03 January 2008

Mandates: Bad Solution

Good piece on Huffington Post from Larry Womack — he begins with a quote from Obama: "It would be extremely unfair to enact a mandate before we make health care affordable."

Here, in Womack's words, is the argument against mandates: "Seventy-six percent of these people [who filed for bankruptcy for medical reasons] had medical insurance. Many of those lost it when they became ill and therefore unable to work. For the rest, it just wasn't enough to cover the staggering costs of an out-of-control system of medicine. Researchers concluded that a national health insurance system could eliminate half of all bankruptcies, sparing about 2.2 million hard-working, bill-paying citizens from financial ruin every year."

Regarding the difference between Hillary's plan and Obama's: "They're both awful, and they're both a hell of a lot better than the big nothing we have now."

I don't know about that, but Womack's right about this:
It's been stated many times that virtually every essential public service is handled by the government, except health care. Rightly so, since it seems a rather absurd omission--the very purpose of government is, after all, to provide a basic level of safety. If you're mugged, beaten and set on fire, the government will hose you down and even punish the guy who did it. You're just on your own when it comes to those potentially-fatal burns....

As long as we allow them to, our leaders will offer us small solutions to big problems. Clinton got burned in 1993, and now makes no secret of the fact that she won't do anything until we've built "a national consensus." The US health care system has class IV hemorrhaging and our leaders are tossing us band-aids.
Womack links to a piece on mandates that ran in the Baltimore Sun the day after Christmas. Its writer, David Nitkin, goes to a Harvard health policy professor, Robert Blendon, who says that Switzerland and the Netherlands are the only two countries with anything like a mandate, and that their systems are quite different from those being proposed here.

Nitkin doesn't explain how they're different, nor does he point out that the Netherlands system is all of a year old, and, says David Himmelstein, the Swiss system isn't that much older.

I expect that the difference lies in the European systems being regulated to an extent that make them truly the counterparts of utilities — in it for public service, not profit.

Nitkin writes "Many voters, particularly Democrats, say the affordability and availability of health care is a top concern they want to see the next president address. But while voters tell pollsters that they want a presidential candidate who supports universal health care, far fewer say they want a Medicare-style government program that replaces private markets."

That may have been true 10 years ago, but no longer. Celinda Lake's survey numbers for the Hearndon Alliance show 67 percent of Americans in favor of expansion of health care — as Nitkin says, they want this addressed.

But nearly two-thirds of voters in an AP poll last week said explicitly that they favor an expanded Medicare for All. That is not "far fewer," as Nitkin claims.

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