On universal healthcare’s sustainability
Hilker and SDS posted a quote from Thomas Sowell that argued that Universal Health Care was, in essence, impossibly expensive. Though I can’t know their hearts, I think they acknowledge a religious duty to care for the least fortunate and are aware that this duty should transcend partisan affiliation. Thus for Hilker and SDS (if I’m not mistaken) might oppose universal coverage if they believed that 1) it won’t actually succeed or 2) we have a better way to accomplish the same goal. Unfortunately, it’s become more and more clear that we don’t actually have a better way to accomplish the goal of caring for the sick among us. So the question becomes whether universal health care is possible. So I wrote,
“Check out this argument. It’s not that universal healthcare is a bad thing. It’s not even that it’s not worth paying for. It’s that it’s impossible. Universal Health Care (or something like it) would be a great thing. And, if we actually believe a lot of those things we say we believe about caring for the least among us, it’s probably morally required. But, if we can convince ourselves it’s impossible, we don’t have to worry about it. Except that it isn’t impossible. The U.K. can do it. Canada can do it. Universal health care does not reduce a country to some kind of Soviet Bloc police state. Massachusetts has managed it. It’s not easy. And it’s almost certain to be difficult. But we can do it.”
Check out this argument. It cites other programs as evidence that universal health care works. Thing is, these other programs aren’t actually “doing it.” Their programs are unsustainable, both from a quality care standpoint as well as an economic one.
These “universal” programs are only universal in that everyone pays for them. Not everyone benefits the same. Universal coverage is theoretical. Delays in treatment are abundant. Thousands of people die because they do not receive the care they were promised under this banner of health care for all. [Something about letting your yes be yes…] They are paying for (and counting on) coverage they aren’t getting. What’s moral about forcing someone into that situation?
And yes, there’s the economics of it, which doesn’t seem to be a big deal. The Massachusetts, Maine, & Tennessee programs have all failed to live up to the hype: they are enrolling nowhere near promised levels, costs for everyone are going up, and budgets are “more what you’d call ‘guidelines’ than actual rules. [Welcome aboard the Black Pearl!]”
That’s a nice segue into the rest of the quoted quote, the part about inevitable, unforeseen consequences. But then, I’ve always thought that universal health care is more about the short-term benefits of telling people they have health care than the long-term benefits of actually taking care of them.
SDS added, “Exactly.”
It shouldn’t surprise anybody that large programs have had budget difficulties lately. The recession has made things very difficult for a lot of states and a lot of countries. Education is getting squeezed. Some cities are laying of police or firefighters. Revenue is simply down. Public entities are hurting. Private businesses are folding. Finding a budget difficulty this year is about as difficult as finding wind in a hurricane. Massachusetts has a budget gap this year—but it’s not caused primarily by the health care law. And, most importantly, there’s no serious consideration of eliminating it. If the program is over budget, it’s because its need was underestimated.
Are delays in treatment abundant? Sure. Just as they are now. Are people dying due to the inaccessibility or delay of quality medical care? In some cases—though not in anywhere near the numbers they are now. But, as a general rule, the universal programs work pretty well. They manage to deliver a comparable or superior level of care to what we do—but they do it on a much smaller budget. If they were willing to spend the kind of money we spend, we could do a lot better.
Will there be problems in implementation? There are always problems in implementation. Would adding twenty million people to our medical system strain it? Sure, briefly. Fortunately, we have the capacity to build new hospitals or train new doctors. And since the current proposals take so long to go fully into effect, I suspect the transition could go pretty smoothly.
Do you really think Massachusetts program isn’t getting the anticipated number of people? It’s rate of uninsured is 3%. The house bill promises to cover all but 4%. That’s a pretty impressive number.
But let’s put all this in perspective. Currently, tens of thousands of people are dying every year for lack of health insurance. We could virtually eliminate all of these deaths—and dramatically improve the quality of life for millions more—at an annual cost of roughly 15% of what we’re spending on the military. If you’re looking for a downside, you’ll always be able to find one. But at this point, I think much of the opposition to universal health care is simply an unwillingness to concede a past error.
