Column: If you want to save money on healthcare, get sick in some other country

Sept. 24, 2019 5 AM PT

It never fails to astonish when some Americans say they prefer paying the highest healthcare prices in the world and having millions of people uninsured rather than adopt effective approaches to affordable universal coverage found in nearly all other developed countries.

My recent column on a Valley Village woman who was charged $200 for a cloth sling for her dislocated shoulder — a price tag about 900% more than similar slings found on Amazon — touched a nerve with many readers.

Along with dozens of stories about other medical overcharges, I received an eye-opening anecdote from La Cañada Flintridge resident Lisa Walker, who returned recently from a three-week stay in South Africa, where she had volunteered at an animal reserve.

Walker, 62, told me she contracted African tick-bite fever while abroad. That’s a bacterial infection, the symptoms of which can include fever, headache and severe muscle pain, according to the Centers for Disease Control and Prevention.

“I could barely walk,” Walker recalled. “My legs were completely swollen.”

She said she went to an emergency room in Johannesburg, where she was seen by a triage nurse within 10 minutes and sat down with a doctor shortly afterward. She described the hospital as “first-rate” and “very professional.”

“I felt like the care was equivalent to anything I could receive in the U.S.”

After Walker was treated for her infection, she was charged the equivalent of about $35 for the ER visit. The five medicines prescribed, including antibiotics and anti-nausea drugs, cost a total of roughly $22.

“That’s it,” Walker said. “No extra fees.”

And then she posed the question all Americans should be wondering: “How can we be so far behind South Africa?”

Or Germany, or France, or Britain, or Canada, or Japan, or Australia, or most of our other economic peers whose citizens pay about half what Americans pay for healthcare.

What these countries have that we don’t are variations of single-payer insurance systems that cover everyone. They also aren’t shy about regulating medical costs to prevent price gouging.

I’m not saying we want to mirror any other country’s system. But it’s hard not to think we’d benefit by adapting what works abroad to suit our needs.

The South African system is instructive. The country’s 1996 Constitution states that everyone has a right “to have access to healthcare services, including reproductive healthcare.”

To meet that goal, South Africa has both public and private medical facilities. In Walker’s case, she visited a private hospital, Arwyp Medical Centre.

The system is far from perfect. The vast majority of South Africans receive treatment at government-run hospitals and clinics. The wealthiest 20% favor more expensive private care.

This structure creates a disparity in quality of treatment. It also creates funding challenges for public facilities, which are denied the most lucrative patients.

However, as Walker discovered, South Africa’s system nevertheless boasts ready access to treatment, and prices that actually reflect the cost of care, rather than whatever amount healthcare providers think they can get away with.

The country is now rolling out a taxpayer-funded national insurance program that will provide equitable coverage and care to all citizens. It’s expected to be fully implemented by 2022.

Again, I’m not saying the South African system is an ideal fit for this country. But South Africa at least is charting a course toward universal coverage — a goal that both Democrats and Republicans claim to share.

Despite our financial advantages, we’re nowhere close to such an accomplishment.

About 27.5 million Americans, or 8.5% of the population, lacked health insurance last year, according to the Census Bureau. That’s up from 7.9% in 2017.

La Mirada resident Craig Mears, 64, told me about the years he spent stationed in South Korea and Japan as a military doctor. He said his son was prone to dislocating his shoulder, and there were no emergency medical facilities available on base at night.

“We went to ERs in South Korea and in Japan,” Mears said. “The quality of care was very good, and the prices were affordable.” Each hospital visit, he said, cost no more than “a few hundred dollars.”

Compare that with my recent column, in which a pair of Burbank hospital visits for a dislocated shoulder resulted in more than $6,000 in medical bills.

South Korea ranks first among developed nations for healthcare access, according to the Organization for Economic Development and Cooperation, and treatment quality is considered to be among the world’s best.

South Korea’s universal coverage is provided through a single-payer insurance system. Most hospitals are privately owned.

In Japan, people can receive health insurance from an employer or from the government. Hospitals must be run as nonprofit entities and be managed by physicians.

The Japanese enjoy the longest average lifespans of anyone in the world (83.7 years). South Korea is No. 11 on the World Health Organization’s life-expectancy list. America is a distant No. 31.

Citizens of nearly every other developed country live longer than we do and pay less for healthcare. That alone says we could be doing much better.

Walker is now fully recovered from her tick-bite fever. In fact, she just returned last week from a camping trip.

I asked what she’d learned from her overseas medical mishap.

“I learned that unless you’ve had an experience with another country’s healthcare system, you don’t know what you’re talking about,” Walker replied.

“All I can say is that they treated me well, it didn’t cost a lot of money, and the people around me seemed happy with the treatment they were receiving.”

Those seem like pretty good benchmarks for decent healthcare.

Maybe one day we’ll be as fortunate.