Why I Believe in Communism and the Motherland
July 30, 2009
I thought that headline might grab you. Now I’ll get right to the point: We need a single-payer health care system in this country. I know this option is off the table in the current health care debate, and many Americans (maybe you) wouldn’t have it any other way. But hear me out if you will, because it is precisely the fear of government intervention that has stalled the process and will leave us with some watered-down, overly complex piece of garbage, if Congress can manage to pass anything at all.
Your Republicans and your Blue Dogs say the concern is cost, and cost certainly is a concern, but if their constituents picked up a bullhorn and demanded a single-payer system or else, they’d figure out a way to pay for it. But their constituents won’t do that because they are terrified. Terrified of a government-run plan.
Do those very same politicians have a hand in that terror? Of course they do, they fuel it every day, as does the propaganda from the insurance industry. But rather than dwell on that, let’s talk about just why government should run health care.
First—and someone please call me and explain why I’m wrong about this if you think I am—it’s better for business. American businesses complain all the time that they have difficulty competing internationally because of labor costs. Isn’t health care part of that? Isn’t it an enormous burden on companies that could be taken off their shoulders with a single-payer system? Yes, it may involve an increase in taxes. Though if we would distribute the taxes we already collect in a way that prioritizes the health and education of the American people instead of, say, unnecessary wars, it wouldn’t have to. In the end, it seems to me that a single-payer system would have to benefit companies and save them money. Except the insurance and pharmaceutical companies, of course.
Our free-market economy is a beautiful thing (the headline really was a joke) and it works most of the time. It does not work with health care. There are theories about this by more intelligent people than myself that you may have heard—Kenneth Arrow’s “Uncertainty and the Welfare Economics of Health Care,” for example. Arrow argues, among other things, that health care cannot be treated like other commodities because you don’t know when or whether you’ll need care, but if you do, the care can be overwhelmingly expensive. And as the vast majority of us cannot afford to pay for cancer treatments ourselves, we need some sort of insurance.
And here’s the thing: Insurance companies make money by denying you care. “I do not want the government coming between me and my doctor.” Well, guess what? You’ve got someone between you and your doctor now, and they do not have your best interests at heart. Companies exist to make money. And there is nothing wrong with that when you are talking about televisions and cars and donuts and soda pop. But when you are talking about the life of a human being, it is unethical to put profits first.
Moreover, there isn’t really competition in health care. For true competition to exist, notes Jack E. Lohman, a retired business owner from Colgate, Wis. and a member of the Business Coalition for Single Payer Healthcare, there must be price and quality transparency, rational and informed consumers and perfect information. In health care we have none of these.
You think you have more choice with our current system? You think you can choose your doctor? What if the doctor you want doesn’t take your insurance? Or you have a plan that limits you to a certain pool of physicians? Really, you don’t even get to choose the insurance you have, do you? Your employer chooses it for you. If you have a job. That’s another thing I’ll never understand: Americans scream and yell about freedom. But how is it freedom to be tied to a job you may or may not like because you are afraid of losing your health insurance?
I have never lived in Canada or France, so I cannot speak knowledgably about their systems. But I did live in Spain for three and a half years, so I do know what one system of “socialized medicine” is like. And it did not scare me away. I had good experiences and bad, excellent doctors and crappy doctors, long waits and short waits, just like here. No system is perfect.
And it goes without saying that the federal government does not do everything well. The incompetence in Washington can be staggering. But it seems to me that if government exists for anything at all it should be to provide its citizens these four services: national defense, infrastructure, education and health care. The U.S. government already handles the first two of these pretty competently. (Try driving on the roads in Costa Rica if you don’t believe me.) And we already trust the U.S. government to provide health care to our elderly, our poor and our veterans, three of the most needy and vulnerable groups.
Which brings me to this: Whether you like the idea of government-run health care or not, most of us will end up there one day anyway. It’s called Medicare. And wouldn’t it be so much simpler to expand Medicare to all Americans, rather than leave it to the current Democratic Congress to come up with a plan that actually works?
Really, they’ve already answered this question for me, haven’t they? Because after all of the bickering and the diluting and the kissing of the special interest ass, we’re likely going to end up with very little change at all. Maybe you’re okay with that. Polls are showing that many Americans, especially insured Americans, are fast wondering whether this whole health care reform thing is really necessary.
To this, all I can say is: Change: 0; Fear: 1.
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