Tuesday, February 26, 2008


Half-measures for Universal Health Care

It has been written of President Franklin D. Roosevelt that he would first decide what he wanted to do or accomplish. Having decided that, he would then see how close he could come to accomplishing it. He was lauded for following the course of a realistic and practical politician.

There's another side to this approach to governing. If you can not achieve all of what you want to achieve, is it worth while working on something that achieves only a part of what you want? I apply this question to the health plans promoted by several Democratic and Republican politicians: Clinton, Schwarzenegger, Nunez, Romney, and others. These plans all amount to an effort to fix or improve our existing system of providing health care to Americans. Although the supporters of these plans are sincere in wanting to do something to improve a poorly functioning system, I think they are like applying band-aids to a severely injured individual who needs surgery to stop internal bleeding.

The essence of the Clinton-Schwarzenegger-Romney plan is to require all employers (of more than just a few employees) to provide subsidized health insurance for their employees. If an employer wishes, he can instead pay money to the State which will be used to subsidize health insurance to those individuals who are not covered by an employer. There are differences among them as to how much the non-insuring employers should pay, whether all persons are to be required to purchase insurance, and what coverage the insurers are required to provide. Basically, they are all attempts to make a system, originally designed by some employers to attract skilled and expensive workers, provide affordable health care for everyone. These plans are attempts to make a system which was never intended or designed to provide universal health care provide it.

In spite of my criticism, the C-S-R plan does amount to doing something. It won't provide universal health care. It may provide universal health insurance, which is not the same thing. Experience with private for-profit insurers shows that having insurance does not necessarily guarantee having adequate health and medical care. My question is, is it worth while doing?

One can argue that enacting a plan that provides good medical and health care to every American is not politically possible at present. Too many people will argue against it with arguments about "big government," bureaucratic control of medical decisions, inefficiency of government, and the like. I argue that, in spite of the difficulties, our political leaders should try for a universal health plan and not an almost universal insurance plan. The President should be committed to it and should use his press conferences and other unique opportunities to speak to the American People to explain why a universal health provider plan is better than any insurance plan. And that means that we need a President who is committed to the idea of universal health care. The candidates among the Democrats who are committed to this goal have been discarded by the primary voters. There is no hope, in this generation at least, that a Republican candidate would be so committed.

Perhaps, in the end, we will have to accept, for the time being, a half-measure or a band-aid. Winston Churchill once observed that the "American People will always to the right thing, but only after trying all the alternatives."

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