A protest against Republican efforts to repeal the Affordable Care Act, in Los Angeles.
Credit: David McNew
What exactly are we fighting over when it comes to health reform? Is there really a fundamental philosophical difference between the parties’ positions? Does either party actually have a philosophy of American health care?
On the one hand, the difference between the parties seems clear: the GOP plan is basically a tax cut for the rich that takes health care away from the poorest Americans and leaves the states holding the bag. But, as a matter of structure — as opposed to generosity — the GOP plan may differ from Obamacare a lot less than it looks (setting aside the cruelty of its effects).
The House plan relies on government tax credits, regulation of the insurance industry, and continued government funding to keep the low-income population insured. In other words, it is a plan that relies on both government intervention and the private sector. And it walks a thin line between the idea that in […]
In the present debate about health care, we often confuse two issues that are kept fundamentally separate in the Affordable Care Act. One is the issue of health care dealt with in sections 4,000 et seq of the act, and the other is who will pay for it, which is dealt with in sections 1 through 3,999. Health care would appear to be a fundamental goal of society, but who pays for it is not so clearly articulated. The payments as we know them are merely an issue of insurance, not of health care. In the conservative lexicon, I doubt that there would be much opposition to insurance as a general principle. The next step is to look at subsidies from the government. I doubt that many conservatives would be against subsidies for businesses and high end taxpayers. It seems that the argument really is about money, and whether it is health care or any other form of insurance and subsidy, it seems we are all for the same thing: it is merely a question of who should receive the benefits. I vote for the people.
Stephan, I think the more cogent question is how much of our GDP do we want to spend on healthcare. With the illness profit system (which you have so aptly named), the costs are exorbitant. However, with prevention care available to all, there would be far fewer people showing up in ER’s. Without Insurance companies, Big Pharma and HMO’s with their multimillion dollar CEO’s skimming vast profit into their pockets, the cost of healthcare would go down.
I have 7 docs in my family. The consensus is that while the food industry is killing us with antibiotics and additives (think trans fat), and possibly GMO’s, the government will not restrict this industry until they have skin in the game. It is only when our taxes start funding the diabetes epidemic and all the obesity related diseases will Congress take action to require our food suppliers to provide us with healthier products.
I think we need to provide basic health care to all citizens because that’s what modern societies do.
But Obamacare doesn’t do that because there are a lot of people who can’t afford to pay $10,000 up front for insurance and a $10,000 deductible the sake of a tax credit later.
Neither the Democrats nor the Republicans are ready to do what really needs to be done.
Germany has a public/private system that we might follow. “National Health” for basic needs and private insurance for high-cost items like heart surgery.
Years ago I lived in England and Canada. Both countries had nationalized healthcare, and the difference was staggering. When healthcare is a profession it is focused on wellness; when healthcare is an industry it is focused on profit. We obviously suffer the consequences of that focus on profit. In the UK and Canada people had the option of choosing private insurers if they preferred that over the nationalized system; it often meant shorter wait times and flashier equipment, but not better care. I would love to see nationalized medicine here in the US, but doubt that anyone within government and industry has the guts to let go of their cash cow at a time when the population is aging. Not enough people realize yet that the entire industry profits by keeping us all sick and in regular need of doctor visits, tests, and pharmaceuticals… there is no profit motive to cure anyone.