Universal Health Care in America

A conversation came up at a birthday party this weekend concerning "Universal Health Care in America". It strikes me that there is enough confusion about this that it is an easy mark to shot down rather than support. It seems that it isn't clear what this means. For example, Bush and company refer to it as the ability for everyone to have access to health insurance (I think this means that if you can afford the insurance you should be able to get it - which is actually an advancement from the current situation). I think it means that everyone can get health care, and nobody needs insurance. All citizens get health care just by being a citizen (and maybe something to do with some of the folks who are legally here from other countries). The government pays the bills, and the money comes from taxes.

My understanding is that this can be done cheaper than we are now doing using insurance. The extra overhead in the insurance approach more than offsets the extra cost that we would have because of additional people getting health care. The overall cost that has to be paid goes down, not up. I don't think we will all get a break. Some of us, such as myself, will end up paying more in taxes to offset what we are now paying to the insurance companies. The big advantage is that if a big, expensive medical thing happens to someone in my family it won't bankrupt me. Basically, it would give me better high end coverage than I can currently obtain. The low end people who can't afford health insurance will still not have to pay much, or anything, because they also don't pay much or anything in taxes. The advantage is that they will be able to get lower cost care at a doctor's office, rather than very expensive care at emergency rooms.

I don't think it necessarily means going to a government run health care system. The current approach to giving care can stay pretty much like it is. A mix of private and government hospitals, and private doctors. HMOs and PPOs would be a thing of the past, so some of the artificial organizations that have come about in the past decade or so will probably go away and go back to what they were before the insurance companies forced the doctors and hospitals to join into groups based upon the type of insurance plans they will accept.

In summary, it could be a single payer system, but not a government run health care system.

Oh yes, it would still be possible to purchase medical insurance for certain types of "extra" care (maybe better rooms, maybe some types of elective procedures, etc). This is done in other countries and seems to work just fine. The extra usually seems to be quite inexpensive and allows a little increase from a basic level of care.

I think those who believe that we need to provide healthcare for everyone need to get clear about what is meant. Most of the arguments that I hear about the proposal are centered upon people's fears of what would happen if the government ran the health care facilities. I agree with those fears, I think it would likely be a terrible mess. However, that isn't necessarily the way that it would get implemented. I think we can have the same (or better) health care facilities, using the system that we used to have here (before the times of "managed" - or mangled - care), it would just be funded differently.

There are lots of other costs that would go down with this approach, especially the health care insurance issues that are charged multiple times but only paid once. For example, health care is a large portion of automobile insurance, worker's compensation insurance, business insurance, and others. If health care was provided regardless of the cause, then that portion of the expenses could be removed from all of the other insurance plans.

This whole approach would give business a much needed relief from the pressures and costs of insurance, and would increase the level of care to our citizens. I think it is an idea that is way past the time to implement it. I am personally embarrassed to have the type of health care mess that we currently have. It is one of many deep embarrassment that I have about America (such as our sterling response to Katrina).