Thursday 20 August 2009

Socialized Medicine

Despite being erroneously labeled “socialized medicine,” the US will eventually wend its way towards adopting a single-payer, non-profit, health insurance system.
Why? It’s the American way – you pay for what you get and take responsibility for yourself. Those two bedrock principles of capitalism are rarely extolled in the current shrill debate on health coverage, but because of economic necessity they will surely reassert themselves.
This was explained to me some years back by an industrialist. He operates a small factory that manufactures a specialized high-end product. Business was booming and he was on the verge of expanding until he crunched the numbers.
If he doubled his work force he would then come into the sights of Chinese entrepreneurs. There was no way he could compete, for his costs would be so much greater - in particular health insurance for his employees.
Calvin Coolidge stated that the business of America is business. Old Cal may have been given to overstatement, but when American businesses are unable to compete with the rest of the world, then we all have a problem – particularly in this current economic downturn.
The US always emerges from a recession a somewhat different country. There have been four major downturns since I first began zooming down Route 80 to gigs throughout the Mid-West. It’s getting harder to remember a time when the boarded-up factories of Cleveland, Toledo and Detroit provided decent living wages to thousands of blue and white-collar workers.
Those jobs will not be coming back. The question is what, if anything, will replace them? Are we doomed to sink into a service economy of part-time workers with little or no benefits? Or will the US rebound leaner and meaner with entrepreneurs creating meaningful well-paid jobs in new industries?
Given my industrialist friend’s decision and the seeming unwillingness of our politicians to grasp the nettle of ever-escalating health insurance costs, you tell me.
A single-payer system is not even up for debate at the moment despite its obvious economic merits. As ever there’s a systemic reluctance to face the reality that if we continue with the status quo, costs will continue to escalate and more people will lose their coverage.
And yet with the Dr. No attitude of the majority of the Republican Party, combined with the reluctance of many Democrats to embrace a government sponsored public alternative to private health insurers, that’s what we’re facing. And this time we won’t have a Hillary to blame.
Given their past records - and without a strong viable public alternative “to keep them honest,” - there is little chance private health insurance companies will keep their premiums anywhere in line with inflation.
But over and over we hear the tired old refrain, “keep the government out of medicine.” And even the ridiculous, “don’t let Washington take over my Medicare.”
Perhaps, it’s time for a national “turn your TV off week” so that people can actually look at the facts and figures without being bamboozled by talking heads vying for ratings, and other vested interests.
Meanwhile the “S” word is back with a bang, though some of the best managed and most respected institutions in the US are “socialized” and run by the government – Medicare, Veterans Administration, and the Armed Services, to name but a few.
The current proposed changes to health insurance are mere fingers in a leaky dam. By the time congressional compromises have been made and chits called in, they will be anemic at best.
Still, if they include a public government-backed alternative to the private health insurers, some meaningful competition will be provided thereby saving us from drowning in a sea of rising costs.
The proposed changes, unfortunately, will do little to help our businesses become competitive with the rest of the industrialized world.
But at least we’ll have made a symbolic start and the vast majority of Americans will for the first time be covered. From these small essential beginnings, perhaps we can reassure ourselves that it is possible to work together towards really improving the social and economic fabric of the country, and not run for cover every time the “S” word is employed as a diversion.
Then with time and the eventual introduction of a single payer system, we can all take responsibility for our own health insurance, and eventually even our own health.

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