The Illusion of Now

The decisions we make have short term and long term effects. This holds true for every aspect of life. This doesn’t just affect certain subcategories of our healthcare policy; it is revealed in nearly every facet of our system, including our willingness to adjust it. As T.R. Reid so eloquently and wittily points out, the United States’ decisions regarding health care reflect a culture of impatience and a focus on the now.

Reid begins the latter half of the book by looking into the Canadian system and how they were able to convince their citizens that nationalized universal healthcare could function effectively. Reid points out that the wait times in Canada are a source of concern and annoyance for many Canadians. And yet, they still overwhelmingly support the model. In the U.S., we are unable to accept short term setbacks even if there is a possibility of long term success. We’ve gotten to the point where eating a meal is often decided by how fast it can be prepared and consumed. Convincing our nation that they’re going to need to wait a little longer to see a doctor ends the argument in most cases; even if the overall outcome is improved.

A compelling piece that appears throughout “Healing of America” is how each country goes about shaping the case for healthcare reform. While nearly every other industrialized democracy poses the moral question of health care to its voters, the U.S. has primarily used economic reasoning. Even Bill Clinton, a democrat, framed the need for health care reform around the need to reduce the deficit and lift the economy. This is a reflection of how we as a country have decided to make our voting decisions. In my opinion, an overwhelming majority of citizens will vote for the candidate that they believe will help them immediately.

Still don't think we're impatient? Look at how journalism has changed. Stories and content are no longer about quality, but about who can get things out the quickest. We are striving for instant gratification via retweets and links. In fact, NPR wrote an article about Americans have become "impatient with....wait for it...impatience."

Fast forward to 2016, and with a 19 trillion dollar debt, the challenge of health care reform is almost indescribable. Bernie Sanders is proposing a single-payer system that will reduce costs and increase coverage for most families; but to pay for it many Americans(including the middle class) will have to pay more in taxes. While the policy would almost certainly reduce overall costs in the long term, Americans envision their paychecks getting a little smaller in the short term and make their decisions accordingly. Considering all of this, a total overhaul of the health care system seems nearly impossible.

This is the point at which Reid constantly reminds us that however improbable the situation may seem, numerous other nations have faced the same problem and successfully found a more effective alternative. Where I think the U.S. could learn a lot is by looking at Switzerland. A strong capitalist democracy(yes, that drew me in quickly) understood that in order to maintain a basis for fair competition, they needed to adjust their system. What I liked most was that Switzerland was able to establish a bottom line plan that all insurers had to offer, but still allowed for their citizens to choose a better/more expensive plan if they wanted to.

The Swiss sacrificed a portion of their economic ideology in their reform, but only in the short term. By keeping insurance providers private, competition and choice were able to remain strong. By establishing a basic package of care that is not-for-profit, all citizens were able to obtain health insurance. Switzerland, as Reid would say, decided which inequalities they were going to keep, and which they were going to throw away. We have these arguments on a nearly daily basis even in our own country. Unfortunately, immediate results will often overpower potential long term gain.

Reid shows us that no matter how bad our situation seems, there has been precedent set by other nations that change can occur. Reid wants us to answer “The First Question”--is health care for all a basic human right? However, in the U.S., that’s not the first question at all. In a nation based on values of hard work and efficiency, impatience and a focus on the now is a sometimes debilitating side effect.