On healthcare

Well, nearly complete. Because remember, that rugby pitch was in the United States. And so is McCosh, and the specialist, and the hospital, and the nurse who pushed the wheelchair, and the anaesthesiologist and the friendly policeman in the car. And in America, you can see a sparkling dollar sign spin behind every smile.

I didn’t have to wait long at the hospital. The specialist was a skillful, experienced plastic surgeon. The nurse didn’t grab cash out of my hands and make a run for it while I was strapped down in the wheelchair. In fact, the quality of service was excellent. I felt safe and appreciated the smiles. It was a land flowing with milk and honey — but it has its own looming wilderness.

The wild landscape of private medical insurance is a terrifying backdrop to an otherwise welcoming system. Like many international students, particularly Europeans, I come from a country where we don’t have to pay for health care.

I live in the United Kingdom, where less than 12 percent of the population pays for private health insurance, and where that portion can still access public resources if required. We are not used to the practicalities of handing over cash for medical care. At home, you break your nose, you walk into a hospital, you sit in the waiting room for three days, someone fixes it, and you exit the building.

This is not an argument for either private health insurance or state-supplied medical care. Both systems have their own advantages and drawbacks. In the UK, you might wait longer, have less choice and endure slightly diminished quality of care, but paying no fee can result in less over-doctoring and a more equal standard of care. Healthcare in the United States might be, on average, more expensive, but there’s variety, consistent quality and more easily accessible care. The studies are equally inconclusive. In a survey by the Royal Society of Medicine, the National Health Service in the United Kingdom ranks second only to Ireland in terms of cost efficiency, and in a different study by the Commonwealth Fund, the United States is first in providing the “right care” for a given condition. And, as The New York Times has mentioned, the medical system in the United States has a strong reputation for “top-of-the-line care.” There’s no easy way to compare the two systems. Both methods have their merits, but anything even approaching a final judgement cannot be made on this page.

So, let’s get back to that terrifying landscape of insurance. Whether the U.S. system is better or worse, the very prospect of paying medical costs, themselves masked in a new language of deductibles and co-payments, is absolutely terrifying for the foreigner, and likely for most Americans, too. Sifting through reams of legalistic jargon and being prompted to sign at the foot of a page you do not understand: This is the dark side of America’s otherwise bright and shining healthcare system.

You might like the standard of care, but the stress of paperwork and hidden costs is a pressure that can easily outweigh the reassurances of better quality and increased attention. If the United States is to truly benefit from its private healthcare, it needs to adopt some of those comforting aspects of state-run care. Insurance can be more streamlined. In 1980, the U.S. government imposed on itself the Paperwork Reduction Act. Insurers should invest some of their own profits in working toward a similar solution for patients. Plans should be more transparent in what they will and will not cover, and the claims process should be made easier. When Johnny — or Jane — arrives at McCosh for their weekly STI test, they first pay $14 and, as the University Health Services’ website makes clear, will then “submit a claim to their insurance carrier.” This is unnecessarily cyclical, and a solution requires initiative from both health providers like McCosh and from insurance carriers. Less paperwork and more transparency will result in less stress and perhaps, then, even promote faster recovery: The U.S. health system has room to improve.

Princeton students will be the next health-care CEOs. Princeton students will be able to improve the current system. America has a brilliant medical network, envied across the world. But it must take responsibility for removing some of the stress from the process. America doesn’t normally like to rely on the state for assistance. That’s fine. But until the private sector adopts a more responsible approach to business, there is much room to improve. Our generation should shoulder the burden.