Tuesday, April 04, 2006

The Government Must Be Involved in Health Care Reform

That was quick. Conservative commentators are jumping all over the Wisconsin Health Plan, which was proposed on March 21 in the form of a legislative bill (AB 1140) by Rep. Jon Richards (D-Milwaukee) and Rep. Curt Gielow (R-Mequon).

These conservative voices are writing off the WHP as “socialized medicine.”

Some (see here and here) have even lamented the fact that the plan would mandate health coverage for virtually all Wisconsin residents under the age of 65. How dare they!

This is unbelievable. Well, maybe not unbelievable, but at the very least it’s troubling.

The authors of this plan have a done an excellent job balancing the need to provide basic health care services to all citizens with the dominant marketplace ideology of competition. I have written before that this marketplace ideology compromises the plan by not allowing it to significantly reduce overall cost, but nevertheless the plan should not be merely rejected by tagging it with an inflammatory (and inaccurate) label.

A long time ago in this country, health care benefits were linked to employment rather than citizenship. We’re the only industrialized nation in the world to have such a system for health care benefits, but, for better or for worse, that’s the system we have.

A big problem with linking health care benefits to employment is that as health care costs have been increasing in recent years, employers no longer want to provide health insurance to their employees.

The WHP both transforms and reinforces this employment-based system by granting health care coverage based on citizenship while linking funding to an assessment on employers and employees. In this sense, the WHP centralizes and expands our current system. The hope is that by centralizing, the overall cost of the system will decrease.

I’m skeptical of the claim that costs will go down under the WHP, but that’s only because the competitive marketplace ideology of the business community refuses to allow for a plan that would alter our multiple-payer health insurance system—which is the predominant cause of the increased health care costs. Countries that feature a single-payer system in some form--either exclusively like in Canada and the UK or as part of a dual system like in France--pay less for health care while still getting more of it, as this table clearly demonstrates.

The conservative commentators who reject the WHP as “socialized medicine” appear to be more concerned with avoiding anything that resembles an expansion of government services than they are with avoiding the rising number of uninsured (including an increasing number of employed people) and the rapidly skyrocketing costs of health care.

I can only imagine how conservatives would react to a plan that would not only centralize the payers but also reduce the overall number of payers, which is the only way to viably decrease costs.

I guess it’s just a matter of where you put your priorities.

I was glad to see Rick at “Shark and Shepherd” provide some sanity from the conservative side of the blogosphere on this issue. He points out that health care for all is in the best interest of the marketplace by taking health care out of the concerns people might have about starting up a business and also out of the concerns of more established businesses that are faced with an older workforce.

This is also true for government. The same conservatives who flatly reject the WHP also criticize the cost of the health plans enjoyed by government employees, claiming that these employees should simply pay more for their health care expenses.

But as the business world is making clear, simply making employees pay for a larger portion of their health care doesn't do anything for the overall issue of rising costs. After all, employees aren’t in any better of a financial position to deal with the rising costs of health care than employers.

Why wouldn’t we want a system that reduces the cost of health care for all employers (including government) and for all employees?

The only way we’re going to be able to do reduce overall costs is by reducing the number of payers in the system. The only viable way to do this is to get the government involved.

So what’s it going to be, watch health care costs skyrocket beyond what anyone can afford, employer or employee, or allow the government to step in and reduce those costs?


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