Some Thoughts About HealthcareSeptember 6, 2009
A quick piece I wrote sometime last year, or so–all the more relevant right now.
I’m a fiscally conservative liberal. It sounds like a contradiction in terms, but I promise you, it isn’t. I’m certainly not a libertarian, and I do not propose that I fall anywhere in your neat little political spectrum graph you have embedded in your head. I believe in providing some basic necessities of life, such as healthcare, retirement security, and social safety nets through grouping our resources as a community. I believe that we can do so in a cost saving manner, while ensuring a quality of life that is greater than current conditions.
That is how I view the function of government. I see it as our collective ability to help each other, and ourselves, through working in concert on the most basic of needs. We needn’t create massive bureaucracies to do so, nor do we need to give up our individual rights. No one wishes to have a government that is oppressive, or one that takes too much, and provides too little. These are the ingredients to doing the opposite of the what was intended.
The free market is fine and dandy for many, many things. It has proven effective at controlling costs up to a point, and provided us with ingenuity and inventiveness unseen for the vast majority of human history. It seeks to fill needs not yet provided, and punish those who would attempt to become robber barons. But it doesn’t always work. We know this. It isn’t that it needs to be done away with, or massively overhauled, it doesn’t. It just needs common sense measures to ensure it’s proper functioning.
The best example of the free market’s imperfection can be found in the mills and factories of the early twentieth century. Men, women, and children forced to labor in squalid conditions, and made to live as slaves within a framework of freedom. As a people, we rejected this, and rightly so. We put in place regulations and guidelines to correct the abuse of a few on the many, and the system was saved from catastrophe.
We have these dilemmas on a smaller scale each generation. Today, we have a few that need to be addressed. The free market has attempted to provide inexpensive healthcare while regulations have been put in place to help those that the corporate structure cannot, or will not help. These regulations are seen to have have worked against the goal of providing healthcare at a less expensive rate, making insurance and related costs skyrocket. Whether this is necessarily true is debatable, but I think there maybe some truth to the argument.
How are we to both provide inexpensive healthcare and also ensure the health of the population at large? We cannot sit idly by as millions of us suffer cruel fates because of the free market, just as we cannot let our desire to help collapse our ability to provide these services. We must choose a direction, either one that is less regulated, but may abuse those it provides services to, or one that is given to all of us, and is thus protected from such inequities. Either way, there is no doubt that lawsuits must be limited, and bad providers of services found and kept from hurting people. I don’t think anybody will disagree with that last point.
The best example on the world stage may very well come from a stereotyped people. The French. Sure, the French are the symbol of everything bad to the conservatives, yet there healthcare system may be the very best example of a market driven universal healthcare. A decent jumping off point for future discussions on the ability to help all without hurting everyone in the process.
The Frech system is not perfect, of course, but it does provide a wonderful array of services for almost half of what individual expenditures are here in the United States. The per capita cost in France is about $3500, while in the US it’s closing in on $7000. The french get to see their own doctor, and are reimbursed buy the government for a vast number of services. The individual can chose to get further private insurance for procedures that don’t fall into a basic medical needs category, and thus the extra costs of abuse of the system is avoided.
The system doesn’t have the long waits and poor service that conservatives put forward as arguments against universal coverage, and it’s bureaucracy is limited by the use of electronic filing and streamlined electronic transfers of funds. They limit the costs, and maintain a system that was rated number one in the world by the World Health Association in 2001. Half the cost, and everyone is provided for.
Businesses still provide their employees with extra insurance, as benefits, and a way to attract the best workers. Some self employed even completely forgo the system and provide themsleves with their own full coverage insurances. It’s a flexible system that does a number of exceptional things, while maintaining exceptional savings.