What Civilized Country Operates Like This?

You have seen it. The plastic bucket beside the cash register at the convenience store. A photo is taped to it. A child needs an operation. His father lost his job. The family lost its insurance. They are about to lose their home. Can you spare some change?

What civilized country operates like this? In case God-and-country defenders of the status quo need reminding, America’s for-profit health insurance system serves neither.

Reform advocates must hammer away at this relentlessly: health insurance reform is a moral issue more than an economic one.

Nicholas Kristof delivered further proof [1] that the system is morally bankrupt in the October 4 New York Times.

Travis and Michael Waddington hoped to donate a kidney to their father, David, 58, a wine retailer and victim of polycystic kidney disease. PKD had destroyed David’s kidneys. Since the disease is genetic, Travis and Michael needed to be tested for the disease themselves before donating. Yet a positive result might mean the sons might never be able to get insurance. So their doctors advised against getting tested. Another advised getting tested under fictitious names. To protect their sons, husband and wife shot down the idea, even at the risk of David’s life.

Eventually, David received a kidney from a deceased donor, but Michael recently began experiencing PKD symptoms and now faces an insurance nightmare now all too familiar, obtaining affordable insurance – or any insurance – after being diagnosed with a serious illness.

Closer to home, an acquaintance recently donated a kidney to his father under somewhat different circumstances, but with similar risks. Such acts of mercy by organ donors (talk about risky behavior) present insurers with an elective pre-existing condition, and present donors with a moral dilemma. Fortunately, his father’s insurance covered both transplant surgeries. But both the son’s own physician and the transplant surgeons recommended that he say nothing to his insurer. It was illegal to deny coverage or insurance to organ donors, doctors told him. Nonetheless, they often heard of it happening.

Why tempt fate? He told his insurer nothing.

Kristoff calls an insurance system that forces patients into such impossible choices, “the disgrace of the industrialized world.”

But that’s putting it mildly. As T.R. Reid puts it in The Healing of America [2], our system is virtually a worldwide laughingstock. One thing on which experts at international health care symposia can agree, Reid explains, is that the U.S. for-profit insurance system is a mess. “Bashing the U.S. system is a standard agenda item.”

Joanne Ford, a patient on Social Security disability and wearing Coke-bottle eyeglasses, arrived for a Remote Area Medical free clinic in Knoxville. She came hoping to get a new pair for free. But nearly last in line, she almost missed her chance. Interviewed by 60 Minutes [3], Ford said tearfully, “I am sad that we are the wealthiest nation in the world and we don’t take care of our own.”

Even the socialist bogeymen of Europe treat their own better.

For-profit insurance can be cruel and capricious, not unlike the age of Dickens that Keith Olbermann invoked in a recent hour-long commentary [4]. America’s uninsured have "a 40 percent higher risk of death than their privately insured counterparts," a new Harvard study [5] finds. Furthermore, 45,000 Americans a year die from lack of health insurance. Like Dickens’ London, America’s working poor too often are either invisible or else blamed as surplus population [6] –– impediments to the economic fortunes of their “betters.”

It is a seasonal tradition to revisit cherished redemption stories during the coming dark nights around the solstice, to refresh human connections not just to family and friends, but to our fellow men. Defenders of the status quo, especially, need to refresh theirs.

America would do well to revisit those redemption stories earlier this year as it considers how best to rehabilitate a business more informed by Wall Street than A Christmas Carol. For-profit health insurance is rare in the civilized world, and rightly so. It is a cold-hearted business more interested in serving the numbers on its balance sheets than the humanity behind the numbers.

That calls into question the humanity of its defenders, like the conservative radio icon who brags about taking on all comers with half his brain tied behind his back. That would be the feeling half. The human half. The half that Messrs. Scrooge and Potter let atrophy as an impediment to being good men of business.

Right now, a popular caterer downtown has posters on her door. A child needs an operation. A strawberry blonde boy in an adult-sized straw hat. He has a severe immune deficiency disease. He is with his parents at Duke University Medical Center for a bone marrow transplant. There's a pancake breakfast to raise money.

You might as well hold a bake sale to buy a bomber.

What civilized country operates like this?