Thursday, July 9, 2009

The Market Has Failed!

It is with great frustration that I listen to the health care debate, and that the Democrats allow the Republicans to control the terms of the debate without salient, charged rebuttal.

In particular, there is the accusation that any government plan would ration health care. This may be a legitimate concern for people who can afford to buy anything they want, already, if they are afraid that they might be prevented from paying for their extra services. Which seems absurd. But Health care is being rationed now, for the middle and lower class, in at least two ways. First, many people have no care at all, or the care they get is at emergency rooms, which does not provide a full spectrum of care. Second, even those who have health care insurance do not have the security of knowing that their care is guaranteed. Each plan, to start with, is limited in the procedures it will allow, and then, insurance companies may refuse to pay for catastrophic care, for opaque, unpredictable reasons. The patch work of health care provision now available to Americans amounts to being the most rationed system in the industrial world. A public system which does not exclude anyone (Universality), which provides a reasonable and standardized package of services(Completeness), and does not refuse payments capriciously (security), would be less rationed than the current system.

There is also the charge that a government sponsored option would cost the taxpayers, and drain customers away from the existing system. But taxpayers are consumers and consumers of health care services - even those who do not need many - are already paying heavily for services. Why is our system the most expensive in the industrial world, with the lowest quality output? When Republicans charge that the system would cost too much, Democrats must answer, loudly, that the system costs too much NOW, and that when the cost to the private sector is added to the cost to the public sector, the overall cost of health care may be slightly more, and possibly even less, but ALL Americans will have health insurance! This will result in a dramatic improvement in the health of the American workforce and therefore the efficiency of the economy.
And the competition provided by the public program will drive costs down. (Of course if you want efficiency, you need a single-payer system.)

This, for many Republicans, is a cause for complaint. They say, "Competition by the government is unfair". I say "The market has had a chance to prove it can provide services efficiently. It cannot. It is extremely expensive [is not EFFICIENT], it is extremely discriminatory of both persons and services [is
neither UNIVERSAL to persons, nor offering a COMPLETE range of services], and it routinely denies care to those whom it does insure by refusing payment for particular services, or by un-enrolling them entirely, [enrollees have no SECURITY that payment will be made or that they will remain insured], nor does the market provide reasonably-priced insurance THROUGHOUT LIFE. That the market cannot guarantee Efficient, Universal, Complete and Secure health Care services Throughout Life, is dangerous for both citizens and the nation. The Market has failed. The time has come for market advocates to get out of the way and to let the people, through their public institutions, create a system of their own.

The system currently under consideration is not the most efficient possible, nor will it provide Efficient, Universal, Complete and Secure Care Throughout Life [EUCS-CTL]. Trying to get to an EUCS-CTL system via this plan is like trying to get fire wood by splitting knots. It will be painful and difficult, and compromises to meet Republicans half way will result in a system that is everything the Republicans are worried it will be: Expensive and Cumbersome. In effect, a perfect whipping horse. But we have a chance if we meet their arguments with effective salient rhetoric of our own:
1) Health care is being rationed now and a public plan would be would be less rationed than the current system.
2) When the cost of health care to both private and public sectors are added, the new system will not burden the economy more than the current system, and ALL Americans will have health insurance!
3) The Market has failed. The time has come to let the people stand up their own health care system.


I am sure that Democrats generally understand these issues, but I have not heard the vigorous rebuttals to Republican arguments that success in this debate follows. We truly need to answer them. THE MARKET HAS FAILED! COUNT THE WAYS! WE NEED A HEALTH CARE SYSTEM FOR PEOPLE, NOT PROFITS!

No comments: