While sitting in the the waiting room this morning for a routine medical lab test, I applied my designer’s eye to what I was experiencing and started thinking about the state of user experience in American healthcare.
From my perspective as a designer and a patient, I characterize the state of the industry today as “an awkward cyborg.” On one hand, we have the shiny veneer of technological innovation, but on the other, we still have a lot of work to do to address the human emotional elements of the healthcare experience.
Healthcare is a human right. But as the healthcare debate drags on here in the US, its legitimacy as a right is under attack.
Eddie (friend from college) shared on Facebook today an opinion piece in the Wall Street Journal by John Mackey, co-founder and CEO of Whole Foods, “The Whole Foods Alternative To ObamaCare”:
Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?
Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That’s because there isn’t any. This “right” has never existed in America
The reason is that advocates of government medicine are upholding health care as a moral right. The moral goal of a “right” to health care is blinding people to the cause and effect relationship between government actions and rising prices.
But the very idea that health care — or any good provided by others — is a “right” is a contradiction. The rights enshrined in the Declaration of Independence were to life, liberty, and the pursuit of happiness. Each of these is a right to act, not a right to things. “To secure these rights governments are instituted,” which means to secure the rights of each person to exercise his or her liberty in pursuit of his or her own happiness.
They are wrong. The United States has adopted the Universal Declaration on Human Rights (UDHR), which asserts in Article 25, Section 1:
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
While the UDHR is largely an aspirational document, many international lawyers argue that it is now legally binding under international customary law. The US has also signed (but not yet ratified) the International Covenant on Economic, Social, and Cultural Rights (ICESCR), which guarantees in article 12:
1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for:
(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;
(b) The improvement of all aspects of environmental and industrial hygiene;
(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases;
(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.
Whole Foods is leaving a bad taste in my mouth right now. I have been a frequent shopper there, but now I have my doubts. Boycott?
Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.
<sarcasm>Well, I’m glad I have the “right” to pay a premium at Whole Foods for my healthy food fix.</sarcasm> DJ, another Facebook friend, puts things into perspective: “of course, good food (like good health care) should take all of your paycheck. that’s the whole paycheck way.” Telling poor people to spend more money that they don’t have to eat healthy food they can’t afford so they don’t get sick and require health care they can’t pay for is just a sick sick way of asking “why don’t they eat cake?” I know the attribution to Marie Antoinette is apocryphal, but you get my point.
Mackey tries to bring Canada and the UK into his argument:
Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments.
Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor’s Business Daily. In England, the waiting list is 1.8 million.
Unlike the US, Canada and UK have ratified the ICESCR, so there is a legally binding right to health in those countries. Healthcare rationing and long wait times are some of the typical talking points of those opposed to national health care in this country. But let’s look at the real numbers. A June 2009 Gallup Poll found that 16% of US adults over age 18 are without health insurance. The US Census Bureau estimates that there are about 307 million people in the US. So 16% of 307 million is about 49 million Americans without health insurance. That’s more than the entire population of Canada. I wonder how long those 49 million Americans have to wait when they need health care. How about forever?
At Whole Foods we allow our team members to vote on what benefits they most want the company to fund.
That’s great John Mackey, but how about this idea: “In the United States, we allow the people to vote on what health plan they most want the government to fund.” And by “the people”, I mean including those 49 million American adults without health insurance, not just CEOs who probably have very good health insurance for themselves spouting off about “what the people need” in an op-ed.
I’ve recently seen this ad on TV and YouTube:
The ad was made by Americans Against Food Taxes, an interest group that includes some big agro-businesses and industrial fast food producers who are opposed to a proposed tax on soft drinks and juice drinks, in other words, beverages that contain high fructose corn syrup (HFCS).
Pardon the pun, but this ad, like HFCS found in soft drinks and juice drinks, is pretty corny stuff. Let’s cut through the saccharine images of an All-American family and the folksy populist spin. First, “juice drinks,” as defined by the USDA is different from “100% juice.” Juice drinks only constitute a small percentage of actual fruit juice, and can contain added water, sugar/HFCS, coloring, and vitamins. In these USDA health guidelines (PDF), the example juice drink only contains 5% juice. The proposed tax is on soda and juice drinks, NOT on 100% juice or fresh fruit. Last time I checked, soda and juice drinks were not essential foundations in the food pyramid.
I’m no fan of big agro-business lobbies or a Federal nanny state, but guaranteeing all Americans basic access to health care is an important issue that needs funding. So where do we go from here? Well, if we follow the money (and the trail of corn kernels), we find that soft drinks and juice drinks are able to be sold relatively cheaply because of existing government intervention in the form of subsidies. These government subsides—our taxpayer money— artificially lower the price of corn and corn derivatives like high fructose corn syrup. When we buy a soda, we aren’t paying the REAL market price because the cost of producing corn syrup, a major ingredient, is subsidized by our tax dollars. Hey, isn’t that soda socialism or something?
Now here’s the part where I might even get mistaken for a conservative: Instead of levying taxes on soda and juice drinks to fund health care, why not just cut costs by reducing or even eliminating the corn subsidies, and use the savings to fund health care reform? These subsidies are taxes that we have already paid that are a standing government bailout that props up an essentially non-market-based business model.
Insert folksy Fox News-worthy soundbite: “Calm down about socialized medicine ’cause corn subsidies ain’t so capitalist either!”
The Environmental Working Group’s Farm Subsidy Database shows that there were $21.6 billion in corn subsidies in the four-year period from 2003-2006 (inclusive). The Global Development and Environment Institute at Tufts University found that HFCS producers received an implicit $234 million dollar a year subsidy derived from overall corn subsidies. Meanwhile, the WSJ reports that the Congressional Budget Office estimates that “adding a tax of three cents per 12-ounce serving to these types of sweetened drinks would generate $24 billion over the next four years.” If the amount of money spent on four years of corn subsidies were redirected towards health care, we would already be 90% of the way to the potential $24 billion that could be raised by new taxes on soda and juice drinks.
Why bother with new taxes on struggling American families when the government can just stop using our taxpayer money to subsidize artificially-cheap corn, the staple of the industrial agro-businesses, and use it as a down payment on health care reform?