Sunday :: Apr 20, 2008

Searching for Universal Healthcare


by Mary

Last week, Frontline featured an excellent documentary talking about how other wealthy capitalistic societies have solved the problem of providing universal healthcare for their citizens. TR Reid, a veteran foreign correspondent for the Washington Post and frequent guest on NPR, explored the ways five countries have solved the problem of covering everyone's healthcare without destroying their capitalistic societies. By examining the healthcare systems of Britain, Japan, Germany, Taiwan and Switzerland, Reid makes a convincing case that Americans too should be able to find a way to cover everyone and to rein in the exploding healthcare costs as well.

Kevin captured the conclusion well:

These ideas aren't as foreign as they seem. If you're a U.S. veteran, your healthcare is like Britain. If you're a senior citizen on Medicare, you're Taiwan. If you're a worker who gets insurance from your employer, you're Germany.

What Reid says is that each of these countries came to the same set of policy goals to make universal healthcare work although they varied the ways they achieved these goals:

  1. Insurance companies were forced to accept everyone
  2. All individuals were mandated to contribute (through taxes or having to buy insurance)
  3. Doctors and hospitals (and drug companies) had to accept fixed payments for care negotiated upfront

Yet, for the citizens of these countries, none of these things were a problem because they all felt like their system worked well for them, their families and their country. In fact, they were all much happier with their systems than Americans are with ours. And they all would be horrified to hear that anyone could go bankrupt or die because they couldn't get coverage.

For me, the most telling story was that of Switzerland, where universal coverage was not achieved until 1994. Before 1994, the healthcare system was much like ours is today. But then in 1994, citizens of Switzerland were allowed to vote on a referendum requiring universal coverage using private insurance companies, mandating that all individuals buy their insurance with the poor being covered by the government and with regulating the prices that could be charged. This referendum was hotly contested with the conservatives predicting doom and the entrenched interests spending a huge war chest to defeat it. It won by the very narrowest of margins, just barely over 50%. But now that it has been in place for over a decade, even the most conservative, die-hard capitalists believe that healthcare is a right and that their country is better because they cover everyone. They could not imagine going back to the way it was before.

As TR Reid said, all of these capitalist countries realized that the market could not solve this problem and that providing healthcare was a basic function that a wealthy capitalistic society should provide. They came to realize that there were limits on what the market could do.

Unfortunately, we are not yet there which is why John McCain can claim that individuals should shoulder even more of the risks and cost, government should get out of the business of regulating the system, and as a very wealthy man, he can believe that this proposal is a "solution" for the healthcare crisis.

That said, can we make sure that which ever Democratic candidate gets the nomination that they are forced by progressives (all of us) to fight hard for universal coverage? If we don't make it a priority this time, then we deserve the impoverishment that will come when this current system completely collapses.

Mary :: 7:23 PM :: Comments (21) :: Digg It!