It was just after lunch that my father started to have excruciating pain down his left belly. Suspecting food poisoning, he reassured the family and lay down on the sofa to rest. But half an hour later, he was groaning in agony and paralysed by pain. I called the ambulance.
Eventually, my father was treated at a nearby hospital, with an emergency kidney stone removal. We were relieved most of all, that the problem was identified and settled, and that there was a system in place to take care of us. The ambulance arrived shortly after the call, the emergency doctors were there to receive us, and the hospital was well-equipped. With health settled, the next thing we had to worry about was cost.
My father was not covered by Medicare, and all expenditure had to be out-of-pocket. Ambulance – . Admission – . Doctor’s consultation – . It continued piling up. Thankfully, he was covered by private insurance instead and we were reimbursed. But I wondered – ‘what if we didn’t have insurance? How would we pay for this?’
The United States (US) has a system of healthcare where services are traded like a commodity, and is the only developed nation without a universal healthcare system in place. Without private health insurance, one would not be able to afford healthcare. A friend of mine studying in the US told me he wouldn’t see a doctor, or even if he had to, he would walk or take a taxi to the hospital himself – an ambulance cost $4000. The people who cannot afford healthcare, don’t receive it, and there have been reports of families who have gone bankrupt just paying for their medical bills.
If healthcare is a fundamental human right, then should we deny treatment to someone just on the basis on their financial capability? The people who get sick did not ask to get sick. Yet under such a system they are responsible for footing the cost. If my father didn’t have private insurance, should we have just stayed at home and self-medicate on pain-killers?
The opposite end of the ideological spectrum lies across the Pacific in the United Kingdom (UK), where the National Health Service (NHS) provides free healthcare to all British citizens. Everything is free – from consultations, medications, admissions, surgeries. As long as there is a medical need, you will receive it. Basic, universal healthcare – a safety net for everyone. But the NHS is struggling too, due to lack of funding, doctor shortage and increased patient load. Patients in the NHS are waiting years for elective surgeries, or waiting in the lobbies of emergency departments because there are no available beds. A system which caters for all regardless of social or economic status is struggling.
What both systems highlight is a fundamental questioning of what healthcare truly exists for. Its primary goals consist in promoting health, curing and preventing diseases and ultimately untimely death. But for a patient, becoming ill is not simply about getting cured, but raises questions of meaning. Every disturbance of health is a disturbance of life itself, of what is meaningful for life and of individual identity. Healthcare is a social institution which exists to keep us alive, and by extension also sustains what it means to be alive. It’s effective function and delivery of services is the cornerstone of civil and democratic societies. My family could rest easy knowing that there was a system in place to protect my father when illness and disease struck.
However, idealism has to be tempered with realism, and the divisive question remains – who will pay for this? Should it be entirely the government’s responsibility, or the individual’s? Healthcare is very expensive. Being denied life-saving treatment because one is unable to afford it is unthinkable. But having an entirely universal system like the NHS is also struggling financially, and having a detriment on the patients that it seeks to serve. Building a more sustainable and humane healthcare system will be difficult and complex.