March 4, 2008--Healthcare Jujitsu

Saturday Night Live got at least one thing right last week—nobody, and I mean nobody, wants to hear anything more from Hillary Clinton about healthcare. Or, for that matter, from anyone else.

Enough about “mandates” and “co-payments” and the meaning of “universal.” Who is it that said, “Keep it simple, stupid”?

How about someone keeping it this simple:

Every child living in the U.S. and every American citizen gets health care and doesn’t have to pay anything "out of pocket" for it.

No mandates required, no means-testing, no subsidies to low income people, no choice of carriers because this plan would not be insurance but rather health coverage for everyone.

I already hear the outcries—Socialized Medicine. End of discussion. End of anything resembling universal healthcare even though everyone knows that neither Clinton’s nor Obama’s more nuanced plans have any chance whatsoever of being enacted into law by Congress.

I don’t care if the Democrats win the presidency and more than 60 seats in the Senate—it ain’t gonna happen. Too many legislators are on the medical conglomerate’s various payrolls or in their hip pockets.

So, in the face of that reality, why not advocate and fight for a system that is fair and would work?

Here’s how to frame the argument:

We have public education in this country but no one has to be mandated to purchase Education Insurance.

If our house is on fire we don’t have to see if we have been subsidized to buy Fire-Protection Insurance. We just call 911 and the fire brigade shows up and doesn’t leave a co-payment bill.

If we suspect a burglar is lurking at our back door we don’t have to call our insurance agent to see if we are covered for police services. We simply dial 911.

And we don’t have to shell out for 911 Insurance. There’s about a one dollar a month charge added to our telephone bill for that. But the cops, after they’ve checked things out at our house, don’t ask to see evidence of Police Insurance.

When we have to raise an army to protect us or invade another country in the Middle East, the government simply seeks volunteers and pays and (sort of) equips them. Is this Socialized Defense?

Then, in regard to at least one aspect of medical treatment, if we have a heart attack at home we again call 911 and an ambulance and EMS workers show up in a flash and take us, without charge and without checking to see if we have EMS Insurance, to the ER where we are treated whether or not we have ER Insurance.

So why not go the whole way? If it’s OK to have tax dollars (that’s how all these services are paid for) cover the costs of fire and police protection, why not for all of our medical services? Why is it OK to “socialize” some essential services and not the most universally critical?

If we could get past the socialized medicine objection (and that clearly represents a huge obstacle), we’d have to face the equally controversial one about cost and the other about effectiveness. But it is projected that by 2017 the total tab for medical services in America will top 4 trillion dollars—about 20 percent of our economy. So it's obvious that the money's there. It is “simply” a matter of figuring out how best to deploy it, yet none of our various candidates’ plans are more realistic or likely to be enacted.

Let’s, therefore, really shake things up and talk about something, admittedly as unlikely to be approved, but that would get the job done. Or at least move the argument in the right direction.