Dr Robert Massie: The Insurance System Needs Fixing in the United States

The American system of insurance doesn’t work, because we give the best care at the lowest cost to the people who don't need it and the worst care at the highest cost to the people who do, noted Robert K. Massie, Jr, PhD, MA, of the Society for Progress. He was born with severe factor VIII hemophilia in August 1956 and contracted HIV in 1978, as well as hepatitis C, from contaminated blood products—and received care outside of the United States growing up, which he credits with saving his life.

Transcript

Is insurance in the United States broken?

I mean, let me be really blunt about this. Most Americans do not realize how ridiculous we look to the rest of the world, which has solved the medical distribution problem going back to 1948.

I've traveled all over the world, and I just want to tell you: the absurdities, the bankruptcies, the failures, the poor medical outcomes that happen in the United States do not take place in most other countries. I've been treated in France, I've been treated in England, which people make fun of, and yet it's wonderful, wonderful care.

I, at one point in my career, toured and looked at the medical systems in Sweden and Denmark and Switzerland and Germany. Recently, I was in Italy. The Italian system is not perfect, but let me tell you something: no one in any of those countries ever, ever worries, are they going to get medical care. Just think about that. Whereas in the United States, medical costs are among the highest—in some cases, the highest—cause of medical bankruptcy and an untold number of horrible medical outcomes, and a huge amount of completely unnecessary stress in people's lives, as parents worry about their children or they’re seniors.

And the truth is, we've have more or less solved this if you happen to be 65. We have Medicare. I'm about to turn 65. But because of a really broken and perverse ideology in the United States, we are denying ourselves a system and a right that pretty much everybody else in the developed world has. And it's absolutely shocking.

I started working on this in the 70s. So here I am, I'm going on 45 years of looking at the question of national health insurance. And yet, as you might imagine, the system we have now, if you really think about it, the concept of insurance doesn't work here. Because insurance is based on the idea that we all get paid a little money but none of us knows who's gonna get their house burned down, for example. So we all pay a little fire insurance.

Modern medicine is about predicting accurately who's going to get which diseases. And as we become more and more genetically adept at figuring out who has a predisposition for a disease, then we can identify preexisting conditions before they exist. I mean, really preexisting, long before we actually even experienced them.

And so what do insurance companies do? They try and get rid of the people who need medical care, except for the fact that we now have Obamacare, which is still there, that prevents people from being kicked off.

To put as simply as possible: we give the best care at the lowest cost to the people who don't need it. And we give the worst care at the highest cost to the people who actually need medical care. And that's about as dumb as you can get, and yet that is an accurate description of the American system.

So yes, the outcomes would be dramatically better. We would be using preventive care rather than acute care, we would dramatically lower costs, and we would have much healthier people. But unfortunately, the American people do not realize what's happening in the rest of the country or have lost enough of their own sense of self-worth that they aren't willing to demand what virtually everybody else says because somehow we think it's impossible. That's sad. It's long overdue and needs to be changed.