Support Health Care Reform Now
Page Five
Does Socialism Actually Work Better in Health Care?
I have outlined above the reasons why the new system may be better off without a public option for the time being. The public option will have a hard time competing with private insurers who will take months to approve fifty–somethings while they approve twenty-somethings almost at once. This unlevel playing field could soon undermine the public option. But will it matter in the long run whether the new health insurance system includes a public option?
Contrary to the dogma we hear constantly from free market fundamentalists, there is overwhelming evidence that the Federal government administers health insurance at least as efficiently as the private sector, and there is considerable evidence the Federal government is more efficient. The Administrative costs of Medicare, for example, are just a small fraction of those of most private health insurers. Medicare also requires no advertising, no sales force, and no profits to be returned to shareholders.
Medicare also places less accounting burden on doctors and hospitals – a factor that has not yet been measured, as far as I know – because doctors and hospitals are more familiar with Medicare rates and policies. They therefore face less of a learning curve and less uncertainty when submitting invoices.
There is good reason to believe that a well-designed public option, like Medicare, could give the health insurance industry plenty of meaningful competition and this competition will benefit consumers, as competition always does. But this healthy competition will only benefit consumers if the universal mandate is vigorously enforced. If the Federal government takes a lax attitude towards enforcement, as past experience suggests it will, the private insurers will soon put the public option out of business for reasons we have seen above.
If Congress approves the public option and if the Obama Administration enforces the universal mandate on companies and individuals with zeal – both big ifs – the result will be public and private competition in the same industry as there is now, for example, between the Postal Service, UPS, and FedEx. Both public and private insurers will develop distinctive niches that will make the whole system more competitive, more complex, and yet more efficient.
This is the greatest promise of the new law. The result of this more efficient system will be improved health for the American people. It will not be easy to achieve, but it is possible with vigorous enforcement. If Americans – individuals and private companies – are allowed to bend the law to suit themselves, however, the new system will fail to produce much improvement in our national health. But it will still be better than the status quo, because even a slight improvement in efficiency and outcomes is better than none.
Public Good
Single Payer has exactly zero chance of passing Congress in 2010.
If the government really is more efficient than private companies in administering health insurance – as the evidence seems to show – why not go to a single-payer plan like the Canadian system? Whatever the relative efficiencies, Americans’ instinctual fear and loathing of government – especially among conservatives – makes single payer a no sale in Congress. There is exactly zero chance a single payer plan could pass Congress in 2010. Conservatives would fight tooth and nail, villifying the plan as "socialism". They believe socialized medicine --something our close allies have already implemented -- would very likely destroy the United States.
Understanding this, the Obama Administration shrewdly refused to consider this option. President Obama would rather get something done that helps people and saves lives now rather than wait for a supposedly “perfect” solution that might or might not be achievable at some date in the future. Conservative Americans' distrust of their own national government might dissipate at some point in the distant future – perhaps – but it would be unwise to bet on that happening this year or next.
Because of the health care debate some Americans have already begun to rethink their attitudes. Many have come to realize that health care is not really a private consumer good like a car, a house, a computer, or a television set. Instead, there are powerful reasons to think of health care as a public good, like national defense, police protection, fire protection, public schools, and government itself. There is a persuasive argument that says our health care system should not continue to systematically discriminate against free-lance workers, small business employees, impoverished African-Americans, or backcountry hicks. It ought to treat everyone equally.
It can Happen to Anyone at Any Time
Although most of us are healthy most of the time, we never know when we might need help. Misfortune can strike randomly. I myself was attacked by criminals in South Texas five months ago and badly wounded by a machete knife. My wounds required surgery and five days in the hospital. I racked up more than $40,000 in health care costs, but I was fortunate to be insured through the Writers Guild at that time, and so the impact of this event on my life will be limited to the injuries I suffered. It will not be compounded by financial disaster.
Anyone could have a similar misfortune at any time, whether it’s an auto accident, the discovery of cancer, or a dangerous bout of flu with pneumonia. Isn’t it reasonable to agree that we should all have access to our superb doctors and hospitals on an equal basis?
All Americans should support the health care reform bills currently moving through the House and the Senate. These bills will save tens of thousands lives every year and move us several steps towards a more just society.
Notes
1. Medical Bankruptcy in the United States, 2007: Results of a National Study, American Journal of Medicine.
http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf
2. The Hidden "Uninsured" Tax on American Families
http://www.familiesusa.org/resources/newsroom/press-releases/2009-press-releases/hidden-health-tax-for.html
3. Harvard Study on Death Rate Differential between Insured and Uninsured:
4. Life Expectancy by Country
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html
<< previous home >>