26 October 2015

Universal Health Care Blues

I've seen recent reports about efforts in several states to enact Single Payer health care.

Universal health care, many Americans do not know, started in Canada a Saskatchewan provincial law (in 1946; primarily as a response to a shortage of doctors, although it's hardly a coincidence that the NHS in Britain dates from around the same time). Only later was it adopted by the nation as a whole.

America is a more difficult case, because the health insurance industry is so deeply entrenched in a for-profit high-marketing expense model, and is already regulated, for better or worse, heavily, on a Federal level (not particularly for the benefit of consumers, but it is regulated). This makes it really hard for states, especially smaller states, to institute truly universal health care for their own citizens.

What is clearly needed is to amend the ACA to allow more robust negotiation, especially with regard to pharmaceuticals, incentivize and later require health providers to be non-profit, and ditto insurance providers, and, most importantly, 1) enhance Medicare so that for its enrollees it is a true universal health care system, like Australia's or Taiwan's... AND.... 2) offer it, in addition to its current aged-and-disabled enrollee elibility class, as a premium-based PUBLIC OPTION to everyone, and FREE to children. This should be Bernie's (or Hillary's for that matter) plan, and, frankly, they should both publish model legislation and promise to do their damndest to get it passed in their first term.

Either concurrently or shortly afterwards, Medicaid could be converted to sliding scale subsidy program for low income people, to pay for the Public Option. Then we would have one form of public health care, which is available to everyone, although not necessarily free to everyone. The subsidies would have to go deep enough to truly guarantee that public option health care is a RIGHT of all citizens, not a privilege that only the wealthy can afford.

I would envision, down the road, that a VA-style public health network would be instituted as an option available to most people (depending on geography), which would provide advanced health care at the lowest possible cost within this system. 

As Dennis Kucinich used to frequently say, the profit motive and health care simply do not mix. 

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