dollars paid.
Even as a young man working on my Boy Scout First Aid Badge (yes, I am an Eagle Scout), I have always believed that healthcare is a fundamental human right. Few things beyond my wife and my children give me as much satisfaction as rendering aid to a fellow human being. Perhaps the fullest expression of humanity occurs when one person provides care to another outside of their family. Our closest allies, Canada and the United Kingdom, have established a healthcare standard for all their citizens. It is time we did the same in America. One of the reasons I joined federal medicine was my desire to work in a system that does not monetize medicine. I personally find the business of healthcare in this country a national shame and tragedy. A few Americans have become fabulously wealthy healthcare businessmen on the backs of millions of suffering citizens. Look up the Sackler family if you need an example. I have and will continue to support and vote for leaders who feel the same on this issue. Because even though I have outstanding healthcare within the federal system, my rights are diminished, like all Americans, by those citizens who do not.