The Problem
This issue is one of the more complex ones facing the nation. It is a massive industry; two trillion dollars are spent on health care every year in the U.S. Yet, despite this vast amount of money, the U.S., the richest nation on earth, is the only industrialized nation without universal health care.
Every year since Bush took office, more Americans have gone without health care, now over 15% of the population. It is the single biggest cause of personal bankruptcy in the U.S. The 47 million hard working Americans that do not have health care coverage often do not seek preventative care since they cannot afford it. This leads to more expensive health problems down the road, costing everyone, including health care providers, more money.
Moreover, the healthier the population, the more productive they are. Our economy loses billions due to people missing work from illness and medical conditions that could have been prevented if they had health care. Even more is lost by declines in productivity since people go to work sick because they cannot afford proper health care, spreading contagious illnesses to their co-workers. Children without health care, especially if they have health problems that could be prevented or cured at an early stage, end up costing our society billions in health costs over the long term.
Health care costs are spiraling out of control, increasing 87% from 2000-2005. In 2006 premiums for families jumped 7.7%, compared to the general inflation rate of 3.5% that year and wage increases of 3.8%. We need to get this under control.
The Solution
Something every other industrialized nation has figured out, except us, is that a government run universal health care system works the best. It is cheaper than the employer based, free for all system we have, and it delivers basic health care faster than ours. Everyone is covered, so the society benefits by preventing many otherwise devastating health problems.
As any insurer will tell you, the more people paying into the plan the cheaper the plan is, as costs are spread out over a larger pool. And as the government acts as the insurer under a universal plan, you eliminate the profit hungry middleman – the insurance company, further saving money.
A universal plan increases bulk purchasing power, drastically reducing the cost of drugs. Businesses, without the burden of paying for the majority of health care, will save hundreds of billions every year.
As the government only runs the insurance side of the health care business, not the actual providing of the health care, patients would be free to seek care from any licensed health care provider, without financial incentives or penalties.
Establishing a single-payer system would create a comprehensive, accurate, and timely national database on health service utilization and health outcomes. This would provide information on gaps and disparities or duplication of care, thereby serving as valuable intelligence for decision-making and resource allocation.
It will enable electronic record-keeping and other innovations that reduce costs, ensure effective treatment and help prevent medical errors.
Since the governmental plan covers basic care, prevention, catastrophic, and emergency care, there is much it does not cover. The current insurance companies come into play here, providing supplemental health insurance to boost the government plan. Still, there will be a large downsizing in the health insurance industry that will cause short-term but sizable economic pain for many people.
The reasons for supporting single payer are practical as well as principled, based upon values of openness, equity, and social responsibility.
Other health care plans
How do other health care plans stack up? A quick synopsis:
The current rage – the mandatory plan
Highlighted by Massachusetts and now California under Gov. Schwarzenegger’s proposal, this answer blends universal coverage with the employer based, private insurer system we have. The main problem with this plan is it does not have the cost saving benefits of a government run plan, and makes it a crime for people not to have health care. It puts the burden on the poor to have health insurance, although many would still not be able to pay insurance even with state support.
Worse, it creates big incentives for employers to drop their health care plans, throwing the burden of paying for health care almost entirely onto the individual. The trick is to make sure businesses pay enough into the system to compensate for forcing individuals to pick up the entire health insurance tab.
Moreover, you still have to go through the evil HMOs, who are in the business of trying to deny you coverage for as many health procedures as possible. So people end up paying for coverage they may not get. That does not happen under a universal government plan. CA’s plan, to its credit, limits the percentage of total premiums insurers can keep as profit.
Businesses support this solution, so it is likely plans like these that will be embraced on a state level, but not federally under the Bush administration. The next President - from either party - may implement something like this. It goes part way to the real solution; the concern is that reform will stop here. There are only so many times the public will stomach altering the health care system.
The current plan – employer based
We all know the problems with this plan, many explained above. There is too much profit motive and greed in this plan to consistently provide adequate health care even to those who are even able to afford coverage. And it is voluntary; meaning if employers do not want to offer health care to their workers, they are on their own. Businesses get screwed too, as they end up footing the bill for spiraling health care costs. As a result fewer businesses offer health care now, and many are ending their pensions for their retirees due to out of control health care.
The conservative answer – health savings accounts
Designed to create another tax haven for wealthy people, this plan does nothing to help the problem, other than make it slightly more affordable for some upper middle class types to pay for their plan. This plan primarily helps self-employed people, who by definition under an employer based health care system, have to buy their own insurance.
Policy Highlights
The details of a universal government health care plan are far too numerous and complex to explicate here. So the basic tenets of a new, universal health care system follow. We will leave the details to the experts.
1) Everyone is covered.
2) We still have private doctors/hospitals; you can go to whatever doctor you want.
3) Medicare/Medicaid get folded into the universal plan.
4) There may be a slight increase in income taxes; there is no separate Medicare/Medicaid tax.
5) Businesses may have to pay a small, flat fee per employee, say $50-100 a month, or a slightly higher amount in taxes, but they save billions by not having to pay for health care premiums.
6) People could purchase supplemental health insurance.
Messages
1) It is immoral for the richest nation on Earth to not provide health care for its citizens.
2) Health is a right, not a privilege of wealth and class. (Kerry’s best message of his 2004 campaign)
3) A universal system saves businesses billions.
4) Your health should not be determined by corporate profits.
5) Single payer health coverage is practical and principled.
Subset Issues
1) Medical Malpractice (coming soon)
2) Stem Cell Research (coming soon)