16 May 2008

Reform: it's about economics

After a panel discussion on healthcare, a Denver business leader told me that his group, which pushes subsidization of healthcare and private insurance expansion, cares more about the economics, whereas single-payer supporters are so about expanding access.

I thought about what I had said, and reassessed my talking points. Most of them were about the economics. He didn't hear that, though. For many mainstream business people, universal healthcare is about access -- like Food Stamps are about access to food. Very nice, of course you don't want people starving in the streets of Cleveland or dying outside hospitals in Muskogee, but he's hearing bleeding heart do-gooder while I'm talking economics.

In the same vein, Ezra Klein writes that he doesn't make that point often enough: "Health reform, which is what we mainly talk about, is about economic security more than it's about health improvement. It's about ensuring people don't go bankrupt when they need care, and ensuring the country doesn't go bankrupt in 30 years beneath the burden of health costs."

Klein goes on to write that the real gains we'll make in health improvement will be due to public health gains. I'd add that a lot of our losses in recent decades have been because of a lack of investment in public health and a willful refusal to acknowledge the damages we've done to our environment through industrialization.

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