Could we just go to single-payer for health care and be done with it? The goal should be public health not profits…

NOTE: All I’ve changed on this post is the headline. But really no matter what, the government has to be involved in health care in order to ensure everyone has it and we all pay one way or another and unless you just say every man and woman for themselves and to heck with poor kids, why not single-payer (government) or socialized medicine? Is it the name that bothers people?

 


 

 

You know, ultimately single-payer healthcare, that is where the government pays for everything, might just be the way to go. Yup, what was once labeled “socialized medicine” or maybe “communism”.

I mean how else are we going to make sure everyone gets healthcare? (that is if we care if everyone gets healthcare.)

And let me go back, I did not mean we should go communist. But that pejorative was once tagged on anything conservatives opposed. Since the Soviet Union, the first nation to ever try communism, no longer exists, and since most of the few remaining communist regimes have resorted to at least some capitalism, socialism has replaced communism (which itself is a form of socialism) as the common pejorative used to oppose anything that does not please über conservatives.

So anyway, former president Barack Obama tried to come up with a way to provide health care to all via the Affordable Care Act, commonly known as Obamacare. I don’t know what his original intention was but it became a compromise between socialized medicine and the capitalist form of private insurance.

But the conservatives, especially the more modern reactionary no-compromise variety, it seems to me were nervous it might actually work and from the start fought it tooth and nail and spread what might be a big lie that it was a disaster. For sure, there were problems. And for sure health care costs have continued to go up. And for sure, still, not everyone is covered.

But I don’t intend to go into all the detail and complexity of the issue, except to note that it is indeed complex. There are a lot of players: the health insurance industry, the medical practitioners, the hospitals and other providers, drug companies, health care workers, and maybe many more.

Not everyone wants the same thing.

But here’s the deal. The goal of the lawmakers and the president should not be to satisfy the various special interest groups but instead to provide health care for all but in an efficient manner that can be economically sustained of course.

We are told that other Western style democracies seemed to have figured out how to do this but for some reason the United States is unique and therefore cannot just copy them.

Single-payer would be costly for the government no doubt. But all methods are costly and we citizens end up paying one way or the other.

It has often been easier, and maybe still is, for the indigent to get medical care than many so-called working poor or even lower middle class, who may not have access to a traditional employer-sponsored group plan, but who do not qualify for government help. But even with that those same people pay for health care for others through their taxes and the costs incurred by an inefficient system that are passed on to them by way of fees.

Also, people with group plans or even purely private plans have had to pay for care for those who could not afford care by way of taxes and the burden on the system that results in higher costs for everyone.

And all I am trying to say here is that in a responsible, civil, and humanitarian society we will continue to make sure that people don’t go without health care, even with the costs it entails.

I heard Kentucky Senator Rand Paul (a Republican with libertarian leanings) say that he thought both Republicans and Democrats want the same thing, basically universal health care or access to health care for all, but disagree on how to get there. And I did of course paraphrase what he said. It seems he is certainly right and in fact within the Republican Party, who has complete control of both houses of congress, there is quite a split.

It’s been said often that the Republicans never did have something workable to replace Obamacare, and now they seem to be caught in a trap of  their own making.

One idea Republicans often promote is health-savings accounts. The idea is that people could then decide to put money back tax free as kind of their own self-insurance. Not a bad idea really, at least conceptually, except if you had enough money to fund an adequate self-insurance fund, you would not need the tax-free savings account, it would seem. Such savings accounts might be adequate for normal medical expenses such as doctor visits perhaps — even then, though, it would seem they might eat up a major portion of the average person’s salary.

I have heard the argument for taking private insurance companies out of the picture, that they just add a layer of bureaucracy and expense. Hmmm, I wonder. Not sure. Unfortunately there will always be a bureaucracy, private or public. We might have more control over a private bureaucracy via the free market. But I am not at all sure about that.

I personally am at that stage in life where I am covered by Social Security under Medicare and I pay for a private supplement. I had employer-subsidized plans in the past and nothing in the way, way past.

I do think it is probably best that all people be required to have insurance, as is the case when you drive a car. It is not practical or fair that someone goes along and pays nothing but then expects to be covered and get top care or care at all, while others act responsibly and pay their premiums. Supposedly if everyone paid premiums the costs would go down or be controlled (would they?).

But at the same time it is wrong to force people to pay for something they cannot reasonably afford.

Having the marketplace determine the cost of health care also seems problematic to me. Personal health care is not something easily worked into a free market. You cannot know exactly when you will need it or what type of coverage you might end up needing and when. And you can hardly force private entities to take a risk that they know is not wise — such as covering people no matter what their likelihood of getting ill or their existing medical history, unless you subsidize the risk taker. A single-payer government insurance or health coverage would not have that worry. It’s concern would be helping people, not making profit. But of course it still has to be paid for somehow, and the marketplace does offer some efficiencies.

So the conundrum: private or public. We tried a blend and may have not given it a chance.

But as far as I am concerned, we should kick the special interests out of the congressional halls, kind of like Jesus kicked the money changers out of the Temple (and I will surely be corrected on that one).

What is good for the people is the important thing.

p.s.

The irony of ironies in the current stalemate on healthcare is that many of the Republican lawmakers who have pushed so hard to repeal Obamacare have found that their own voters depend upon it or something like it. Ooops.

ANOTHER AFTER THOUGHT: Even in Democratic Party-dominated California where both the legislature and the governor’s office are in the party’s hands, single-payer healthcare is being stymied. Maybe the will for universal care is just not there yet, but unless the Republicans at the national level come up with an alternative, I think it one day, not so very long into the future, will be.

 

 

 

 

 

 

 

 

 

 

 

 

 

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