Expanding the Debate on Universal Health Care

Thanks to a mention at Crooks and Liars, this site received over five hundred hits on Thursday. I am awestruck. The influx of traffic created many new visitors and some fantastic comments. Welcome, newcomers! As a result, I am going to take the opportunity today to expand my post regarding practical solutions to universal health care.

As an astute reader pointed out, the Massachusetts plan mandates that every resident of the state purchase coverage from a private carrier, else be fined. That is not what I propose at all; that system is hardly fair. Rather, I believe our government should mandate through legislation that every resident of this country be granted medical insurance. No exceptions. The responsibility, then, rests on the government, not the individual. In an effort to offset costs, some amount of payment should be expected most U.S. residents, but the amount owed should be based on household income and financial means. Taken this way, paying for coverage would resemble the co-pays we provide to insurance carriers for doctor's visits and for prescription drugs. People living below the poverty level would pay little to no additional cost for their coverage. Those who take in higher rates of pay would, of course, pay more into the system.

Responding directly to one of my comments, I am not afraid of socialism, either. However, as I said in my previous entry, if our country's finances were in better shape, a truly socialist system would be more feasible. As it stands now, the money has got to come from somewhere and simply raising taxes alone would not be a sufficient way to cover the additional expense. Our government is trillions of dollars in debt, and even if you dramatically raised the tax rate of the wealthiest of the wealthy-- the top 1% of all earners--the effect produced would be only a drop in the bucket. Furthermore, doing so would encourage the super-wealthy to take their money elsewhere and particularly to other countries where their rate of taxation would be much lower.

Bringing down health care costs by expanding coverage to everyone as well as encouraging competition in providers would bring down costs across the board. The pharmaceutical industry, in particular, charges exorbitant prices for prescription drugs. Those of us unfortunate enough to not have adequate health care, or any at all for that matter, know that a thirty day supply of medication for one particular drug can run upwards of hundreds, occasionally thousands of dollars. When one considers that many individuals must take more than one medication to treat chronic conditions, monthly expenses for prescription drugs alone total several hundred, if not several thousand dollars a month. That is inexcusably wrong.

The flaws in socialistic medical system before have been exhaustively noted. For example, the National Health System (NHS) in the U.K. provides decent baseline coverage for every British citizen, but those who can afford to pay for private care out of pocket often do so. It is easy to understand why. NHS employed doctors do not have the same financial incentives to stay abreast of changes in their field or to treat patients with the same quality of care as doctors in private practice. Doctors in private practice are often more skilled and better qualified. The NHS schedules every procedure and illness, particularly operations, on a priority basis and based on severity. Anyone who has ever spent hours waiting in an emergency room knows this extremely well. A heart attack patient would be seen far sooner than someone with a case of strep throat. Beds are scheduled by priority as well, and the wait time is often lengthy. Those requiring non-life threatening surgeries often wait weeks, if not months, to receive an open slot.

So long as the capitalist system is maintained by this country, it would be unrealistic to expect otherwise. Any socialistic system runs directly at odds with capitalistic models. Financial incentive and profit is the engine that drives our economy. No matter how many layers of government oversight or legislative mandates we add, problems like these will arise. Baseline coverage for everyone is a much more feasible outcome.