Paul Krugman has written an op-ed piece for the New York Times that perfectly sums up the excuses we keep hearing about why universal health care wouldn’t work in the US, and why the excuses aren’t really valid at all.
He sums up the problem:
The United States spends far more on health care per person than any other nation. Yet we have lower life expectancy than most other rich countries. Furthermore, every other advanced country provides all its citizens with health insurance; only in America is a large fraction of the population uninsured or underinsured.
And notes that any reasonable person might then be motivated to question the current system and look to other countries that are doing a better job and try to learn from them. But obviously that is not the case, as we continue on with our health care system headed for a train wreck, adding more people to the ranks of the uninsured every year. 6 years ago, the number we frequently heard regarding the number of Americans without health insurance was about 40 million. Now we hear numbers around 46 or 47 million. But as I’ve written before, the majority of the under-65 population still has employer-sponsored group health insurance, and can’t see what all the fuss is about.
So Mr. Krugman has set about dismantling the excuses. The first one is that people don’t think our uninsured/underinsured problem is really that much of a problem. “I mean, people have access to health care in America,” said President Bush a few months ago. “After all, you just go to an emergency room.” That’s similar to a small child, when told that the family can’t afford to go to the movies, who responds by saying “let’s just write a check!” Yes, more and more people without insurance are using emergency rooms as primary care – apparently with the full blessing of the president. This is causing ever-increasing wait times at emergency rooms all over the country, staffing shortages, and escalating bad debt for hospitals. Somebody has to pay for the care received by uninsured patients in emergency rooms. The result is that costs go up across the board, and patients with insurance end up paying higher prices for their care.
The next excuse that people offer up is that it’s our lifestyle – couch potatoes eating french fries – that’s causing our lowered life expectancy and poorer health compared with our counterparts in other countries. Well, there is no debating the fact that we need to clean up our acts when it comes to taking care of our own health. But the main premise Mr. Krugman addresses in his article is that although we spend far more per capita on health care than other countries, our results are not as good. If it were just our lifestyle – which, sadly enough, a lot of other countries are adopting more and more – that was causing us to spend more on health care, we should expect to have equal or better results, since we’re spending more on treatment. But we don’t.
Then there’s the funniest excuse of all: Health care is better now than it was 50 years ago, so of course it should cost more. Okay. Lots of things have seen improvements in the last 50 years. But if two stores are selling the same computer (obviously a much better model than one you could get in 1995) and one is charging twice as much as the other, with the logic is that it’s because the computer is better than the ones they were selling 10 years ago, would you buy their computer? I doubt it. Health care has improved all over the world in the last 50 years. And yet the US alone doesn’t insure all of it’s citizens, and spends more per capita than any other developed country on health care, while getting poorer results. Yes, health care costs more than it did in the 50s, but why are we not more in line with the rest of the developed world when it comes to how much we spend and the results we get? And why are we the only country that does not provide health care for all its citizens? We don’t need to reinvent the wheel here – we just need to look to those who have already got it rolling.
And then there’s the well-worn outcry against “socialized medicine.” It’s as if we’re waiting for Joseph McCarthy to jump out and start outing Communists. People talk about socialized medicine as if it will turn the whole country into one big Cuba. This is not the case at all – look at Europe and New Zealand. Lots of political and social freedoms, and yet everyone has access to health care (without just going to an emergency room, like the President recommends).
We already have a form of socialized medicine for every American over age 65. Medicare works well. Sure, it has its flaws, but every older American has coverage, from a single-payer government system. Maybe we could focus on working out the kinks in Medicare (part D, perhaps?, or the vast array of Medigap plans that so many seniors don’t understand?) and then extending similar coverage to the rest of the country.
We’re like the kid in second grade who doesn’t want to learn to ride a bike, and tells his parents that it can’t be done. And yet every other kid in his class is cheerfully pedaling along. Maybe when he says that it can’t be done, what he means is that he’s afraid of trying something he hasn’t done before, or of getting a few bumps and bruises as he learns. But once he does learn, he looks back and says “I can’t believe it took me so long to try it. What was I waiting for?”
