SENATOR KIRSTEN GILLIBRAND dropped by Claverack last weekend to speak to a county Democratic Party fundraiser, and the policy issue she stressed most passionately was neither the economy nor Afghanistan, not even global warming or the whackos in North Korea. It was the issue that may well define this era: national healthcare.
President Obama has called for a vote by August on a bill that has yet to be drafted for a program that may cost more than $1 trillion over the next decade. From what she said Saturday evening, the senator from Greenport has a pretty good grasp of the problem, a reasonable approach to fixing it and a clear sense of what’s at stake if she and her colleagues fail.
Lots of people who have lost their health insurance or are barely able to pay for the worst overall healthcare system in the developed world support what’s usually called a single-payer healthcare system. Don’t like the single-payer name? Then call it Medicare. If it works for older Americans, why not make it available to everybody?
Those who resist this approach fear that pigheaded government bureaucrats will make healthcare worse by preventing access to treatment, rationing the types of services and procedures you can get and restricting when you can get them. The folks who worry about this apparently have not noticed that pigheaded bureaucrats working for huge insurance companies block access to treatment and ration care right now. And they may not know that people in other economically advanced countries live longer, healthier lives and never worry about going bankrupt because they can’t pay their medical bills. Or maybe they believe that the people who screwed up private insurance will simply switch to government jobs and offer the same lousy service. Now that is a scary thought.
But those who fear a single-payer system can relax. No one in power in Washington talks anymore about having that type of plan, a point tacitly acknowledged by Sen. Gillibrand, who called instead for “Medicare for all.” She has signed on to a Senate resolution that calls for a health insurance system that allows private companies to compete for your health insurance coverage. But her approach, already endorsed by 27 other Senators, also includes creating a non-profit, government-supported entity that would compete in this new insurance market.
The private insurance companies hate this aspect of healthcare reform. They whine that it’s unfair for the government to compete with them, that it doesn’t let the marketplace work. They got their way with the Medicare drug benefit program, when the government was forbidden to bargain with drug makers on behalf of seniors the way it does for veterans. That’s why the drug program still leaves many seniors without enough coverage to pay for all their medicines.
So let’s ask a basic question here: Is the point of healthcare to enrich stockholders and insurance company executives or is it to improve the health of the public?
If it’s only about the money, then we don’t need reform. But if the nation has an interest in keeping its citizens healthy, then why shouldn’t government compete? If government-backed, non-profit health insurance is worse than what private insurers offer, then people will not use it and the government can shut it down. If it offers better care for less money, then the private companies will have to improve or go away. That’s how the marketplace works, right?
None of this addresses how all of us will pay for a system. But opponents have yet explain how the country can continue under present system, which places crushing burdens on business, distorts labor contracts, drives up municipal costs (and the property taxes to pay them) and pushes people into bankruptcy, not to mention its dismal record in keeping us healthy.
We expect Senator Gillibrand will get hammered by opponents of the Medicare-for-all proposal. They will tell us that she’s robbing us of our rights (to what—bail out private insurers?) and that we risk certain death if we let a government-supported entity get involved (You mean like the same awful government services now available to seniors and veterans?). Blah, blah, blah…
Keep in mind as the mud flies toward her and the program she supports that Sen. Gillibrand is the one working to improve healthcare for the nation. Judge for yourself the motives of those who would stop her.