Universal Health Care

In regard to health care, I feel that we need to create a universal health care system run by the Federal Government along the lines of Social Security (SS) and Medicare. I see few if any advantages to something else. Especially, not an impossibly convoluted bill being considered presently in Congress. We can do it now, which is highly unlikely, or we can do it later when we come to realize what a mess we’ve made of what could be a relatively simple system.

A very basic universal health care program would offer coverage to everyone and be paid into by everyone. The insurance pool and premium base would be the whole nation which allows for true shared risk and reasonable cost. To keep costs down further, a basic system could be created with something like a $500 deductible per person per year and co-payment for insured of 20% up to a maximum of $5000 out of pocket and then full catastrophic coverage beyond that. Those over 65, on disability, or with a chronic disease could be eligible for a tax credit on their co-pay. I would imagine that the poor would need to be given tax credit or assistance to pay premiums they could not afford. Everyone wanting additional coverage could go out on the open market and buy it and/or employers could offer it as a fringe benefit. The basic plan would:
1. eliminate denying coverage for pre-existing condition
2. automatically provide portability
3. involve government negotiating for “fair” pharmaceutical costs
4. identify a fair price for medical procedures
5. not allow dropping of coverage and allow no upper limit on coverage.

The private sector has had well over ¾ of a century to develop a plan to give people in our country a fair and equitable system. But, the system is giving progressively worse coverage at unreasonable increases in cost – we pay more than any other developed nation in the world with health care results that are pretty paltry compared to our relative wealth. I think we should begrudgingly admit there are some things that the private sector just cannot do as well as the government and health care may be one of these. We need a system that allows for basic universal coverage and protects us from economic destitution resulting from poor health.

Would the system be socialistic in nature? Yes it would, just as many other government programs are, like SS, Medicare, universal public education, fees (taxes) on fuel to build roads, farm program with its subsidies, Medicaid and other welfare systems, corporate welfare programs, national park system, etc. At some point we are going to have to get away from the idea that government can’t do anything right and/or that the private sector can do everything better. Both are historically failed notions.

This anti-government ideology is promoted by wealthy conservatives who are comfortable with their privileged position in society and their desire to maintain the status quo; and better yet, add to their advantages. It is seldom mentioned, but they are often recipients of significant special assistance from the government. They have learned that time and money carefully spent catering to public officials pays substantial dividends. Plus, we have learned the hard way that the controls of competition, costs of labor, and supply and demand that are supposed to naturally manage the free-market system to keep things fair and equitable can be too easily circumvented. We are not a nation of small farmers, tradesmen, artisans, and small manufacturers which is what the capitalistic, free-market system was designed for by the founder Adam Smith when he wrote the book the Wealth of Nations.

I prefer that the capitalistic, free-market system be left in place as much as possible to do its magic in allowing everyone to pursue their own productive interests. Some choose to take risk to satisfy their entrepreneurial itch. When they succeed, certainly not a guarantee, they deserve the “fruits of their labor.” Others choose a safer course of selling their gifts of labor to the highest bidder. And, competitive supply and demand should dictate the price of products and services. The capitalistic, free-market system is a thing of beauty when it works this way. But, when it is manipulated in a multitude of clever ways that result in abuse, rewards greed, ignores dishonesty, allows unfair profit taking, and encourages inappropriate risk taking with other people’s money, the government is the only vehicle we have that is powerful enough to insure that the playing field is kept just and fair. In a few selected cases, I think government involvement is the only way we can maintain a vibrant classless society assuring everyone the free choice to take their own “run” at being a productive part of our economy. Health care costs and coverage should not be a barrier to this goal.