The Opportunity Costs of Healthcare in the United States

It’s time we talk about the realities of healthcare in the United States. We rave about the procedures we can do with our amazing technological advancements, brag that we’re the best at healthcare and tend to attribute that claim to the competition among healthcare providers and insurance companies. It forces cost control and innovation all at the same time. But when we speak of cost control, we speak of only the fiscal costs — those costs we can enumerate and boxes we can check.

In economics, they always mention the “opportunity costs” that come with any decision. Opportunity costs are not the actual amount of money being spent, but rather things and possibilities we forego when we make a particular decision. These are supposed to be measured out alongside the actual costs relative to the benefits we receive. When we do this with the United States healthcare system, what do we see?

Benefit: We have some of the strongest engineers working toward developing new technology to aid in the treatment of disease and injury at all degrees of severity. We have one of the most highly trained medical workforces. We can offer a wider range of services than many other nations. We have freedom of patient choice in provider. We have new life-saving drugs entering the market on a constant basis. We do not have long wait times for many procedures.

Costs: The new technology takes an exorbitant amount of money that could be directed to actual patient care. Medical education is one of the most expensive in the country and thus providers must provide expensive care. We offer a wide range of services, but they are often unavailable to the uninsured or underinsured and scrutinized by the overarching insurance companies who hold the purse strings. Freedom of patient choice is a façade for those with few health problems and the middle class, who are able to select their provider from a pool of those who have been “approved” by their insurance companies. The life-saving drugs are all but unreachable to those who require them because prices are set so high and continue to skyrocket. The moment you require a specialist, those “nonexistent” long wait times grow to be three, six, nine months up to one, maybe even two years if your condition is really complicated.

There are realities to our system that people who have never fallen through the cracks do not see. They will never understand that the reason their doctor has to charge so much for a standard service is because their insurance company negotiates that price down to be as low as 25 percent of the normal price, a cost that gets passed down to those who are underinsured and uninsured when they need the services and have to pay full price. They will never see that wait times are damaging to individual physical health and mental health.

They will never see that those “death panels” we are all so scared of in universal health care are already present today in the insurance companies, getting a commission for every patient they deny a service to because they “saved the company money.” They will never face the people who are dying slow, painful deaths because they cannot afford a surgery they need. What about the fact that if you go to a hospital they can’t deny you service if you require treatment? That’s immediate, life-saving treatment — not long-term care needed to be healthy.

But this is America, where we don’t care about quality of life. Where we don’t need everyone to be healthy, just those people who deserve it. “Well, you should have done something to avoid that happening.” “Well I faced adversity too, I managed to get to where I am today.” “A small loan of a million dollars.”

This is America. Land of the free. But if you read the fine print, it reads “Land of the Free offer applicable for certain qualified customers. Only applies if male, white, middle to upper middle class, straight, cisgender and healthy. We will not be held liable for any complications or negative ramifications as a result of our decision-making.” Protect life — but only if it qualifies.

As a country with one of the most foundational texts recognizing equality of personhood and guarantee of rights and opportunity, we are letting ourselves down.