Thursday, March 11, 2010

The Health Care Crisis

In 1921, my great-grandfather, Peter Litwin, spent a week in DeGraff Memorial Hospital, where he had surgery.  Here is his bill for that hospital stay, including the cost of the surgical procedure:

Nine days in the hospital, plus surgery.  Total cost: $30.  

According to the US Census Bureau, the average salary in 1920 was $1236 per year, so this bill represents about 2.5% of the average family's income.

In 2009 dollars, the bill equals $364.69; median US salary in 2009 was about  $27,580 annually, with a median household income of around $52,000.  In current dollars, the bill represents about 1.3% of the median US salary.

Surely health care is better now than it was in 1921.  Surely the improved quality of that care merits some increase, perhaps even a significant increase in cost.  On 21 July 2009, David Leonhardt, a staff writer for the New York Times, placed the total annual cost for health care in the United States at $2.4 trillion, or roughly $15,000 per household.  Theoretically, at least, the average American family spends 54% of its income on health care.  Those robot doctors in "Star Wars", the ones that took the smoldering hunk of poor Anakin Skywalker and turned him into Darth Vader, those guys aren't worth half my family's income.  Bones from "Star Trek" with the scanners and the whoosing noises on the sick bay doors, he's not worth it, either.  What we have, is insanity.

Peter Litwin's hospital bill predates modern anesthesia, and antibiotics, and MRIs.  X-ray technology was in its infancy.  By today's standards, his care was state of the art, if the state was Botswana, and the art was crudely drawn cave paintings.  For all of that, it was affordable.  Maybe he spent his recovery in a ward with twenty other patients.  Maybe his anesthetist was a guy in a silk top hat, wielding an enormous wooden mallet.  Maybe the pre-operative hygienic preparations consisted of sprinkling liberal doses of Holy Water and hoping for the best.

He lived.  And it didn't bankrupt him.

I grew up in a place where doctors were trusted, and respected, and loved, and where they lived in the same neighborhoods as construction workers and teachers and milkmen.  I also grew up in a place where construction workers and teachers and milkmen understood that doctors were just people, that things happened sometimes, and that you didn't roam around, filing malpractice suits when things went wrong.

Our system is broken.  We're broken. 

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