The Orbis

When Bill Clinton proposed a single-payer universal health care initiative (UHC) in the early nineties, the concept was met immediately with virulent hatred from the right, special interest groups and powerful lobbies with a financial stake in the status quo. These groups were able to astutely tap public sentiments in amassing a scare-campaign that quickly sunk the proposal. 

There are numerous pathologies (such as a fear of increasing the size of the federal government) in the American political climate that are barring UHC from penetrating public discourse. For many, blind faith in the free-market and the sentiment that "private is always more efficient than public" is the motivation for dismissing such a sweeping reform initiative.

The trouble with UHC isn't that it's politically infeasible, financially ruinous, or inefficient because none of the above is true. The largest impediment to implementing UHC (besides the fact that our government is currently controlled by a party that is completely deaf and impotent to solve the problem of health care) is that it has yet to receive a fair trial in this country.

There are over 40 million people in the U.S. who do not have any health insurance. For a country touted as the most powerful and affluent in the world, this figure is appalling. Ensuring that every individual has free access to healthcare should be an imperative of any fair and just society. Healthcare, contrary to what those on the right would argue, is not simply a commodity to be bought and sold according to the market, but rather it is a basic human need. As such, it should not be limited to only those who are able to pay for it.

Even some conservatives will reluctantly sympathize with the spirit of social justice inherent in UHC, but skepticism about the political and financial feasibility of UHC frequently colors their arguments against it.

Perhaps the best way to being making a cogent argument for UHC is simply to dispel some of the most popular myths surrounding it:

€¢Myth #1: "It would be too expensive."

Rather than cost more money, UHC would actually reduce the cost of healthcare. The Congressional Budget Office (CBO) estimated that UHC could save up to $14 billion annually. Spreading the risk evenly over the entire population, eliminating deductibles and co-pays and making preventive medicine available to the poor and uninsured are only a few reasons why this is the case. The federal government already subsidizes private health insurance in the form of tax deductions, which raises annual healthcare costs by the billions for the government. Private insurance companies also spend billions on administration and overhead, advertising, and determining and inspecting patient eligibility, all while trying to make a profit. UHC would not be burdened with such costs, and unlike private business, it could run at a loss and still be viable. The pressures of profitability would no longer close the door for millions and drive up costs. As a result, Americans would effectively pay less for health insurance than they do now.  

€¢Myth #2: "It would require a HUGE, inefficient bureaucracy."

The current system is already a HUGE, inefficient bureaucracy! As mentioned, much of the unnecessary overhead and micromanaging in the system now could be eliminated if UHC were implemented. For example, bureaucracy and paperwork involved in determining patient eligibility would be completely unnecessary if everyone were to be covered. Insurance companies spend an estimated 25 cents of every dollar on administration. Canada, which already has a comprehensive UHC in place and still manages to pay 70% less per citizen on healthcare, spends about the equivalent of about 12 cents of every dollar on administration.

€¢Myth #3: "It would restrict patient choice."

First of all, how can we even begin to talk about choice when 40 million Americans don't even have any health insurance at all? "Choice" really isn't an appropriate topic for those who can't afford health care at all. Many of the chronically sick are simply denied coverage by private insurance companies because they aren't good financial investments. The concept of choice probably doesn't resonate much for people in this situation either. But even for the insured under the current system, HMOs and insurance companies alike restrict patients to a strict list of complying physicians. UHC wouldn't directly dictate what doctor you have to see in order to get treatment, and would thus enable more choice in selecting a physician than the current system would.

€¢Myth #4: "It would be a socialist seizure of the medical industry."

It would be nothing of the sort. Socialized medicine would entail hospitals and doctors all being employees of the state. UHC only provides funding for people's healthcare, but doesn't provide the healthcare itself. The only difference is that healthcare insurance plans would be funded by the state. Hospitals, physicians, and other healthcare employees would all remain part of the private sector. Competition between doctors and hospitals would not be eliminated. Although using the "s" word in attacking UHC has proven effective in frightening the populace, UHC would be no more socialist than Medicare, Social Security, or public education (all of which the far-right would gladly see destroyed).

An added benefit of UHC would be that private business would no longer have to worry about healthcare benefits and employees wouldn't have to remain in unpleasant jobs just to keep their benefits. Benefits wouldn't interfere with wage increases and employers would have more financial mobility. The recent problems General Motors has been having with maintaining health benefits for their workers while trying to remain financially afloat have been well documented. GM estimates that health care benefits account for nearly $1,500 of the price of every car they build and sell. Many other companies are switching to "temporary" or outsourced jobs in order to avoid paying benefits. Not only would UHC relieve businesses of having the burden of providing health insurance for their workers, but also the workers would be unconditionally covered regardless of where they work.

Given that worker mobility has increased tremendously in the last 100 years, and that the number of jobs held by the average worker in their lifetime is considerably higher (about 9 to 10 jobs per lifetime), people are frequently between or changing jobs. UHC would work well with the high turnover rate in many jobs by maintaining coverage even during periods of temporary unemployment.

The most frustrating part is that an infinitely better alternative to the current system is starring us in the face, and we aren't even considering it.

Rather than tolerating a system which is set up to make as much money as possible instead of guaranteeing health care coverage for the highest number of people possible, Americans should seriously consider UHC. We should be disgusted with the injustice of a system devised to insure precisely the people who don't need it (e.g. those who are healthy and can afford it) and turn away those who do (e.g. the poor and chronically sick).

Powerful lobbies and special interest groups single-handedly slaughtered the possibility of UHC when it was proposed by Truman in the 1940's and Clinton in the 1990's. Before any serious debate and public deliberation could influence sentiment on UHC, special interest groups and corporate-funded smear campaigns had already damaged the initiative enough to doom it to failure.

Until we devise a system which enables every member of society to gain equal access to quality healthcare, our claim to be the greatest country in the world will perpetually ring hollow.

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