Health Care Debate:
Though I lean toward the progressives in wanting universal health care, no precondition exclusions, and even a Single Payer system, I recognize the complexities in funding, administrating, organizing and executing such a system. It seems to me that most western countries handle this with a simple concept: all people should have access to essentially "free" health care. No one misunderstands that this is paid for by taxes. We rank 37th, according to a 2000 survey, maybe lower now, in quality and availability of health care, but we have excellent medical services. But, of course, we avail ourselves of this fine service only if we can pay for it. So health care in America is not free, and there is no sentiment to make it a "right", vs a commodity. Consequently the horror stories abound of people being denied insurance coverage, bankruptcies, and sometimes death- deaths and tragedies that could have been avoided with universal coverage.
My understanding is that the AMA backs reform, maybe even Single Payer, but not "government run" health care. This is based on the assumption and conventional wisdom that the government will be wasteful, inefficient, unresponsive and insensitive to patients true needs- maybe even usurping a doctor's advice in order to fit some pre-etermined method of treatment. Well, for most of us, that is the system we now have, except we have no recourse but through appeal letters and I suppose litigation, if we are still alive and can afford it, in the event of a dispute.
It seems logical to me, to cut to the chase so to speak, that we use the entire population as a base and insure everyone. It would be interesting to see how the arithmetic works out. If health care is costing $12,000 a year now for most individuals, (I'm assuming no deductibles here), what would it cost if everyone was in the pool? The basic actuarial insurance tables ,I suspect, with everyone in the risk pool, would spread the costs considerably. Of course this is how western countries do it: a tax (or premium) on everyone to cover those that really need it- a true insurance model, since we are all at risk.
Even though western countries struggle with their own budgetary problems in meeting the needs of their citizens under their "free" health care programs, those systems do in fact work. Poor economic conditions as we are experiencing now exacerbate the problem of lack of tax dollars, but this is a temporary situation. Things will get better, funds for health care will be more available. But the bottom line is they are able to fund their universal health care systems through a tax system, similar to the way we fund Medicare, and most tax systems are not anymore burdensome than our own.
Here's the difference: no western countries, eastern, northern or southern ones, either, have taxpayers bearing the burden of the largest Defense budget the world has ever seen. This extra trillion dollars or so, ( including all defense and security related expenditures), is the money we could put toward "free" health care. Of course no one is going to get rid of the Defense Department. But without addressing this elephant in the room, we can not fund any kind of meaningful health care reform. During the 90s we were beginning to get a handle on military spending: Donald Rumsfeld was addressing the problem on September 10th, 2001. We have been sidetracked from this discussion since then and have waged wars, maybe unnecessarily. A reevaluation of our military spending, ten times larger than the next largest spender in the world, is in order. I think only by letting the air out of the bloated elephant in the room will we ever be able to discuss meaningful improvement in health care. There is simply no money to do it otherwise.