SiCKO, Part Four

Did you know that there's a House bill sitting in Congress right now that creates a universal health care system? H.R. 676 was introduced by John Conyers last January, and was referred to subcommittee in February. What do you want to bet that it never finds its way out of committee for a vote?

I think it was Bill Maher who identified this brilliant Republican strategy of proclaiming that the federal government doesn't work and needs to be smaller, then they fuck it up and say "See?!?" Or something along those lines. Well, it's true, but they're not the only ones destroying government these days. Neither party has a stranglehold on corruption and incompetence. But despite their best efforts, there are some things that the feds do well, do OK, or used to do well. They built the federal highway system, created Social Security, and are good at fighting wars (whether the war is justified, and how the aftermath is managed, is another matter entirely). The administrative costs of existing federal health programs such as Medicare and Medicaid are a fraction of private providers' costs, about eight times less. The EPA and Department of the Interior, even while currently hamstrung by the White House, are still working for a cleaner environment and maintaining public parks and open spaces. U.S. attorneys, despite shaky/criminal leadership at the top, are still going after political corruption and organized crime.

Despite all this, there is still reticence about universal coverage. But what do we have to lose? There's widespread acknowledgment that the system is broken, so how are incremental steps to fixing the flawed privately-managed patchwork of health insurance going to help? Sure, people don't want to be taxed more, but if you can show people the numbers, and that any additional taxes would be less than their current premiums plus deductibles plus co-pays, what else is standing in the way? This idea that government will screw it up doesn't hold water, when comparing the two scenarios.

The existing scenario is privatized health care; a provider is interested primarily in providing a good return on shareholders' investments. There is financial incentive to deny costly procedures, while maintaining a minimum level of satisfaction. Why minimum? Well, since so much health care is employer-sponsored, not many people have a choice of who will insure them. Yes, there is often a choice of plans, but the provider is not negotiable. These companies have a captive audience, so to speak, so the level of service must simply reach a level where the company isn't getting the bad publicity that can be detrimental to earnings. Under the current arrangement, your health and personal finances are in jeopardy, should you be denied a claim or if a medical professional or administrator screws up.

Under a universal care scenario, let's assume you're paying about the same; more in taxes, but no premiums or deductibles, so it's a wash. The doctors stay the same, but they're paid by the government. The government administers the system, which they've already proven - with Medicare and Medicaid - that they can do more efficiently than private insurers. There is no incentive to deny care, there's only incentive to keep people healthy. Like docs in Britain, medical professionals would earn bonuses based on health improvements of their patients (accountability!). Yes, there would be screw-ups, but since the whole system doesn't have co-pays or deductibles, the only mistakes are going to be by the doctors, and those will happen no matter what system you're under. In other words, you can't be bankrupted by paying out-of-pocket for the coverage you need.

OK, time to move on, since a four part post on health care probably decimated my already minuscule readership [I'm guessing that it dropped from 5 people down to 2 or 3].