One of the real benefits of writing a column about America every week for foreigners is that you kind of have to start from scratch sometimes. Explaining the American healthcare debate to a society where universal care is almost part of the collective DNA is tough. But I did my best to explain why America's current system is both amazing in so many ways and yet simultaneously cruel and inefficient:
There are many valid criticisms to be made of American healthcare, but let me tell a story that helps explain its strengths. Only 15 years ago, the retrovirus, HIV, was killing thousands in America six times as many young Americans have died of Aids as died in Vietnam and researchers had never found a way to stop such a sophisticated and constantly evolving organism from burying itself in people’s immune systems and slowly destroying them. I was told in 1993 that I had a few years to live. I write this 16 years later with a stronger immune system than I have ever measured before.
America’s much-maligned healthcare system did this.
Without this vast and free market in medical care and pharmaceuticals, without the potential for making large amounts of money from affluent and insured patients, the innovation of treatments and regimens would never have occurred at the pace it did. Yes, publicly funded research was also vital but it is rightly restricted to basic science, not finessing drugs for humans. Now we have dozens of anti-HIV drugs, from several private companies, competing with each other, and my life is saved. How do I put a price on that?
Here’s the catch. This miraculous process was possible for me only because I had insurance through my employer. When I quit my job editing The New Republic, in part to grapple with HIV’s toll, my employer compassionately allowed me to stay on staff at a low salary solely to protect me from going without insurance at all. You see: once without insurance in America, I would never have been able to get it again. I would have had a “pre-existing condition” and no insurance company would have accepted me.