For thousands of years, legends have existed about a magical spring that restores the youth of anyone who drinks from it. Such has been the power of the legend that it is recorded in the ancient writings of Herodotus and Priester John. Belief in such a possibility was apparently a driving force behind Ponce de Leon’s trek in the early 1500’s into what is now the state of Florida. And, not unlike that intrepid Spaniard, millions of people all over the world have longed for a drink of those same waters, searching for the vitality and health of a robust youth.
Interestingly enough, a bit of that health desire has occurred as life expectancy has increased and science has added to the understanding of disease and the treatment of injuries and illness. And, with the United States spending roughly 2.6 trillion dollars annually on health care, more than any other country, it would be reasonable to assume that America is the healthiest nation in the world and that some semblance of the”fountain of youth” may not be all that unreal.
We die younger and we are in poorer health compared to other developed nations that spend far less than we do for health care. Our infant mortality is higher and fully two out of three of us are obese. Heart disease, HIV infections, teen pregnancy, lung disease, diabetes and disabilities, coupled with drug addiction and violence paint a picture far different from those other countries where people live longer and enjoy better health. In spite of all the money being spent, something is badly wrong with America’s approach to keeping itself healthy.
It would appear that we are searching in the wrong places for solutions that would lead to our own spring water of health and we are paying far too much to do so. We rely on technology and pharmacology to get us out of the hole of fragile health we have dug with our spoons and forks. We demand for ourselves the most sophisticated care available and reject the reforms in our systems that would allow a more level field of access to medical care for everyone. We have abandoned the time honored tradition of first seeking the advice of our primary care healers while they have substituted “hang up and dial 911” for the responsive voice of someone who can offer immediate help (and often prevent an expensive trip to the hospital emergency department.)
The way we seek and obtain medical care and health advice has undergone dramatic changes in the past two or three decades. Much of the change, however, does not seem to have made the differences in the quality of our lives we anticipated. Certainly not what we expected from the price we pay!
There are no simple answers. Poverty, social and ethnic disparities, lack of continuity of care, deficits in health and medical literacy, violence, substance abuse, a pharmaceutical product for every occasion and of course the prevalence of unhealthy ways of living are just a few of the reasons the health of Americans is behind other developed nations.
One thing is apparent however. Individuals who have no means to pay for medical care are likely to be the least healthy. All other factors aside, uninsured or inadequately covered persons receive less preventive care, tend to seek medical help as a last resort and are not part of a continuous and supportive medical home. Given the millions of our citizens who are without health coverage, it is very easy to understand why they are less healthy and in the end cost the health care system more because they lack early, affordable, continuous and less expensive ways of obtaining routine care and medical treatment when they are ill or injured. Thus they are added to the reasons why America as a country lags behind other developed nations.
It seems reasonable to assume then that if health insurance were made available to that segment of the population, the so called “working poor” they would enjoy better health, be more productive in the places they work and ultimately reduce the cost of medical care for everyone. That is exactly what one portion of the health reform legislation, Medicaid expansion, was designed to do.
By raising Medicaid eligibility for all persons up to 138% of the federal poverty level ($31,809 for a family of four) millions of low income citizens are now able to obtain health care. A good deal for America’s working poor and not a bad deal for states as the federal government will pay all of the cost of newly eligible individuals enrolled for the first three years and 90% thereafter.
Too good to pass up, right?
Not so, according to the ideological bent of conservative legislators who still claim that “Obamacare” opens the floodgates to “socialized medicine” and who reject any expansion of Medicaid that would entitle more people to have good health care. Somehow, if we are to search in better places for health care for everyone, and thus have a healthier America, we must get over the notion that those who can’t pay for it don’t deserve it. Ultimately then, it would appear that the search for that elusive and mystical fountain of health must come from a different direction. A direction that challenges our moral integrity and just how much value we place on caring for each other.