But even if we discard these absurdities, and tune out the raucous scenes at town-hall meetings, one big distraction remains: the question of whether a “public option” should be part of the health care solution. To me, the issue is a red herring, and is getting in the way of genuine reform.
In debating the public option ”” that is, an insurance option run by the government ”” the politicians themselves are making exaggerated claims about its pros and cons. We hear from the right that an insurance plan run by the government will drive all private-sector insurers out of business and be the first step toward socialism, if not communism. The left claims that only a public option can give evil insurers the competition they need to create much-needed reform.
To evaluate these contentions, we need to know some details about how a public option would work in practice. And those details have been missing.
One can look Medicare part D to see what having a “public” option will do. My mom had a prescription plan through my dad’s private insurance. As soon as part D came through, they dumped my mom and told her to sign up for the government plan. Anyone that thinks that Walmart won’t do the same with the “public option” is being foolish.
And, let’s not forget, Medicare part D was originally projected to cost $400 billion. Today, just six years on, it’s already at $950 billion. So factor that into the CBO’s estimates of Obamacare setting the nation back “just” a cool trillion bucks.
It seems to me that Americans want to have their cake and to eat it, and there are difficult choices that need to be made but no one is prepared to. It would appear that there is a basic incompatibility between a hybrid publicly/privately funded system. At the same time, those people who talk about the value of individuality and freedom of choice are usually those who have adequate health insurance, not the millions who go without.
It ought not to be beyond the wit of the American people, for my money the most ingenious and creative in the world, to develop a system which provides adequate coverage for the bulk of the population in a manner that works within a genuinely American model. The truth is that something significant has to be done because with an aging population and increasingly expensive treatments, that healthcare proportion of GDP is going to keep on rising, and in the process will do great damage to America’s prosperity and ability to compete in the world.
What is going to be required, however, to reach such a point is a willingness to accept that basic healthcare provision is a fundamental necessity for every citizen, and that greed and ideological war is getting in the way of discovering how to make that happen. So let’s sit down like intelligent, thoughtful, caring human beings and see if we can talk creatively about it.
It doesn’t help such a discussion that so much disinformation has been poured like vitriol into the debate, especially the trashing of the British National Health Service. As one who now lives under the British system I will happily concede that it is not the greatest, except that there is not a person in this country (young or old) who has to worry about where medical care is going to come from. You don’t see thousands lining up in the streets of Britain seeking free healthcare from a voluntary free clinic because there are no other options.
All systems can be wasteful, but there is a huge amount of waste in the US system that could readily be pruned. A few years ago my wife fainted in church. We took her to the Emergency Room to be checked over and was fine — but did she really need a CT Scan? Recently, now we are here in England my wife had a fall and cut her chin badly. Once again it meant a trip to the Emergency but I was beautifully surprised at the thorough, but cost efficient, manner in which she was treated. When I visit my MD in the States there are far more (unnecessary) cautionary tests than is the case in Britain, and while the NHS does have a bureaucracy, it is dwarfed by the medical bureaucracy of every US insurance company that has covered us (including the present one).
My daughter is an MD. She is on the staff of a leading US teaching hospital. She was trained in the United Kingdom and is registered both with the AMA and the BMA. She told me yesterday that she cannot listen to the healthcare debate as important as it is because the misinformation makes her so angry. The debate is not helped by the twisting of the facts and deliberate misinformation — the point Stephen Hawking was trying to make when he said that on a number of occasions, one quite recently, the NHS had saved his life.
This debate, as Richard Thaler points out, requires intelligent engagement from all sides
Welcome input from Mr. Kew. So much of the commentary in this country on this important subject is mass hysteria aggravated by misinformation or ignorance. It is a tremendously complex issue and one that can’t be made better except by a willingness to deal with program and budgetary details.
To me the answer is simple and obvious. Health care should not be in government hands. In general, government programs are ill conceived, very poorly run, intrusive and extremely expensive. They are used primarily for political purposes rather than the good of the people. Please, never forget, freedom is a gift from God and is a very precious thing. Do not lightly throw it away.