WHEN MITT ROMNEY was governor of Massachusetts, he implemented a state-wide healthcare overhaul that President Barack Obama used as a model for his own, federal healthcare reform bill. This was Romney’s signature achievement as governor, and it’s an impressive one. But because Republicans are in thrall to the notion of Government As Problem, poor Mitt has had to disown his own legislative baby, as it were.
From the gate, President Obama has allowed his opponents to frame this issue for him. He’s played defense ever since. Now that Romney has to pretend to hate the very good idea he originated—regarding it as a youthful indiscretion, like the time he had a sip of Dr. Pepper, instead of celebrating it, which would do much to make him seem less like a robot—Obama has a chance to seize control of the issue.
Listen up, David Axelrod—here are five arguments for universal health care the Democrats should be making:
1. It’s in the Constitution.
It is the job of the president, the Congress, and the Supreme Court to, above all, uphold the charges set forth in the Constitution, which begins thus:
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
Where is it written that “provide for the common defence” is limited solely to military engagement? Answer: it isn’t. That’s because the Founders, in their infinite and inviolable wisdom, recognized that domestic tranquility and general welfare might one day be threatened by a force more nefarious than an army of foreign humans.
Although the United States has plenty of enemies against whom we may one day have to make conventional war, the fact is, at this stage of our history, the greatest threat to our national security is a biological, rather than military, foe. An outbreak of smallpox, or some mutant strain of avian flu, is far more likely to wipe us out in mass numbers than a North Korean nuke. Did you see Contagion? That could totally happen.
When a candidate or Congressman says the healthcare system is just fine, thank you, that a single-payer option is socialist, what he’s really saying is, “I’m more interested in enriching my benefactors, the health insurance companies, than upholding the Constitution.”
2. It’s pro-business.
Our current healthcare system is bad for businesses large and small. It’s bad for doctors, it’s bad for patients. The only business it’s good for is the health insurance business. How the GOP, a party that presumes to be pro-business, could support it so staunchly and reflexively baffles the mind.
Founded on the odd mandate that employers should spring for health care, our current system puts a strangehold on small business, the lifeblood of American innovation and ingenuity. How many would-be entrepreneurs decide not to start up a new business because of concerns about health care expenses? How many existing small businesses are not hiring more workers because of concerns about health care expenses?
And it’s not just small companies. Our current healthcare system almost brought down General Motors, long considered the bluest of blue-chip American companies, and one of the biggest corporations in the country. GM’s near collapse (sidenote: Romney, the Bain Capitalist, would have let it die; Obama, flexing his mighty socialist muscles, saved the auto industry) was not the result of decreased demand for American automobiles. Rising health care costs are what came this close to killing Detroit.
One of the main reasons wages have been essentially flat since I left college in the mid-nineties is that any increase in employee compensation goes directly to covering increased healthcare premiums. Liberated from the shackles of the healthcare mandate, companies would be free to increase salaries and hire more employees. (Also, unwieldy unions, like the Teachers Union, would no longer have to trouble themselves with negotiating healthcare costs during collective bargaining—a win for everyone).
But why would we want that, when noted scholar Sarah Palin insists that universal coverage would bring about “death panels?”
3. It’s non-discriminatory.
This week, I found out that an old friend of mine, Melanie, is trapped in insurance hell because of her congenital heart defect, aortic coarctation. She thought the issue was corrected by surgery when she was five, but she recently discovered, to her horror, that this type of surgery has been found to not be as effective as originally thought. (That she found this out not from her doctor but on the internet, and then only after insurance carriers suddenly refused to give her coverage without any explanation, only underscores what a mess our healthcare “system” is). Through no fault of her own, Melanie—a healthy, health-conscious person—will wind up paying thousands of dollars out-of-pocket for the rest of her life.
I understand the actuarial reasons for an insurer to choose not to get involved with Melanie, or the thousands of Americans with corresponding medical histories who are similarly screwed. But how exactly is this fair? Aortic coarctation is something she was born with, in the same way that other people are born with dark skin. I don’t see how denying Melanie medical coverage because of a congenital heart condition is any different than denying, say, Zadie Smith medical coverage because she’s black (Zadie Smith, of course, is British, so she never has to worry about this crap).
4. For-profit health insurers operate at cross purposes.
Monthly premiums, co-payments, and deductibles are skyrocketing, which is bad for both individuals and their employers, who in some combination pay the bills. High student loans, ever higher malpractice insurance premiums, and the monopolistic “reasonable and customary” rules imposed by insurance companies mean that providers, too, are suffering. So if the patients are paying more, and the doctors are making less, where is all the money going? To the insurance companies. And therein lies the problem.
For-profit health insurers seek to cover only the relatively healthy, to minimize risk (ask Melanie); keep “reasonable and customary” costs as low as possible, to maximize profits; and require byzantine rules and regulations, to make collecting money—whether you’re a patient or provider—so frustrating that you give up. You can run a health insurance company to generate as much profit as possible, or you can run a health insurance company to provide the best care possible, for the most people, at the lowest cost. What you can’t do is both. Even if you say so on your prospectus.
(This inherent contradiction, incidentally, is unique to health insurance. Life insurance companies never have more than one claim per person, and the only way to beat the system—that is, to get the biggest payoff from the least investment—is to die immediately: not what you or the company want. Homeowners and automotive insurance are volitive; you can choose not to own a home or drive a car. But everybody gets sick sometimes).
Why would any thinking person support a system that is essentially Conflict of Interest, Inc.? (Anyone besides the Crown Prince of Conflict of Interest, Dick Cheney, that is.)
5. Government is the solution, not the problem.
You may be an eye doctor, Rand Paul, but you can’t see the truth. The only force big enough to combat the juggernaut that is the health insurance companies is the federal government. Period. In this fight, you’re either with the government (that is, the people) or the corporations (also people, if you think like Mitt).
The GOP, so quick to pay lip service to states rights, will soon have an opportunity to put their money—which is to say, federal money—where their mouth is. Rep. Jim McDermott (D-Wash.) will shortly introduce the State-Based Universal Healthcare Act to Congress. If passed, it would enable federal money to flow to states that create their own state-wide universal health care systems.
If When Republicans kill the bill, we’ll know for sure that they’re more concerned with pleasing their corporate overlords than helping people.
The countries of Europe and Canada have given us plenty of models for universal health care. Here’s another: a quasi-governmental system, modeled on the Fed, owned in part by member health insurers, overseen by a federal appointee, answerable to Congress. I’m sure there are others. (And if you ever find yourself arguing for the current system on the grounds that emergency rooms are prohibited by law from denying medical treatment, I shall direct you to my brother, who works in the ER, or any of his colleagues, who will explain how inefficient and dunderheaded that policy is).
We can find a solution, but only if both sides are willing to do so; the first step is admitting we have a problem. Obamacare—or Romneycare, if you will—is a step in the right direction, but not a solution to the larger issue: no one, individual or shareholder, should profit by denying medical help to the sick.
Interesting article, thank you! About point 2 – it has always disappointed me that that those opposing “Obamacare” can’t come up with better arguments (whether you personally endorse them or not) for their point that healthcare decisions would shift from the actuarial analyses of insurance companies to the government. And…this is the thing that never gets said…although insurance companies make actuarial decisions about their insureds’ likelihood of future claims, the patients have recourse if they don’t like their insurance company’s decision, with the ultimate resort being suing for millions. (I work on many of these cases a year, and it is rare for a jury to let an insurance company off the hook.) If the system changed to universal healthcare, those actuarial decisions will still have to be made. The government in some form would have to take it over. What sort of recourse would patients who claim to be harmed by the healthcare system have? I don’t know because nobody has asked and nobody talks about it. But I suspect that a lack of recourse for patients would be/will be an unintended consequence of universal health care.
Anyway, to the extent there would be “death panels” with the new healthcare, there are such panels in the healthcare situation we now have. They are just called something different: actuarial tables.
Thanks again – interesting article.
Thanks for the thoughtful comment. No promises on what the ultimate solution should be, but the current system is both not working, and costing more and more each year. If you’re walking in the wrong direction, the first thing you have to do is turn around.
The accident of fdiinng this post has brightened my day
Thx 4 that.
It is not just insurance companies making a killing financially, it is all the hospital suppliers and drug companies that make a fortune. Read TIME magazine’s recent article by Steven Brill. He is right on target. The system is horribly broken. I should know; I’m a physician.
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You state that “Government is the solution, not the problem.” Our you nutts????Our government spent over $600 million building a health care web site (that sucks) that Google could have built for $10 million. What makes you think they can efficiently run heath care?
The UK Government released statistics today stating that wait times for critical care in the government controlled health system are spiraling out of control. One example…the U.S. wait for routine check-ups was significantly less (20 days) than for sick Brits needing heart surgery (57 days), or Canadians with “probable cancer” of the gastrointestinal tract (26 days) or proven GI bleeding (71 days).
I own a business. I employ nearly 100 people. I provide health care for my staff. I can guarantee you that Government is NOT the solution.
Love this article – it’s truly a masterpiece and insightful, especially with all the personal remarks and anecdotes. But I really dislike the analogy of comparing a congenital heart disease, a deformity, to being born with dark skin, as if dark skin, in itself, is a deformity or disease. I understand the message you were trying to convey, though, but I really would suggest that if you were trying to strengthen your arguments further in this day in age, that you not compare a congenital heart disease to the completely valid and not in anyway deformed pigment of someone’s skin. Also, Europe is a continent, not a country. Love the article, anyhow – the points were incredibly strong.
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