Tuesday, September 18, 2007



by Jerome Grossman

The leading contenders for the Democratic nomination for president of the United States have proposed reforms of the nation's health-care system. The plans of Hillary Clinton, Barack Obama and John Edwards are similar in outline, but not necessarily in detail. Especially noteworthy is their retention of the basic system relying on business and insurance companies to finance health care.

However, each candidate articulated themes contrary to the current basic system. They praise government - run Medicare for low administrative costs, high efficiency, and for not cherry picking patients. They praise the government - run Veterans Administration for the same features as well as consumer satisfaction. They praise government -run systems in other industrialized nations pointing out that the U.S. lags behind all most all of these nations in adult longevity and infant mortality. Yet the candidates insist on retaining our current system with minor modifications. Universal Medicare would eliminate the cost of health insurance to businesses and lower insurance costs by about 25% percent by eliminating advertising, big execuitive salaries salaries and insurance company bureaucracy aimed at increasing market share and profitability.

The primary constituency of business is the stockholder and the primary activity is to cut costs and maximize profits. In health care this usually means insure as few workers as possible for the fewest ailments. Insurance companies are also focused on the bottom line, charging as much as the market will bear while avoiding the large expenses of the very sick The maneuvers toward these objectives inflate the cost of healthcare

Expanding Medicare to the entire population would realize the goal of universality, improve the national health, lower administrative costs, shift control of care to doctors and hospitals. Why should seniors and veterans be the only groups receiving government subsidies for health care? What about that 10 year old girl I see through my window? How about the worker who repairs my necessities?

Only a universal health system run by the government is defensible morally and politically. Equality and democracy require it. How long will the voters allow this unfairness and waste of money on a basic right to life to continue? Will one of the presidential candidates, from either party, endorse the Medicare approach and arouse the voters to demand it?

The answer to that question is " NO." American political leaders are understandably intimidated by the economic and political power of the health and insurance industries. They remember how Hillary Clinton's mild health reform proposals of 1993 were defeated, and even worse, ridiculed to such extent that it affects her campaign for president 15 years later.

Any proposed change must not be perceived as attacking the profit motive, the most dynamic element in the American economic juggernaut. However, certain communal activities do not lend themselves to the profit model. Health care, education and the military rely on the values of equality, cooperation and even sacrifice. The model for each is common benefit before individual advancement and profit.

However, there may be a way to resolve the dilemma, by following the example of big business. Our government cannot drive the health and insurance industries out of business to install a universal Medicare, but it could buy them out and make health a government monopoly. Give them their profit, give stockholders, executives, workers a big payout, something on the order of100% profit or a years salary. Even if costs one trillion dollars, the lower costs could return the capital outlay in ten years or less. The new efficiencies, the new satisfactions, the increased longevity, the saving of children's lives could transform our lives as they have already benefited our senior population since 1965. And think of the value of increased happiness, of diminished worry about the precious gift of life. Do we have the courage to break the pattern of the past, for ourselves and future generations?

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