As someone who really cares about this site and community, I believe that diarists like nyceve and others who write about the murder by spreadsheet practices in America are doing us and the world a great public service. It is shameful that the land that perfected free enterprise would be so unwilling to challenge a system that is at its heart cruel, uncompetitive and anti-growth.
The more that health insurance moves away from being a safety net in times of need and towards becoming more opaque and risky than a derivative market, the more that people stop believing in the simple idea that in America, if you work hard enough, you can give yourself a fighting chance to succeed.
The bottom line? Health care is, and will always be a moral issue, the equitable and cost effective provision of which is not a privilege but a right.
This is why I support a strong public plan, because once health care reform is passed, we can never go back to allowing insurance companies to play the awful role that they play in the lives of millions, off of the backs of decent people who want nothing more but to live without fear of the other shoe falling.
Having said that, I just want to caution people who believe that there is one form of health care provision that is equitable for all for all time.
There isn't.
The difficult truth is that any system is highly influenced by the society in which it exists. For example, no system is immune from a large elderly population, or by a large population of unhealthy and/or obese people. In addition, as societies grow larger, shortages of key personnel in certain areas can make providing reasonable and equitable medical care very difficult to provide.
Lost in all of our discussions about health care is are stories this one one out of Canada from last week:
Insurers (in Canada, ed.) are "responsible, essentially, for the supplemental health care in this country, and if you don't have a good primary system, it's going to be harder to have a good secondary system," Frank Swedlove, president of the Canadian Life and Health Insurance Association Inc., said in an interview Wednesday. "We don't think the solution is just to throw more money at it."
In fact, despite high and rising expenditures, Canada's system is only performing "moderately well" compared to other developed countries, the association argued in its report. For instance, Canada has fewer physicians per capita, and fewer acute-care hospital beds, than most other OECD countries.
If current spending rates continue, health care will rise to 17 per cent of gross domestic product by 2025, from about 10 per cent today, the association said.
I will certainly grant you that this is an insurance company that did the study, and I wouldn't trust their projections about future growth without further inspection, but it can't be ignored that costs are still around 10% of Canadian GDP. That's a fact. Like America, they soon will also have a reasonably large generation retire.
I know you're thinking, well, they want to create their own murder by spreadsheet system, so why not badmouth the current Canadian system?
However, what Mr. Swedlove says about primary care is correct: if we cannot have primary care do better, we will always have high health care costs.
At root of that? We and the Canadians need to be healthier. We need to exercise, eat right, and be proactive about our health from a very early age.
While health care is a right, we as people have a responsibility to the whole system, both government-run and/or privately-managed, to make it as easy as possible by pursuing real prevention and health.
Health care costs will remain high if we continue to foster chronic disease through poor habits and through permitting large food conglomerates to stuff our food full of hormones, chemicals, antibiotics and other unnatural substances. Which reminds me, I need to quit diet sodas.
Look, I'm sure you've heard all this before, but my message is, no one system will save us. No one system will prevent unfortunate and unfair outcomes completely. Single-payer won't save us from the travails of bureaucracy when one is sick.
Let's just remember that when we think that we are "settling" for the public plan instead single-payer. Thanks for listening.