Medical bills and human freedom

By Daniel Wilcock

Time Magazine’s recent cover story on medical bills is an exhaustive, painful-to-read reminder about how out of whack America’s system of paying for health care has become. The stories of individuals not insured or covered under Medicare being charged 400% more than the Medicare rate for the same services reveals a bitter irony: those who have the least protection, such as the underemployed, get charged the most.

America has a problem with medical bills, the staggering proportions of which the article outlines:

“According to one of a series of exhaustive studies done by the McKinsey & Co. consulting firm, we spend more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. We may be shocked at the $60 billion price tag for cleaning up after Hurricane Sandy. We spent almost that much last week on health care.”

Reform measures, such as the Affordable Care Act, are vitally important—and not only for the sake of bending down the cost curve.  Human freedom and the pursuit of happiness are also in the mix.

As the Time piece attests, Medical bills are an ever-present risk for everyone, especially those not covered by private insurance or government programs.  The risk of medical bills ties workers to jobs.  Starbucks deserves praise for offering family health insurance to part-time workers (a financial lifeline).

In a column called “A world without work,” New York Times columnist Ross Douthat wrote last week about how we are heading into a new labor paradigm where work becomes scarcer:

“IMAGINE, as 19th-century utopians often did, a society rich enough that fewer and fewer people need to work — a society where leisure becomes universally accessible, where part-time jobs replace the regimented workweek, and where living standards keep rising even though more people have left the work force altogether…Yet the decline of work isn’t actually some wild Marxist scenario. It’s a basic reality of 21st-century American life, one that predates the financial crash and promises to continue apace even as normal economic growth returns.”

Sounds intriguing, but the trend in medical bills makes this picture less rosy, both for individuals and for the government.

I’m all for a society in which people are free to pursue endeavors that give them purpose, rather than just holding down jobs. In the society that Douthat describes, this kind of freedom might become more commonplace. The financial plan presented in the popular book “Your Money or Your Life” helps thrifty people work to a level of wealth in which it’s no longer necessary to work a 9 to 5. This gives them time to pursue things that matter to them and to their communities. Yet the risk of medical bills can scotch the freedom dreams of even the most prodigious wealth accumulators.

America faces a massive challenge in fixing this impediment to freedom. My guess is that the next couple of decades will present many dilemmas that will force some big fixes. Hopefully we’ll be able to look back on this Time cover story as a turning point.

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