Monday, August 04, 2014

The United States Is Still The Only Rich/Developed Nation Without Universal Health Care For Its Citizens

The list at the left shows the nations that have accepted health care as a human right, and established some kind of universal health care system. The citizens in these nations all have access to decent health care -- no matter how rich or poor they may be. The earliest nation to do this was Norway in 1912, and the latest was Israel in 1995 -- but they have all done it.

Reading through that list, you may notice that one nation, the richest nation in the world, is conspicuously absent -- the United States. Although health care costs more per capita in the United States than in any other country (more than twice as much as most of the countries on this list), there are still tens of millions of people in the United States that do not have any access to adequate health care.

They don't have it, because in the U.S. health care is not a right, but a product that is sold to those who can afford it -- and to afford it you either have to be rich, or at least able to afford to purchase a health insurance policy. That leaves many millions of poor people out in the cold.

Obamacare (the Affordable Care Act) was supposed to fix this problem -- by giving subsidies to working and middle class workers to help them buy private insurance, and by expanding Medicaid to cover the poor (who don't make enough money to qualify for a subsidy).

If Obamacare could have been fully implemented, then most (but not all) Americans would have health insurance -- and hopefully the politicians would have found a way to cover the tiny percentage that would have been left out. But it didn't work out that way. Seizing upon a misguided Supreme Court decision, Republican state government in about half of the country's states have refused to expand Medicaid (even though the federal government would have paid for 100% of the expansion for the first 10 years, and 90% after that).

This refusal to expand Medicaid was a purely political decision by the Republicans -- done out of their hatred for having an African-American president in the White House, and their lack of respect for the millions of poor and underprivileged Americans. And it is not likely to change anytime soon. The Republicans simply don't care, and they consider their hatred of the president to be more important than the health and lives of the millions of people to whom they have denied access to health care.

Obamacare is a big improvement over the broken system we had before, and repealing it would be a big mistake. But it has not accomplished the two things it needed to do -- provide access to health care for all Americans, and bring down the cost of health care in the U.S. (to a more reasonable level like that enjoyed by other countries). It has reduced the number of uninsured people and slowed the growth of health care costs -- but that is just not good enough. Costs must be reduced, and ALL citizens must have access to decent health care.

There is a way to accomplish both goals. We need to go to a single-payer, government-run health insurance system that covers all American citizens (something like Medicare for all). This would not just cover everyone -- but would also take the profit margin out of health insurance. Further reductions could be done by negotiating with health care givers and pharmaceutical companies.

I know the Republicans will whine that we could not afford to do that, but they are lying. Other countries have done it, and we could do it too. It could easily be paid for with a small payroll tax on workers combined with a tax on employers (which would be less than they currently pay for employee insurance), and if necessary, supplemented by a small cut to our bloated defense budget (because we don't need to be spending 45% of the entire world's defense spending -- and more than the next 15 biggest spenders combined).

This is imminently doable. We would just need to make the reasonable political decision that the health and lives of all American citizens is more important than the bloated profits of the military-industrial complex (or the politics of hate). It is time for universal health care in this country, and failing to accomplish that shows a lack of moral and political courage.



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