Hey Dr. Gupta, you don’t have to be a brain surgeon to know that our healthcare system needs an overhaul!

Yesterday, I watched with great delight as Michael Moore ripped Wolf Blitzer and his CNN colleague, Dr. Sanjay Gupta, a new you-know-what in response to the good doctor’s biased review of Moore’s latest film, Sicko.

Good for Michael Moore!

And shame on Dr. Gupta for trying to muddy the waters on a much-needed debate about the state of our country’s healthcare system. Michael Moore does a good job of rebutting Dr. Gupta’s review (with a few shots taken at CNN’s coverage of the lead-up to the Iraq war, to boot) so I’m not going to repeat any of it.

But I do feel the need to call the good doctor out on some other points.

According to a WHO report (see also my earlier post on how the US did against other industrialized nations), the US healthcare system ranks 37th in the world, behind all other industrialized nations. Rather than address this startling fact (made even more startling because the US is today the richest country in the world), Dr. Gupta chooses to elide by pointing out that Cuba (featured in Sicko) was ranked 39th!

Um . . . in case you hadn’t noticed, Doctor, Cuba is a small Caribbean island that has endured an economic embargo for the better part of the last half-century. You should be ashamed that this poor country was only two points behind the US in this WHO ranking. I mean, it’s not like when the Founding Fathers set out to build this country, their goal was to create a country with a better health care system than Cuba! And, last time I checked, the Cuban government was not proud enough of the way they do things to invade other countries and bring them a better way of life. We should be ashamed that, despite the wealth and power of the US, we only beat Cuba—which has neither the economic power nor physical infrastructure of the US—by two points!!!

Unlike Dr. Sanjay Gupta, I’m no brain surgeon so I can’t comment on how healthcare works here and abroad, but I do have some experience with the US and British healthcare systems. In the US, my health insurance contribution comes directly out of my paycheck because, unlike millions of other Americans, I’m lucky enough to have a job that provides me with subsidized health insurance. Then, every time I go to the doctor, I pay a $30 co-pay (because I was stupid enough to choose the HMO option). If I have to see a specialist after a visit to my primary-care doctor, I have to pay the specialist a $40 co-pay. Then, if I go the pharmacy to fill a prescription, I have to pay again for my medication. Finally, if I have any bloodwork or other tests done by a lab, I get a bill from the lab. At the end of the scenario outlined above (which happens with some regularity), I end up paying five times! And I’m one of the lucky ones who has health insurance through my work. We all know someone who’s been brought to the brink of financial ruin for failing to get pre-approval for an ambulance ride or an overnight stay in the hospital (as if these kinds of emergencies can ever be planned in advance!).

Compare this to the British healthcare system (NHS). I spent a year doing my Masters degree in London and went to the doctor a couple of times. The doctor’s visit was free and I was able to see him at my own convenience, within a few days of calling to make the appointment. My blood tests were free. My annual HIV test was free. I just walked into the clinic, wrote down my name on a clipboard and waited to be called. When I went to the pharmacy to fill out my prescription, the guy behind the counter took the Rx note and came right back with a bottle of pills and some other stuff. I started walking back to the door and realized I hadn’t paid him. I went back and asked him how much I owed. He asked me, “You’re diabetic, right?” I said I was. He then told me diabetes medication is free under NHS!!!

Granted I was studying in Britain and I had paid my tuition already (which by the way was much cheaper than tuition here) but that’s not why I was eligible for free NHS care. As a visitor on longer than a six-month visa, I was entitled to the same health benefits as British nationals! How many foreign students in the US get such a good deal?

So back to Dr. Sanjay Gupta, who proudly declared in his review of Sicko that waiting periods in European countries for procedures like hip replacements are longer than in the US. Fair enough. But how often does the average person go to the hospital for a hip replacement? And what about the millions of Americans who work part-time (often part-time at multiple jobs so they end up working more than 40-hour weeks) but don’t have health insurance through any one employer? They may not have to wait as long as their German counterparts to have their hips replaced but without health insurance, how do they pay for their hip replacements? Or for that matter, basic healthcare needs?

Sure, Cuba may have a worse healthcare system than we do (but not by much, apparently) but that’s not something to gloat about. Despite that country’s small size and economic stagnation, their healthcare system is only slightly worse than ours. Nonetheless, according to the CIA World Factbook, Cuba has a lower infant mortality rate than Chile and Argentina, two of the most developed countries in Latin America, and a slightly lower infant mortality rate than the US. Before anyone dismisses these figures as Cuban government propaganda, let me remind you these figures come from the CIA. Why would the CIA lie in Cuba’s favor?

So Dr. Gupta—in a clear case of shooting the messenger—tries to undermine Michael Moore’s credibility rather than talk about the problems of our healthcare system. But the truth is, it doesn’t take a brain surgeon to know our system is messed up. Maybe Sanjay Gupta should take a break from playing doctor and devote some more time to being a journalist. It’s high time he and other people in the mainstream media started asking tough questions about the pressing issues of the day.

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Why does it cost so much to get an education in the U.S.?

Like my colleague whose op-ed was recently published in USAToday, I have student loan debts which, by the time I’m done paying them off, will total almost $40,000. Ouch! Like my colleague, I too received a letter from some student loan consolidation service urging me to act fast because Congress was about to enact some bill that would result in my student loan payments going up. My eyes glazed over as I automatically leaned over and dropped the letter into my recycling box.

I spent the next half-hour trying to shake off that feeling you get as you leave the auto mechanic’s after having had your car repaired. You know, that vague feeling of having been swindled?

Now don’t get me wrong, it’s not that I don’t care about getting a good rate on my student loan payments. What I hate is feeling like my postgraduate degree might not have been the wisest financial decision I’ve ever made. Why should I have to feel like a sucker just because I wanted to improve my life chances by advancing my education?

I also deeply resent the student loan industry for treating my education as just another commodity. I mean, it’s not like I just blew thousands of dollars on a new car or designer clothes, so why do I have to put up with these cheap sales tactics? “Act now to lock in all-time low rates!” “Student loan rates going up. Act now!”

But the problem does not lie solely with the student loan industry. We’re all guilty. As long as we insist on viewing higher education as a commodity, student–loan sharks will continue to treat me and other students as mere consumers, no different from homeowners, car owners, or Saturday shoppers.

So what does it mean that higher education is a commodity? Among other things, it means that costs will always be tied to “quality” so the better the school, the higher the tution. But does it have to be this way? When I was doing my Masters course—I went to the University of London because it was much cheaper than comparable U.S. schools—I met many European students who had studied at the region’s best schools without incurring tens of thousands of euros or pounds of debt.

Certainly, the U.S. is home to some of the best universities in the world but why do costs have to be as high as they are? Quality, right? Sure, but only partly. According to the University of Shanghai, which published the rankings of the world’s universities, Harvard University and the University of Cambridge are tied for first place. I’m not sure how these rankings were arrived at but I think we can all agree that Harvard and Cambridge are comparable universities in terms of reputation, academic rigor, and whatever other factors were taken into consideration.

But they are definitely not comparable when it comes to tutition costs. A year of tuition at Cambridge costs £3,070 ($6,143.79) while at Harvard, tuition runs at $31,456 (£15,712.23) annually, five times higher. Why does it cost more to study at some state universities in the U.S. than it does to study at the oldest university in the English-speaking world, which is also one of the best universities in the world?

Part of the answer lies in the fact that in the U.S., higher education—like health care—is treated as a commodity. In other words, people’s willingness to buy a higher education for themselves or their children determines the cost of tuition. As demand increases, so too will prices, in this case tuition costs. In France and Scotland, students protest against tuition increases. In the U.S., we just set up more education savings accounts or borrow more and more money for school.

Clearly, there is more than enough demand for a Harvard education but I’m sure most of it comes from those who are wealthy enough to afford it. The rest of us have to bury ourselves in mountains of student loan debt just so we too can hold advanced degrees.

I have to say, though, it sure beats the hell out of the alternatives available to really poor people.

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