Although the USA has had some of the best health care technology, it has been far behind the rest of the developed world (and even some of the “undeveloped” world) in terms of delivery, availability, and affordability. “Obamacare” fixed some of the worst abuses and greatly expanded health care affordability. With the ACA, tens of millions of Americans who were not covered before.
President Trump and the GOP are discovering that their anti-Obamacare rhetoric did not work and that the program is quite popular. The fears sowed by its opponents such as “death panels” for the elderly or “rationing” of medical care.
Health care has always been “rationed” in this country but according to the ability to pay for it. As for the whine, “I won’t be able to pick my own doctor,” many current plans often limit your choice of providers.
Even so, the ACA is far from perfect. It is in no way “socialized medicine” because the insurance companies are still in charge, albeit with a few much-needed restrictions. The original ACA, for example, called for a public option which the insurance lobbyists made sure was not in the final legislation. This writer always thought it unfair that those who caused “the problem” would be given such a strong voice in “the solution.” Insurance companies make bigger profits by denying care.
Any rational, humane discussion of health care reform should begin with the premise that health care is a right, not a privilege. It should be available to all whether they can pay for it or not. Health care is like fire or police protection; it is a public service available to all that we pay for via taxation. People in a civilized society do not live or die based on their ability to pay for the privilege. Medicine should not be a for-profit industry.
Affordable health care is, of course, a human right but one could also make an argument that it is also a constitutional right. Now, a constitutional “strict constructionist” will ask: “where is the right to health care written in the body of the U.S. Constitution or the Bill of Rights?” And, they are right. It’s not.
But, as this writer is a “loose” constructionist, he believes that the U.S. Constitution and its meaning changes as the country changes. One could make an argument that a right to health care is found in the Ninth Amendment, the Amendment that basically says that Americans have more rights than those actually enumerated.
The courts have recognized “implied” rights that are never actually mentioned in our founding document. For example, the right to privacy is not mentioned in the Constitution at all but the courts have ruled that this right exists. This was the basis of rulings protection women’s reproductive freedom. In the modern world, where most developed democratic have universal health care, could it not be argued that in the modern context, affordable health care is a right?
There are many ideas about how to reform health care. However, the main considerations must be availability and affordability and a recognition that it is a right and not a privilege.
The best solution would be a single-payer system. It would not be completely free. Employees should contribute at least part of the cost through payroll deductions, just as we do with Social Security. Those deductions could be made on a sliding scale of income. If someone is unemployed or underemployed, they would still be covered.
No, this is not “socialized medicine.” Perhaps the insurance would be government-run but physicians and other providers would still be in private practice. Besides, if they looked at the situation, we already have single-payer plans and even “socialized medicine in this country. We just don’t provide it for everybody. After all, what is Medicare but a single-payer play and what are V.A. hospitals, military hospitals, and the National Health Service but government-run medicine?
We also need to reign in “Big Pharma.” Patents on medications are extended for too long, holding up cheaper generic copies. The pharmaceutical industry is out of control. Medications in the USA can cost 10 times what they cost in Canada.
It should be our shame that the richest and most powerful country in the world cannot come up with something better than what we have.
(Scott Cracraft is a citizen, a taxpayer, a veteran, and a resident of Gilford.)