It's Worse Than Ezra Says...

05/10/2010 05:12 am ET | Updated May 25, 2011
  • D. Brad Wright Assistant Professor in the Department of Health Management and Policy at the University of Iowa

Ezra Klein nailed it the other day when he wrote the following:

"There's a difference between the statements 'America has the best health care system in the world' and 'With enough money, you can purchase the best health care in the world in America.' But that difference gets run over in political conversations....People should ask themselves a very simple question: Do they think they are likelier to lose their job and fall into the health care situation of the uninsured or become an influential politician [or extremely wealthy individual] and enjoy the health care options available to the most powerful people in the world?"

I'd go a step further. You don't have to lose your job to fall into the ranks of the uninsured. All you have to do is get really sick and have your annual and lifetime limits run out. Or have your coverage rescinded. Or have your employer stop offering benefits because they have gotten to be too expensive. Or continue to have coverage for which you can no longer afford your share of the out-of-pocket expenses. Or simply be underinsured because your policy lacks certain benefits you never thought you'd need until the unforeseen happened.

None of these scenarios should change the way you answer the simple question Ezra posed. But they do change the underlying odds substantially, and should make it even clearer that you and I are unlikely ever to find ourselves so wealthy as to have access to the best care in the world. Which is precisely why Ezra concludes the following:

"If you're a United States Senator, America may have the best health care in the world. But if you're an ordinary person with the same vulnerability to bad luck that we all have, you're better off being in Canada, or France, or Japan, or somewhere that doesn't take your insurance away when Wall Street causes the economy to crash."

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