04 June 2009

Lincoln was for govt-financed health care


James Nowlan, a Republican at the University of Chicago, has a column in today's Chicago Tribune. It's notable both for what it says and what it doesn't say.
"Abraham Lincoln declared that government should do only that which the people cannot do so well for themselves -- defense, highways, public safety, education. And government has done a good job of fulfilling this compact with the public. In recent decades, we have been adding health care to the compact, in increments: first the elderly with Medicare, then the poor, and more recently, children, both through Medicaid. If you're not in one of these categories, you scramble for health care. Everyone in my rural area hustles to find the shelter of health-care coverage. Farmers' wives take jobs at the school in town -- for health coverage for the family. Whenever a job change is contemplated, the biggest question is: 'Will there be benefits [health coverage]?'"
Nowlan addresses the irreconcilable tension between Americans believing that their taxes are too high and at the same time believing that the government should make sure everyone has health care.

Then, as if he can't quite help himself, he points out that Medicaid and Medicare are the biggest chunk of government expenditures on health care - something that is misleading because it doesn't note the other government expenditures on health care, such as the tax breaks for companies that provide health insurance and the cost of paying for private insurance for all municipal, county, state, and federal workers, including the military.

He notes that the cost of Medicare and Medicaid have gone up 7 percent a year, "far outstripping inflation," without noting that the rate of increase of private insurance puts Medicare and Medicaid increases in the dust.

Even so, the quote from Lincoln was nice. The experience of other industrialized democracies fairly proves that government does a better job of managing health care financing than does the private sector. (If, of course, you factor in health of the population as being at all important. If you're willing to write off a substantial portion of your work force - the Darwinian cost of doing business - then our system clearly is more profitable and therefore better, capitalistically speaking.)

Then again the right has so vilified the competence of the American government that it's possible that people think that whereas the Swedish or German or Taiwanese government can competently manage health care financing, our own government cannot.

The question then becomes "Why does the right wing hate America?"

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