Actress and singer Selena Gomez recently revealed that she underwent chemotherapy for Lupus, which is the same treatment that I endured in 2010. My personal journey in pursuit of wellness has been, and continues to be, long and arduous. In my pre-teen years, I began having uncontrollable nose bleeds that would last for hours coupled with shooting pain through my chest and left arm. I spent several years thereafter poked and prodded — bone marrow samples, seemingly endless tubes of blood, EKG tests and beyond. It wasn’t until four years later that I received the fateful diagnosis: Systemic Lupus Erythematosus. SLE, as it is commonly referred, is an autoimmune disease where the body cannot recognize its own cells from foreign invaders — thereby…
Actress and singer Selena Gomez recently revealed that she underwent chemotherapy for Lupus, which is the same treatment that I endured in 2010. My personal journey in pursuit of wellness has been, and continues to be, long and arduous.
In my pre-teen years, I began having uncontrollable nose bleeds that would last for hours coupled with shooting pain through my chest and left arm. I spent several years thereafter poked and prodded — bone marrow samples, seemingly endless tubes of blood, EKG tests and beyond.
It wasn’t until four years later that I received the fateful diagnosis: Systemic Lupus Erythematosus. SLE, as it is commonly referred, is an autoimmune disease where the body cannot recognize its own cells from foreign invaders — thereby turning on itself and attacking healthy parts of the body.
SLE manifests in each individual differently, warranting a highly customized treatment path tailored to one’s bodily response — and often remaining at the whim of medical insurance approvals.
This has become the roller coaster ride that I never wanted to be on, and has altered the trajectory of my life.
I write this from a place of medical privilege, as I have now experienced autoimmune care in three different countries, on three different continents — the United States, Germany and Taiwan. The Taiwanese people ought to be boastful about their highly effective government-run, single-payer, nationalized healthcare model. Yet, they largely remain humble of its remarkable efficacy.
In many regards, it resembles the Kaiser Permanente model in the U.S. in that every specialist resides within the same facility. I was never in danger of losing my home or going into bankruptcy as a result of medical debt, and I never once had to battle an insurance company. I knew I had access to care within my budget. I could simply focus on getting well again.
Truly utilitarian in scope, all Taiwanese and foreign residents have equitable access to the system with no financial barriers to entry. It was most astounding to be able to purchase the exact medications — manufactured in Germany — for a fraction of what I pay here. In the U.S., domestic prescription drug spending continues to rise, raking in $374 billion last year, a 13 percent increase over 2013. It remains to be seen how this year will close, though the recent Turing Pharmaceutical debacle highlights that the ethical triage between recouping research and development costs, attaining a return on investment, and balancing patient accessibility, remains murky, at best.
Despite the vast investment in the current health infrastructure, severe gaps in patient outcomes continue to pervade, which are eye-popping when compared cross-nationally. In an October analysis from The Commonwealth Fund, health spending, patient service usage, and cost were juxtaposed across thirteen high-income countries — Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the U.S.
The results are rather scathing. At 17.1 percent of GDP, the U.S. spends the most on its health infrastructure, though many of our outcomes continue to trail behind peer national models. For example, of the countries studied, the U.S. leads with the lowest life expectancy at birth and the highest infant mortality rate. As such, 6.1 newborns will die per every 1,000 live births here, compared to 2.1 in Japan. Additionally, 68 percent of Americans over the age of 65 will manage at least two chronic conditions, while only 33 percent of those in the U.K. will do so. We must start asking, by whom and for who are health services to be delivered?
During the Affordable Care Act rollout, one online commentator declared his neighbor’s newfound ability to participate in the health marketplace akin to receiving a flat screen television for free. Therein lies the crux of the health care discourse in the United States: the fiercely held cultural belief that our health is something to be worked toward and voraciously earned.
How badly do you really want it?
This serves as the single greatest impediment to our progress in attaining better health outcomes. If we cannot agree that access to care is a foundational human right and not something to be restricted for the privileged few — that access is not something to be earned — then we have lost half of the battle already.
There will be no flawless and fit-for-all means of administering care, though we certainly have learnings to glean from other nations — and even other sectors. We must begin envisioning a new health delivery mechanism that will provide us with more effective outcomes, less long-term spend, and most importantly a model by which all people can attain their human right to health and wellness. It’s far more valuable than any flat screen TV.
Bridget Cooney is an often stubborn patient, as well as a graduate student of Ethics, Peace, and Global Affairs at American University’s School of International Service in Washington, D.C.
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