Friday, July 9, 2010

Death Panels--Again

Nearly every other industrialized country recognizes health care as a human right, whose costs and benefits are shared among all citizens. But in the United States, health care is treated as a commodity that is purchased, in one way or another, by those who can afford it. Conservatives embrace this notion as the perfect expression of the all-powerful market; though they make a great show of recoiling from the term, in practice they are endorsing rationing on the basis of wealth.

The public option for universal coverage was the one provision that addressed the cancer of the system: private insurance. When the whole system is designed so that private insurance companies can make as much money as possible, the incentives are always going to be wrong. Since they have a permanent incentive to lower costs by denying care and increase profits by charging more for premiums, they will always find a way around the regulations and reforms. And they have an army of lawyers and lobbyists to help them do so--and a whole department full of public relation operatives to sell their right to do so to the citizenry.

In a country that already spends more than 16 percent of each GDP dollar on health care (PDF), it's easy to see why so many people believe there's simply not enough of it to go around. The US spends 134 percent more than the median of the world's most developed nations, but we get less for our money—fewer physician visits and hospital days per capita, for example—than our counterparts in countries like Germany, Canada, and Australia. (We do, however, have more MRI machines and more cesarean sections!)

Where does the money go? By most estimates, administration and insurance profits alone eat upward from 30 percent of our total health care bill (and most of that is in the private sector—Medicare's overhead is around 2 percent). In other words, we don't have too little to go around—we overpay for what we get, and we don't allocate our spending where it does us the most good.

But in the absence of any serious challenge to the health-care-as-commodity system, we are doomed to a battlefield scenario where Americans must fight to secure their share of a "scarce" resource in a life-and-death struggle that pits the rich against the poor, the insured against the uninsured—and increasingly, the young against the old.

Rep. John Conyers fought for universal health care throughout the Bush II administration. But when it came time to legislate, his bill was passed over for the current behemoth crafted by lobbyists. On 10 March 2010, Rep. Alan Grayson introduced a bill (H.R. 4789) which would give the option to buy into Medicare to every citizen of the United States.

There are answers out there. The solution is available. Medicare for All!

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