QATAR (Al Jazeera), August 20, 2008:
By Barnaby Phillips
Many Americans are turning to alternative health practices
Barnaby Phillips, Al Jazeera's Europe correspondent, travelled across the US to find out what ordinary Americans feel about five key electoral issues. In part two of American Challenge, he finds a country struggling to cope with the increasing cost of healthcare. (In part one, the focus was on Economy)
Gibson Glass, 58, enjoys his jogs though New York City's Central Park.
But he is not just running for fun. Gibson is one of more than 40 million Americans who does not have health insurance.
So, for Gibson, regular exercise is a form of health insurance. He is a freelance picture framer, and he says he simply cannot afford to pay about $600 each month on insurance.
He says that the United States' healthcare system is "totally messed up" because, as he puts it, "everybody should be able to afford health insurance, whatever their income, and I have a pretty good income, I just can't afford it."
Gibson has worked out the odds and is making a rational decision, based on his circumstances.
Seven years from now, when he is 65, he will qualify for Medicare, government-funded healthcare for the US's elderly.
Unhealthy dilemma
In the meantime, he would rather spend his precious money on going to the theatre and concerts and seeing friends for dinner.
Gibson Glass says he cannot afford to pay for healthcare
These are things that give his life quality, and, as he says, "make him a healthier person".
The dilemmas Gibson faces and the decisions he is making are being replicated all over the US, a country which spends about twice as much per capita on health as Europe, yet conspicuously fails to deliver quality healthcare to a growing number of its citizens.
In fact, Gibson, who runs around 40 miles a week and eats very carefully, considers himself relatively fortunate.
"There are people who should have health insurance who are unhealthy and in dire straits, they should be able to go to the doctor whenever they want, whenever they feel bad, and they don't."
And, he argues, the fact these people do not have access to decent primary healthcare pushes costs up for everyone, because they tend to go a doctor when their condition is more complicated, and expensive, to treat.
The good side
I heard exactly the same thing from Herbert Pardes, president of New York's renowned New York Presbyterian Hospital, and one of the US's most distinguished doctors.
He says that people without health insurance "often come to the emergency room when the illness is well along, maybe more difficult to control or cure, maybe more costly to cure, whereas if they had been going for more regular care to a practitioner the problem would have been caught earlier, might be easier to treat, and would be less costly".
It is very easy to point out what is wrong with healthcare in the US (in fact, it seems to be a favourite pastime of all my American friends), but it is important to remember what is good about it.
A hospital like New York Presbyterian, on Manhattan's Upper West Side district, is a case in point.
Cost of care
The technology is state-of-the-art, and much more widely available than in many other wealthy countries.
There are no long waiting-lists, for example, for people to have MRI and CAT scans.
And it is also important to remember, contrary to some European assumptions, that there is a substantial amount of government-funded healthcare in America.
Herbert Pardes says people often wait too long before seeking treatment
According to Dr Pardes, some 60 per cent of the patients who come to his hospital are on Medicare (government-funded healthcare for the elderly) or Medicaid, (government-funded healthcare for poor people).
Another 30 per cent of patients have private insurance. In the US you get what you pay for, and health is no exception.
Many of the privately insured are accommodated in a spectacular ward, where luxurious rooms have sweeping views over the Hudson River. There is even a living room with a grand piano.
Hospital staff point out this ward is not exclusively for people with private insurance, and that it is very common for it to accommodate uninsured people when the rest of the hospital is full, but still, it is the uninsured - the remaining 10 per cent of patients at New York Presbyterian - who are being let down by the current system.
Here, as in all US hospitals, they can only receive treatment if they come to the emergency room.
This seems to be neither a good deal for the uninsured, nor the most sensible use of US hospital resources.
In fact, the growing numbers of uninsured patients are putting hospitals in financial difficulty, as state governments fail to reimburse hospitals adequately for the costs of treating the uninsured.
Campaign concern
There are other complications to US healthcare; high administrative costs to manage this labyrinthine system, unnecessary legal costs, and capricious inconsistencies from state to state.
Not surprisingly, given this mess, how to broaden and improve health coverage is one of the most important issues in the election.
Barack Obama is proposing a scheme to provide subsidies to make healthcare insurance more affordable, whereas John McCain wants to create tax incentives to encourage people to take out their own health insurance, rather than through their employees.
It is an extremely complex issue, although almost everyone in the US agrees on the necessity for reform.
On a bright sunny morning in Brooklyn, I found myself on a flat rooftop, talking to Sophie as she did her yoga.
Staying healthy?
Until recently Sophie did not have health insurance; she fell sick, and she is still trying to work out how to pay her medical bills.
Now Sophie does have health insurance, but it is basic and she would probably be classified amongst the 16 million Americans who are "underinsured", ie they do have some cover, but it does not meet many of their typical medical bills.
"Last week my eye started getting all red," she said, and she instantly began calculating whether she could see a doctor.
"And I think that's the problem - you need to figure out how to see a doctor in America if you are uninsured or have basic insurance," she told me.
"In a number of other countries, there's a clinic down the street, I can go there, that's no problem."
The fear of not being able to pay for the cost of staying healthy.
This is an uncomfortable fact of life for Sophie, Gibson, and too many Americans.
Source: Al Jazeera
Many Americans are turning to alternative health practices
Barnaby Phillips, Al Jazeera's Europe correspondent, travelled across the US to find out what ordinary Americans feel about five key electoral issues. In part two of American Challenge, he finds a country struggling to cope with the increasing cost of healthcare. (In part one, the focus was on Economy)
Gibson Glass, 58, enjoys his jogs though New York City's Central Park.
But he is not just running for fun. Gibson is one of more than 40 million Americans who does not have health insurance.
So, for Gibson, regular exercise is a form of health insurance. He is a freelance picture framer, and he says he simply cannot afford to pay about $600 each month on insurance.
He says that the United States' healthcare system is "totally messed up" because, as he puts it, "everybody should be able to afford health insurance, whatever their income, and I have a pretty good income, I just can't afford it."
Gibson has worked out the odds and is making a rational decision, based on his circumstances.
Seven years from now, when he is 65, he will qualify for Medicare, government-funded healthcare for the US's elderly.
Unhealthy dilemma
In the meantime, he would rather spend his precious money on going to the theatre and concerts and seeing friends for dinner.
Gibson Glass says he cannot afford to pay for healthcare
These are things that give his life quality, and, as he says, "make him a healthier person".
The dilemmas Gibson faces and the decisions he is making are being replicated all over the US, a country which spends about twice as much per capita on health as Europe, yet conspicuously fails to deliver quality healthcare to a growing number of its citizens.
In fact, Gibson, who runs around 40 miles a week and eats very carefully, considers himself relatively fortunate.
"There are people who should have health insurance who are unhealthy and in dire straits, they should be able to go to the doctor whenever they want, whenever they feel bad, and they don't."
And, he argues, the fact these people do not have access to decent primary healthcare pushes costs up for everyone, because they tend to go a doctor when their condition is more complicated, and expensive, to treat.
The good side
I heard exactly the same thing from Herbert Pardes, president of New York's renowned New York Presbyterian Hospital, and one of the US's most distinguished doctors.
He says that people without health insurance "often come to the emergency room when the illness is well along, maybe more difficult to control or cure, maybe more costly to cure, whereas if they had been going for more regular care to a practitioner the problem would have been caught earlier, might be easier to treat, and would be less costly".
It is very easy to point out what is wrong with healthcare in the US (in fact, it seems to be a favourite pastime of all my American friends), but it is important to remember what is good about it.
A hospital like New York Presbyterian, on Manhattan's Upper West Side district, is a case in point.
Cost of care
The technology is state-of-the-art, and much more widely available than in many other wealthy countries.
There are no long waiting-lists, for example, for people to have MRI and CAT scans.
And it is also important to remember, contrary to some European assumptions, that there is a substantial amount of government-funded healthcare in America.
Herbert Pardes says people often wait too long before seeking treatment
According to Dr Pardes, some 60 per cent of the patients who come to his hospital are on Medicare (government-funded healthcare for the elderly) or Medicaid, (government-funded healthcare for poor people).
Another 30 per cent of patients have private insurance. In the US you get what you pay for, and health is no exception.
Many of the privately insured are accommodated in a spectacular ward, where luxurious rooms have sweeping views over the Hudson River. There is even a living room with a grand piano.
Hospital staff point out this ward is not exclusively for people with private insurance, and that it is very common for it to accommodate uninsured people when the rest of the hospital is full, but still, it is the uninsured - the remaining 10 per cent of patients at New York Presbyterian - who are being let down by the current system.
Here, as in all US hospitals, they can only receive treatment if they come to the emergency room.
This seems to be neither a good deal for the uninsured, nor the most sensible use of US hospital resources.
In fact, the growing numbers of uninsured patients are putting hospitals in financial difficulty, as state governments fail to reimburse hospitals adequately for the costs of treating the uninsured.
Campaign concern
There are other complications to US healthcare; high administrative costs to manage this labyrinthine system, unnecessary legal costs, and capricious inconsistencies from state to state.
Not surprisingly, given this mess, how to broaden and improve health coverage is one of the most important issues in the election.
Barack Obama is proposing a scheme to provide subsidies to make healthcare insurance more affordable, whereas John McCain wants to create tax incentives to encourage people to take out their own health insurance, rather than through their employees.
It is an extremely complex issue, although almost everyone in the US agrees on the necessity for reform.
On a bright sunny morning in Brooklyn, I found myself on a flat rooftop, talking to Sophie as she did her yoga.
Staying healthy?
Until recently Sophie did not have health insurance; she fell sick, and she is still trying to work out how to pay her medical bills.
Now Sophie does have health insurance, but it is basic and she would probably be classified amongst the 16 million Americans who are "underinsured", ie they do have some cover, but it does not meet many of their typical medical bills.
"Last week my eye started getting all red," she said, and she instantly began calculating whether she could see a doctor.
"And I think that's the problem - you need to figure out how to see a doctor in America if you are uninsured or have basic insurance," she told me.
"In a number of other countries, there's a clinic down the street, I can go there, that's no problem."
The fear of not being able to pay for the cost of staying healthy.
This is an uncomfortable fact of life for Sophie, Gibson, and too many Americans.
Source: Al Jazeera
