Health Care For All

Socialism refers to “an economic system in which the production and distribution of goods are controlled substantially by the government rather than by private enterprise, and in which cooperation rather than competition guides economic activity.” (dictionary.com) 

If a country decides that public education is an entitlement and all of its citizens should have access to it, then collects taxes to provide those services, is that an example of socialism?  Not by the definition above, or any other I have found.  And if you substitute health care for education in the above sentence, does that make it socialism?

More to the point, whether you think the government does a good job or a bad job of providing public education (and I will concede that you could be right either way, depending on where you live), I doubt you would want to eliminate it anywhere in America.  So why do we fundamentally believe that every child is entitled to an education, but every citizen is not entitled to health care? 

Today’s AP news reports “White House appears ready to drop public option.”  My reaction: “ Please don’t.”  Like many who have thought it through, I believe that without a public option, we won’t really have health care reform.  Furthermore, I believe that it comes down to a simple choice: do we care about the future of the health care companies or the health of the people? 

Again let’s look at the public school system.  If we did not have a public option, there would no doubt be plenty of entrepreneurs ready to offer schools to meet all sorts of different needs.  But without question, some families would not be able to afford any of them, while others would pay for the cream of the crop.  With a public option, there are fewer entrepreneurs making money from education, but just enough to meet the needs of those who can afford to and choose to pay extra for what they consider better.  I suspect that health care would be the same.  The choice would be the same for consumers, take what the government offers for free or pay extra for more options.  After all, that is exactly what those with Medicare have now.  Lots of private insurers offer supplemental benefits which Medicare recipients can add to their basic plan, but no one goes without. 

There is no question, however, that providing a public option means less business for the existing health care providers.  That is why they are spending so much money to defeat it.  So what do we owe them?  Lately our government has been spending a lot of money to keep big businesses in business.  Where do the big health insurers fit in?  

The answer to that question came to me when I noticed that my neighborhood video store had gone out of business.  I thought about the fact that only a few years ago video stores were on every block; now there are very few left.  Before DVRs and Netflix and Pay-per-view at home, video stores were very profitable for the clever entrepreneurs who thought to go into that business, but no longer.  The smart folks who profited from the sale of VCRs and video rentals and such have either moved on to a new enterprise, are retired on their profits, or are bemoaning their fate.  But time marches on in a capitalist economy. 

Now you could say we have not let that happen to the big banks, or the big auto companies, so why the health care companies?  And I would say that it is happening to banks and auto companies, many of which are going out of business daily.  And five years from now you will not recognize the banking system or the auto companies left standing.  Unfortunately, a huge percentage of our unregulated capitalistic society was sitting on the shoulders of a few big banks and big auto companies, and letting them go under all at once threatened to take the whole country with them.  So wisdom had it that, like it or not, we had no choice but to prop them up while the companies rebuilt their foundations (kind of like a remodel).  

Not so the health insurers.  While hopefully the public system will be more efficient than the private insurers (the Medicare system, with its lack of profit and large-scale purchasing ability is far more cost-effective than private insurance), we will be insuring more people, and thus the number of jobs in the field should at least stay the same.  So the economy will not collapse if we acknowledge that the nation’s health care system has outlived its usefulness. 

Now other people say, if we have a public option, private health insurers will go out of business and people will have no option for health care services.  But under the French system, which offers both a public and a private option, about 75% of people have only the public option, while 25% choose a supplemental or optional private insurer.  This sounds a lot like our public school system which has not eliminated choice for those who want to attend a private school, while Medicare has opened wide a market for supplemental insurance companies. 

So why not a public option?  Because the insurance companies don’t want it? 

Please, President Obama, don’t give in.