The conservatives, led by McCain, are at it again. First they claim that America has the best health care system in the world. Then they decry socialized medicine as violating basic principles of liberty. No American should be forced to rely on inefficient government services for their health care. A person’s health should be an individual responsibility, with each citizen free to pick and choose the companies that provide the best services at the lowest cost.
But if the free market should rule medical care, then why not police and fire protection as well? Why should any American have to pay taxes to a government run police monopoly for the protection of their own bodies and those of their precious family? There are constant complaints of poor police response time and the follow up investigation, as well as brutality. So why can’t a good American citizen be freed of confiscatory taxes, and instead use the money to provide their own protection? After all, it’s the American Way. Want to protect your home? Get some guns, a dog or two, and an alarm system. For professional help, contract with a private security company that provides the highest level of service for the least lucre. Worried about being mugged while out on the town? Hire personal protection for the evening through your friendly neighborhood Rent-A-Bodyguard Inc.
Same thing with fire protection. It’s an socialistic outrage that taxpayers are forced to cough up part of their hard earned income to pay a government dominated fire department whose services may or may not suit a person’s needs. It should be a matter of personal responsibility. Don’t think you need professional help? Or can’t afford it? Buy a bunch of fire extinguishers, install a sprinkler system, and hope for the best. It’s your choice. Worried that fighting a fire on your own might not be prudent? Contract with the privately owned and operated fire company that provides the best cost/service ratio.
Here’s the thing. Once upon a time in America we actually did have a free market for fire protection! So why was it socialized? Because the private system didn’t work out very well. So many were unable or unwilling to pay for protection that structures were left free to burn, often bringing down surrounding apartments and buildings. Whole cities were put at risk. Besides, how does one compare service/cost ratios when it comes to fire protection, or that matter police work? It is not like buying a car or a computer. The private fire prevention system was so ineffective, and downright dangerous, that eventually it was abandoned in favor the far more efficient, communalistic arrangement we have today.
Aside from a libertarian fringe, conservatives are not clamoring to privatize the fire and police departments, even though these are exactly the kind universal, socialistic systems that conservative claim to despise on principle. Instead, the right lavishes praise and admiration on these premiere examples of successful socialism (they do the same thing with another prime example of federal socialism, the armed forces). By no means is this the sole example of cynical conservative hypocrisy. The same conservatives who denounce government subsidies for green energy sources are happy to see billions of your tax dollars poured into the coffers of the nuclear power and oil industries. Likewise most conservatives who attack welfare for the poor favor corporate welfare and bailouts in its many guises. When your average conservative claims that they are opposed to universal health care because they are opposed on principle to socialism, they’re lying. And they are lying when they assert the superiority of America medicine.
No advanced democracy is stupid enough to allow a free market of police or fire protection to operate without the involvement of a universal government system. Nor is any 1st world nation stupid enough to allow a free market for medical care — except of course for ours. It is important to understand that universal health care is not necessarily socialized health care. The latter is true only when most or all medical facilities and caregivers are government owned and employed, as in England. In many countries, such as France, the state provides the basic funding through taxes, but much of the infrastructure and personnel are private. Also variable is the degree of supplementary care that citizens can pay for outside the universal system, it can range from none to whatever citizens are willing to pay.
Relation of % of GDP to Health Care to Life Span and Infant Mortality (Data for plots from UN)
America’s privatized health care system is a Byzantine, Rube Goldberg complex that has proven no more successful than the privatized fire protection system we used to suffer under. It is well known that about a third of Americans lack adequate insurance, but that just scratches the surface of the problem. Among western nations only the Irish and Danes live shorter lives, and the US has the highest juvenile mortality rates in the first world. We are killing off our kids nearly twice as fast as the Swedes and Japanese, and about as rapidly as some developing countries such as Malaysia and Cuba. This shockingly poor performance is true even though medical costs soak up a stunning 15% of the American economy, compared to just 6-11% in all other western democracies. Our arrangement is so inefficient that we are wasting, for absolutely no gain, literally well over half a trillion dollars a year. The damage this fantastic squandering of money — we might as well be shooting the stuff into the sun — cannot be exaggerated.
Dwarfing the money being spent on Iraq, it rivals in scale the entire budget of the Defense Department. This colossal wastage is probably the most serious unnecessary loss to the American economy, yet it goes largely ignored. This is a grave mistake, the financial depletion is one of the reasons why we are hard pressed to maintain our deteriorating infrastructures. Think of what would could be done with that half trillion. For one thing, a portion could be used to develop the new generation of antibiotics that are desperately needed to combat the wave of drug resistant bacteria that are making going to the hospital dangerous again. More money could go into taking all we are learning about genetics and cellular biology to effectively deal with cancers — which is vastly greater threat to our well being than Iraq ever was. We would not have a Medicaid funding crisis.
On an individual basis Americans pay from half to twice as much per person for health care than do citizens of any other western nation. With medical expenses rising much faster than inflation in general, it’s one of the reasons why most Americans are finding it increasingly difficult to make ends meet. Half of the millions of individual bankruptcies that occur in a given year involve massive medical expenses not covered by insurance. It happens all the time. A typical nuclear family has the nice house and cars, cable on their plasma TV, and pleasant vacations. Without warning the breadwinner, through not fault of their own, loses their job, and with that goes the health insurance. A member of the family becomes seriously ill, medical expenses amounting to hundreds of thousands of dollars pile up, the health providers require the family to charge it on their cards piling up high interest debt, and soon the family has lost it all. As Michael Moore’s Sicko exposed, even those who think they are well covered often are not.
Rationing of care is rampant in America, only the wealthiest can afford to acquire whatever procedures and treatment they can get. Critics of universal care point to Canadians crossing the border to get specific treatments (a result of overly strict socialization not found in even better run systems). They do not mention that some Americans are traveling all the way to India to undergo vital surgeries they cannot afford in the states. Studies and surveys show that in exchange for all they spend on health care, Americans are actually getting lower levels of basic service than are their western counterparts, who report higher levels of overall satisfaction. We even lag well behind other advanced nations in using the hi-tech information technologies — computerized patient data and prescriptions and the like — that improve patient care while minimizing the dangerous errors that plaque the American system.
But liberals too are making a mistake, and blunder that when one thinks about it is rather bizarre. The left is fond of getting after private companies for not providing adequate health care coverage for their employees. Wal-Mart is a favorite target. Nuttier still is corporate America, which has traditionally opposed universal health care. What are all you folks thinking?! Why in the world should any non-medical company be involved, or want to be involved, in the health care business? Why do companies that are having a hard enough time making cars have to deal with this problem? Or retail chains? Or the owner of a corner bookstore? That management and labor have to repeatedly engage in bitter battles over health care compensation is social and economic madness. No other advanced democracy is dumb enough to allow this sort of thing. The involvement of general business in the health insurance business in the first place is an accident of our nation’s history. After WW II, when the rest of the west was well on its way to universalizing health care along the lines of fire and police protection, the US decided to dump the bulk of health care costs on business. This was when medicine did not cost that much, and American doctors were opposed tooth and nail to “socialized medicine.” If not for that error we would not be in the mess that we are now.
If they were in their right minds, all Yankee capitalists and investors (outside the insurance industry) would be begging the feds to please, please take this financial gorilla off their backs. Because health care costs are so outrageously high, American products are overpriced compared to their foreign competition, contributing to the trade imbalance and the debt load, while suppressing job creation. That employees are fearful of losing their health insurance if they quit their jobs impairs the job mobility that is supposed to be one of the positive freedoms of the modern economy. The sky high insurance premiums paid by the self employed (many thousands of dollars per annum for a healthy person in their fifties) if they can get it in the first place discourages people from striking out on their own to set up the single person and small businesses that are supposed to be another benefit of the 21st century economy.
Right wing “thinkers” like Newt Gingerich love spinning out one pet theory after another on how to adjust the free market — and tax breaks that do the lower classes little good because they don’t pay taxes anyway — to supposedly make health care more accessible and affordable. Cooking up novel but not necessarily practical ideas gives them something to do, it’s intellectually entertaining. The conservative ideologues will never stop concocting such schemes, which are nothing more than band aids whose actual effect is to perpetually put off what has to be done. Doing the latter is academically rather dull because little innovation is called for, instead it means picking out and applying the best aspects of what has already proven effective in western nations. The medical portion of the economy is well on its way to engulfing a full fifth of the gross national product as it bankrupts the middle class, and leaves the lower class with out proper access to the care they desperately need. Things are so bad that even the corporate powers are starting to discard the old knee jerk ideological rejection of progressive medical coverage as they cry uncle. As for McCain, he does not have a clue; his election will bog down progress on the problem for yet more years.
The following is a modest proposal on how to reduce bitter left versus right ideology in favor of a more bipartisan approach that voters will support. First, emphasize the savings to be made by switching over to a more progressive, universal arrangement in which every American has full access to good solid health care simply by being a citizen. The savings amount to trillions for the economy as a whole over the span of a few years. For each person it is over couple thousand of dollars each year, or well above a hundred thousand over a lifetime. No citizen will receive a bewildering flurry of co-payment bills after receiving care. No American will ever go bankrupt due to overwhelming medical expenses. It cannot be overemphasized how imperative it is to get across how a universal system will actually benefit the entrepreneurial free market by reducing the burden of medical expenses, and by encouraging self-employment and small businesses. Above all else, get the big corporations to see the big advantages of getting out of the business of health coverage. Explain that universal health care makes as much sense as socialized police and fire protection, except that there is no need to adopt a fully socialized system in which the entire medical complex is nationalized.
Do that, and the USA will finally be a first world nation with a first world medical complex. One can only hope.