My Dog and Health Care

Over the weekend, we rushed our dog Hamlet to an emergency clinic in Riverhead, New York, where the vets who saw him said he had suffered a "G.I. episode" -- an upset stomach -- caused by a "dietary indiscretion." (The precise source of the indiscretion is still unknown.)

But within 48 hours, our four-year old cockapoo was treated at two New York hospitals -- the East End Veterinary Emergency and Specialty Center, in Riverhead, which admitted him at 3:30 am, and then at the Animal Medical Center, in Manhattan, which was fully staffed despite the holiday. At both centers, he was seen immediately by skilled, caring doctors, and in New York City, by a specialist. He did not have to wait for over two hours in a crowded emergency room as my husband did a week earlier after cutting his hand on a martini glass. The E.R. was overflowing that night with people who, because they had no insurance, could not possibly afford to get the kind of treatment that Hamlet was getting.

Yes, it was expensive. And sure, our dog is special. The son of Princess Fluffy and Ramblin' Rambo, Hamlet is finicky and has grown accustomed to getting his way. But shouldn't the 49 million Americans without insurance get medical care at least as decent as his?

Americans spend roughly twice per capita what citizens of other industrial countries spend on health care for fewer services and often inferior care. In 2000, the World Health Organization ranked the United States 37th in health care -- behind not only virtually all of Europe and Japan, but also Morocco, Chile, and Costa Rica. (Slovenia ranked 38th.) Yes, America leads in many medical fields and offers extraordinary care, especially to those who can afford it.
Yet health care costs now account for nearly a fifth of our gross domestic product, and will account for almost a third in a decade if they are not contained. Still our national debate about how to fix our health care system is as polarized as the rest of our political discourse. The right accuses Obama of wanting to form "death panels" and "socialize" our medical system while the left is divided, disorganized, and often unrealistic about the true cost of universal care.
The media routinely underplay the influence of America's medical super-sector-- our giant health insurance industry, which spent more than $1 billion lobbying over the past 9 years. Sen. Bernie Sanders, the ultra-liberal independent from Vermont, notes that in the past three decades, health insurance bureaucrats, seeking to boost profits by denying subscribers treatment we were promised, have increased 25 times faster than the number of physicians.
Yet President Obama expects his supporters to endorse a policy that even he has been unable to articulate. Fearing a repetition of the Clinton health care debacle, he asked Congress to design a plan. So a gang of six has been huddling -- senators from states whose population represent fewer than six percent of the nation, several of whom have received huge contributions from the insurance industry they are now ostensibly trying to regulate.

There is a saying in the Middle East: a camel is a horse designed by a committee. So far, American health care reform under President Obama is one sick camel.

Belatedly, the president is trying to assert some leadership. On Wednesday he will deliver a major speech on health care. But not all problems can be resolved by eloquence. He must tell us specifically what he has in mind, how he plans for pay for it and get it passed. And he should stop misleading us. Surely he must know that what press spokesman Robert Gibbs said Monday -- namely that an as yet ill-defined "public option" will "not in any way" affect the 160- 180 million Americans who get their insurance primarily through their employer -- is unlikely to be true. Real reform would mean that features of our entire health care system would have to change.

As physicians Arnold S. Relman and Marcia Angell recently wrote, without specifically mentioning the insurance industry, "fee-for-service payment and an entrepreneurial, fragmented system heavily weighted in favor of specialists" are the cause of unsustainable cost inflation.
We, as Americans, are also partly responsible. For as the CDC says, two thirds of us are overweight; one third of us are obese. Some of us still smoke. We don't walk enough, sleep enough, or eat the right food. Our insurance plans don't adequately reward those who do. And we don't make them do so because our political system is as broken as our health care.

I'm relieved that my dog Hamlet got such great and compassionate care this weekend. Now I just want the same for my husband, other family members, our friends, and the rest of my fellow two-legged Americans.