Tuesday, August 12, 2008

Exerpted from Paul Krugman

"What’s easy about guaranteed health care for all? For one thing, we know that it’s economically feasible: every wealthy country except the United States already has some form of guaranteed health care. The hazards Americans treat as facts of life — the risk of losing your insurance, the risk that you won’t be able to afford necessary care, the chance that you’ll be financially ruined by medical costs — would be considered unthinkable in any other advanced nation.

The politics of guaranteed care are also easy, at least in one sense: if the Democrats do manage to establish a system of universal coverage, the nation will love it.

I know that’s not what everyone says; some pundits claim that the United States has a uniquely individualistic culture, and that Americans won’t accept any system that makes health care a collective responsibility. Those who say this, however, seem to forget that we already have a program — you may have heard of it — called Medicare. It’s a program that collects money from every worker’s paycheck and uses it to pay the medical bills of everyone 65 and older. And it’s immensely popular.

There’s every reason to believe that a program that extends universal coverage to the non-elderly would soon become equally popular. Consider the case of Massachusetts, which passed a state-level plan for universal coverage two years ago.

The Massachusetts plan has come in for a lot of criticism. It includes individual mandates — that is, people are required to buy coverage, even if they’d prefer to take their chances. And its costs are running much higher than expected, mainly because it turns out that there were more people without insurance than anyone realized.

Yet recent polls show overwhelming support for the plan — support that has grown stronger since it went into effect, despite the new system’s teething troubles. Once a system of universal health coverage exists, it seems, people want to keep it.

So why be nervous about the prospects for reform? Because it’s hard to get universal care established in the first place. There are, I’d argue, three big hurdles.

First, the Democrats have to win the election — and win it by enough to face down Republicans, who are still, 42 years after Medicare went into operation, denouncing “socialized medicine.”

Second, they have to overcome the public’s fear of change.

Some health care reformers wanted the Democrats to endorse a single-payer, Medicare-type system for all. On the sheer economic merits, they’re right: single-payer would be more efficient than a system that preserves a role for private insurance companies.

But it’s better to have an imperfect universal health care plan than none at all — and the only way to get a universal health care plan passed soon is to inoculate it against Harry-and-Louise-type claims that people will be forced into plans “designed by government bureaucrats.” So the Democratic platform emphasizes choice, declaring that Americans “should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan.” We’ll see if that’s enough.

The final hurdle facing health care reform is the risk that the next president and Congress will lose focus. There will be many problems crying out for solutions, from a weak economy to foreign policy crises. It will be easy and tempting to put health care on the back burner for a bit — and then forget about it."


Dogwalkmusings said...

The trouble with reforming healthcare is that so many entities are involved - the doctors, the pharmas, the insurance companies - all wanting more than their piece of the pie. It's something that can't be legislated away.

Margie's Musings said...

The other first world countries in the world have managed it. We just need to bite the bullet and do it. Things continue to get worse all the time. I talked to a small business owner today that has a $5,000 deductible. She doesn't go to the doctor because she can't afford the $65. office call and all the expensive tests they always order.

I also talked to a 78 year old friend today that has had a night cough for seven weeks. The doctor finally prescribed a cough medicine for her today but it wasn't covered by her insurance plan and cost $93. She couldn't afford the cough syrup.

Blue Ridge Blue Collar Girl said...

Thank you, Margie, for the well-expressed posts you've written about our broken health care system. Our family now has insurance, but we can barely afford the premium. And, like your friends, we almost never use it because of the high co-payment and deductible. No solution is perfect, but, as you say, "it's better to have an imperfect universal health care plan than none at all."

Margie's Musings said...

That's how I feel too. When I was working in the FAST (financial assistance short term) office I met many many low income people who had no insurance and did not qualify for Medicade. It was tragic especially with the terrible health problems many of them had...and couldn't afford treatment

Now we have the Montgomery County Health Clinic and it is basically a free clinic since it is on a sliding scale and most people who use it are below poverty level.

Margie's Musings said...

Our legislators have the ideal health care program. It's something that should be expanded for every citizen