Health Care: victims of our own framing

Story:
There is a strong push now to extend health care coverage to the 47 million people in this country who are uninsured. This is certainly with our fundamental frames of empathy and respect for human dignity. In our country which can afford it, adequate health care should be a fundamental human right. This should be the true meaning of "right to life". (Would it be possible for progressives to retake that frame?)

But what I see happening is that progressives are being co-opted on this issue. Mitt Romney in Massachusetts enacted the skeleton of a state health care program which requires all citizens to obtain health coverage through an insurance company. Those who cannot afford the cost are to be subsidized by state taxes. Thus health care becomes a form of welfare, not a human right. This is really just a subsidy for the insurance industry. Businesses will be encouraged to jettison health care coverage for their employees. It will create new layers of bureaucracy to decide if the poor are really deserving of a subsidy, to make sure everyone has obtained insurance and to police the insurance industry. The theory behind insurance is to pool the risk, to smooth out the cost fluctuations and make the cost more predictable. Eighty percent of insured people pay in much more than they get out. As voters, they will object to their taxes going to other peoples' health care and they will cut health coverage to the bare minimum. This will discredit the whole notion of public health care.

Insuring the uninsured is only part of the problem. We also have to bring down the cost of medicaL care. Our country spends almost twice as much (as a percent of GNP) as other industrialized countries, and yet we have poorer outcomes. We need to frame this as a way to bring down costs for business and corporations, so they can compete effectively in the world of globalization and so that General Motors won't be bankrupted by their commitments to their retirees. Unfortunately, in this country, progressive initiatives don't win unless a substantial portion of the corporate world are on our side. our options on how to proceed are:

Expand American Socialized Medicine. This is where the Doctors and Nurses and other health care workers are employees of the government. This includes the Veteran's Administration and Veteran's hospitals, public University hospitals the National Institutes of Health and the CDC. This is the most efficient and highest quality health care available in this country (on a mass basis). This is where most of the innovation in medical treatment and drug research is done. (If you look into it, you will find that most of the "research" done by drug companies is market research.) If our socialized medicine infrastructure were mandated to find ways to bring down the cost of medical care, we could lead the world in bringing affordable medicine to every person.

Expand American Single Payer System. This is where the government insures everybody. The example of course is Medicare. Because of the scale and because they are not trying to weed out preexisting conditions, administrative costs for Medicare are between 1% and 2% instead of the 20% typical of insurance companies. Also scale gives Medicare the power to contain costs. And it could be mandated to carry out effective public preventive care programs. Right now, we should be lobbying to extend Medicare to all children under the age of 18 (or 21). This is cheap and a Trojan Horse initiative because ten years from now they will be voters wondering why medicare doesn't cover everybody.

The Romney-Schwartzegger initiative is mostly a subsidy to insurance companies. It is a "free market" program designed to co-opt us bleeding heart liberals by providing insurance to the uninsured. But it is unsustainable, because it does little to contain costs. And when it fails, it will discredit the idea of government provided healthcare, and we will all be at the mercy of Banana Republic medicine, for only the rich. Bernie Sanders is wrong when he says let the States experiment, because the insurance industry will bully or bribe them into plans like this.

There are also the two ludicrous proposals by George Bush and CATA of "health savings accounts" (really a tax dodge for the rich) and his new idea to tax the middle class employer-provided plans to pay for insurance for the poor. Non-starters.

Government provided health care, either socialized medicine or a single-payer program, should become a progressive "Strategic Initiative". Yes, it will provide medical care to the 47 million uninsured. But it will also help prevent autos, steel and airlines from going bankrupt from their medical obligations negotiated with their pensioners, it will relieve businesses of the health insurance burden for their employees, it will improve our position in world trade by cutting national medical cost probably in half. With preventive care, we can we can greatly improve the health and well being of all Americans. With enhanced public medical research (genetic, stem-cell, drugs, improved efficiency), America can sell affordable medical care to the world, providing jobs here. For progressives, this would invalidate conservative claims about government inefficiency and the universal benefits of private enterprise, and would make enactment of regulation easier.

It is very important that we bleeding heart liberals are not taken in by the corporatist solution to the problem of the uninsured, seen as a serious moral problem only by "nurturant parents". We must make universal health care a strategic initiative to split the business community to get enough political power to enact a really rational government health care program.