A Quandry

A Quandry

October 3, 2014

If there was a part of the US government which could be re-engineered such as to save perhaps $1 Trillion, one would think the Right would be aggressively pursuing it. And, if such a different process had been proven over the years, elsewhere, shown to deliver such savings consistently, along with quality–wouldn’t that seem to be a no-brainer for all, but especially for Conservatives, at the top of whose list is reducing cost?

I’ve been wondering…if Conservatives hate the current health plan (“Obamacare”) so much, why (to my knowledge) has no one on that side of the table offered an alternative?

The November edition of “Consumer Reports” has an article on health care. They point out that our $3 trillion in health care spending costs the US economy about twice as much as in the rest of the world. I imagine every member of our Congress understands this undisputed fact. Of course, this taken alone, gives good reason to complain from both the Right and the Left. It’s outrageous.

There is a good alternative:  What is also widely known is that the substantially less expensive systems in other countries are single payer systems.  This is where the government pays for health care–as in England (9% of GDP), or in Singapore (5% of GDP). I lived in England recently for a year as a student and enjoyed their excellent health care system. Our system costs us 18% of GDP.  No need to go on about what could be done with the savings of 9% or 13% of our $17 Trillion US GDP….schools, infrastructure, debt reduction, and on.

But the Conservatives are caught in a trap. They hate government, arguing that the private sector is a better solution for most everything except defense. It used to be that they also accepted education as a public sector responsibility, but Paul Ryan’s recent document intended to deal with our growing inequality urges vouchers as the solution for education–another attempt to reduce government and let the free market meet most of our needs.

But, education is only one of the critical areas in which  the free market is not meeting our needs–areas which have historically been better served by government.  Another example is housing for the underprivileged. State and federal resources have been largely withdrawn, and we’re experiencing record shortages of affordable housing. Research and development of large opportunities too expensive and risky for the private sector, such as fusion, have not been funded.  Infrastructure in the US is falling far behind that of other countries–roads, bridges, airports are tired and worn. I believe these are the things we should all use our government to do well, and work together to make government effective in these areas, rather than simply forcing them onto a private sector, a private sector which serves many of our needs extremely well, but is not suited to meeting these particular fundamental and critical needs.

So, it must be painful for the Conservatives. If they really want to save the waste occurring in health care, they need to offer up a single payer system in health care. What a fantastic opportunity for the Republican party to support a clear and proven solution to our health care at perhaps half the cost. With the savings, we could significantly reduce the debt without raising taxes!

But…that would involve making effective use of government!  It would involve eliminating a costly private health care insurance industry.  What a quandry! Finding a way to substantially reduce cost in a private health care system leaves Conservatives unable to offer up anything compelling. I guess reducing government trumps saving money.

When I expressed puzzlement over how we evolved to this crisis in health care costs, a friend who is a health care professional explained it to me in simple terms. Coming out of WWII, European governments were not so opposed to anything seemingly of a socialist nature, desperately recognizing the need to use government to help repair destroyed economies. The US, by contrast, emerged from the War with a strong economy, a highly individualistic ethos, and an abhorrence to anything even remotely resembling socialism.

And, this costly obsession has only strengthened, particularly since 1980.

I argue that the current health care system is better than what we had. And I acknowledge, as has our President, that it most certainly can be improved, such as to better meet its objectives, including reducing costs to some degree–something which needs the ideas, engagement, and support of both sides of Congress to effect.

So, there may be other good alternatives not yet proposed by conservatives who are reluctant to have their proposals subjected to opposing scrutiny, but the big fix, the big savings, is in developing our own American single payer system.

I welcome your comments

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