Give the People What They Want: Real Universal Health Care
The nutty thing about the health care debate that will play a prominent role in the next election is that most Americans want pretty much the same outcome: to control costs without sacrificing quality. And that’s not what either major-party candidate is offering. Few think that Obamacare, a Romneycare descendant that contains the same kind of individual mandate the then-governor of Massachusetts signed into law, will get us to that desired goal. Nor would Mitt Romney, who has been reborn as a celebrant of the old, pre-Obama system with a few nips and tucks.
As the nation awaits a Supreme Court ruling on the constitutionality of the Obama health care approach, a new Associated Press-GfK poll suggests that the vast majority of Americans want Congress to come up with a better plan. They know that the current system is unsustainable. Only a third of those polled favored the law President Barack Obama signed, but according to the AP, “... Whatever people think of the law, they don’t want a Supreme Court ruling against it to be the last word on health care reform.” The article continued, “More than three-fourths of Americans want their political leaders to undertake a new effort, rather than leave the health care system alone if the court rules against the law, according to the poll.”
That sentiment underscores the opportunity missed by Obama, who limited his ambition to what Big Pharma and the insurance giants would accept as “reform” in a system that they had so successfully exploited. Obamacare is a faux reform born of opportunism, as was Romney’s original version: Play ball with those who have profited most from the run-up of medical costs and expect them to make it more affordable.
Two dynamics doomed the experiment. First, the new Democratic president wanted to launch a bold progressive program, but rather than channel the spirit of Franklin Delano Roosevelt to address the economic crisis that he inherited, he continued the bailouts begun under George W. Bush and fixed on health care reform instead of the financial pain being suffered by average Americans.
The second dynamic that undercut the health care bill was an overeagerness on the part of the new White House operatives to collaborate with the profiteers in the very industry targeted by reform.
The email trail of cave-ins to the medical industry heavyweights is startlingly clear, and it is difficult to quarrel with the headline on a Wall Street Journal story: “Emails Reveal How the White House Bought Big Pharma.” Except, as a related editorial in the WSJ makes clear, it was the pharmaceutical industry that did the buying, with “a $150 million advertising campaign coordinated with the White House political shop.”
What the industry bought was an end to the notion of a health care “public option,” and a guarantee of no serious restrictions on drug prices, arranged by then White House chief of staff Rahm Emanuel, who was in close communication with the lobbyists involved. The Journal article pointed to the cynical language of the emails exchanged, quoting one incriminating note from a lobbyist: “Rahm asked for Harry and Louise ads thru third party. We’ve already contacted the agent.” The American Medical Association and others also were in on the fix, yet with all of that power being exercised the public wasn’t conned. As the WSJ editorialized (it galls me to agree with that newspaper’s editorialists), “The miracle is that despite this collusion of big government and big business, Obamacare has received the public scorn that it deserves.”
But scorn for an individual mandate that compels consumers to purchase something they don’t want does not translate into a rational alternative to the current mess. Californian Gary Hess, a retired school administrator and a Republican, is quoted in the AP story about the new poll as saying that he wants the Supreme Court to reject the entire Obama plan but that he still wants the government to retain the requirement that insurance companies cover people regardless of their prior medical conditions. “There needs to be compromise on both sides,” he said. Clearly, any good compromise must include both control on costs and the availability of health care to the needy in places other than the very expensive emergency room.
Let me humbly suggest that as an alternative to a mandatory system rejected by the majority, we return to the idea of covering most people by attracting them to quality public and private programs through consumer choice, and that one of those choices be a version of the public option we now offer seniors. It’s called Medicare and it works splendidly.