Tuesday, February 16, 2010

National Health Care

Darren, of Right on the Left Coast, has posted about socialized medicine.

I have to disagree.
"Our federal system was created so that the states could serve as "laboratories" for democracy, trying out programs and seeing if they work. Three states have tried government-mandated health care, and three states have failed at it. Anyone who thinks such a program would succeed at the national level is a liberal political ideologue or a fool, but I repeat myself."
Interesting Dichotomy. False one, too.

First, our states were not created to be laboratories, they were autonomous states banding together for a common goal. Federalism was at a minimum because they had no intention of giving up rights they perceived to be held by the States. Over the years, that has changed as the Nation decided that local practices were in need of improvement. Civil rights vs slavery, national defense, highways, Rural Electrification ... there are many reasons for national control, some better, some worse.
Second, three states have tried and "failed". I doubt any are abject failures. Programs are probably in trouble more because of the poor economy than program deficiencies - though the US tort system and US style of defensive medicine are major factors. Simultaneously providing health care and having fiscal problems doesn't prove causation.

I am not a liberal political ideologue or a fool, yet I believe in the idea of national health care. I present not the evidence of three states who have attempted it and "failed", but rather of those who are still giving it a go, and those Nations around the world who have somehow made it work.

One of my students was on a trip to France and got very sick. There was no cost and she was well cared for. She returned to the US three weeks late with no bills. If the French can do this ... why the hell can't we?

The real problem is that too many of us are stuck in an idealized vision of capitalism with the hope that companies will always "do the right thing" and will always be responsible to its patients rather than its shareholders. Unfortunately, the interests of patient and insurance company are ALWAYS at odds.

"What about choice?" is usually the next question. What about it? I have no choice as to plans or company ... I can take my nice plan or drop it (with no way to use that money I refused in a plan of my choice). My choice of doctors is limited and the insurance company has limits on who, when, where, and how much.

"Doctors are going broke over Medicare and Medicaid" Bullshit. They choose to work with those patients and I really doubt any of them are going broke as a result. Frankly, if it's so bad, why does everyone still want it?

"The pharmaceutical companies will go broke because the government will impose price caps just like the other countries." Again, bullshit. The companies can make a profit selling that drug to European markets at a tenth the price but somehow doing the same here will cause them to go broke?"

"The government messes everything up." No. it doesn't. It does a lot of things better than the private sector, and for more people. For instance, I like having public education for all, with private options available to any who choose to pay more.

"Immigrants will bankrupt the system." Really? On what planet has this happened?

Cover everyone to a low, basic level. Cover maintenance, typical injuries. Set limits on what is covered and done. Allow anyone to purchase extra coverage of their choosing. Apply tort reform. Allow for physician review by patients and the public.

We have nationalized (or publicly control) quite a bit in the interest of fairness, of allowing all citizens the benefits of our society, without requiring immediate payment (or, in some cases, any payment):
  • roads, bridges, other infrastructure, snow removal
  • education
  • army, navy, coast guard, national defense and all that
  • electricity, power, water, sewage (Electrification Act and others)
  • rescue, emergency rooms, first responders, fire, police
  • Medicare, Medicaid
And finally,
Can anyone, anyone, really expect California to try such a system given its track record of fiscal mismanagement and our current $20 billion or budget shortfall?
Frankly, I couldn't give less of a damn what California does. That state is a mess in so many ways. It has problems with its budget that have nothing to do with health care. California is so unlike any other state (except maybe Texas) that I couldn't bring myself to suggest that anyone imitate it.


  1. We're just going to disagree on this one. If you want to be like France, well, there's already a place like France. It's called France.

    If you can name one continuing federal social program that's working, that isn't costing more than it's bringing in or even more than it was predicted to, if you can give me *some* glimpse into a reality wherein we can have national health care but won't go bankrupt as a country, I'm listening. But all I hear are crickets.

  2. One program?

    And insisting that the program "bring in more than it's spending" would eliminate Highway funding, Defense, Education, ...

  3. Oh, and the idea of moving to France ... not happening. I love this country, I served this country honorably, and will continue to do so. I don't think that advocacy of a federal program is tantamount to treason and self-loathing. It's called Democracy in action.