Paul Gibbons: U.S. health system an expensive '75 Pinto

Paul Gibbons  —  7/15/2008 5:15 am

Sometimes I wonder whether the good people of Wisconsin are losing their grip. Returning after nearly 30 years' absence, and meeting new friends, the grilling begins: "Is it true that you can't see a doctor for months?" "Can you really not get operations if you are sick?"

I know Europe is 4,000 miles away, but where do these daft ideas come from?

My experience earlier this year at The Edgewater was the most astonishing. No sooner had introductions been made than this local right-wing hack accosted me thus: "Oh, you're from Europe. I hope you're not a doctor." "Why?" "You don't get paid anything over there." "Really, they make at least 200 grand once they are established." "Well, doctors make more here," said he with a triumphant look.

Sadly, even worldly Americans live in a dreamland about European health care. In my 27 years in Europe I have never seen a medical bill or talked to an insurance company. This is despite a variety of minor and major ailments over the years. Dentistry and optometrists are free for children under 18. (College is still pretty close to free also. Oxford University charges $6,000 per year.) Prescriptions cost $12, unless you are poor, pregnant or old and then they are free. That is it. No insurance. No co-pays. No pre-existing conditions. No deductibles.

At this point my new Wisconsin friends encountered a bit of cognitive dissonance -- the psychological term for when facts contradict deeply held beliefs.

"What about the long lines?" Here are the facts. If you are worried about your health, you can see your family doctor within 48 hours. If you are very sick, you go to a primary care center. There you might wait 30 to 90 minutes depending on when you go and how sick the triage nurse thinks you are. If you are dying, you go to the ER just like on TV. For non-urgent surgery, such as a knee replacement, you can wait 90 to 120 days. Urgent surgery happens urgently.

My son had an ear infection. Sunday at 8 p.m. we drove to the primary care center. We waited 30 minutes and walked out with a diagnosis and some Amoxicillin. We got pregnant. We saw the doctor twice and had two scans in the first 90 days, just like in the Great Land of Private Medicine.

More facts? Your health care is the most expensive in the world. That is no bad thing -- who would not prefer a Lexus to a Hyundai? Sadly, it doesn't deliver. The World Health Organization reports that U.S. life expectancy is ranked 24th in the world (below most of the developed world) and the health system's performance is 37th overall, putting it between Costa Rica and Slovenia.

In fact, what Americans have is a very expensive 1975 Pinto.

"Your taxes are crazy over there." Well, we get free health, free schools, almost free college, a state pension system and free transportation when we get old. Poor people are guaranteed an income. Plus we have police, fire, public transportation, roads, and a military for helping W out. Those things cost money. How much are taxes? If you are well off ($90,000-plus), your marginal rate is 40 percent and effective rate is about 33 percent. We don't have property taxes, or state or municipal taxes, but we do have sales tax.

Taxes may be a little higher than Americans are used to but I wonder whether, when health care costs are figured in, we come out so differently. But there are two differences. One, we cover everybody. No 46 million people and 10 million kids without coverage. Second, I have not met an American who is not obsessed with worry over health care -- hence the constant grilling during my return to Badgerland. I hardly know an American family that is not anxious about a serious medical condition destroying a family financially.

It is hard to price well-being and peace of mind, but never having to worry about being sick or old without recourse to care is quite a benefit.

My dear doctor friend in Milwaukee moans loudly about taxes from behind the wheel of his 2007 Suburban, having left his wife's Navigator, a BMW, a Corvette, a Harley and two boats in the garage of his seven-bedroom lakeside house. Nothing is more disgusting than a rich person moaning about taxes. Nothing. God forbid some poor family should get a bit of your hard-earned cash.

Get over it. You have a lot. Share some. Especially if your $750,000 a year was built on public education, state universities, safe streets, collected garbage, a secure country, and other infrastructure built with the taxes of the previous generation.

"The climate for business must be awful." Baloney. The United Kingdom is the eighth largest economy in the world, having just been overtaken by China. It ranks 13th in gross domestic product per person, and the U.S. ranks ninth with 11 percent higher average income. Four of the 15 largest companies in the world are British, including the largest bank and the largest oil company. I've been a small business owner for seven years and we get tax breaks and nice corporate welfare just like you do.

It saddens me to say, because I love America and adore Madison, that you are getting cattle-prodded by the health care system. While prodding you with one hand, the prodders send fat checks to legislators and spend millions on PR to breed ignorance, fear and irrationality. America is the greatest country in the world in many respects; in health care, it is one of the worst. The sooner we wake up to that fact, the sooner it will be as great as we say it is.

Paul Gibbons is a graduate of West High and UW-Madison who has lived in England since 1981. He is chairman of Future Considerations, a management consulting firm, and a writer. E-mail paul@paulgibbons.net

Paul Gibbons  —  7/15/2008 5:15 am