National Health Care and Obama’s Carrot
By Pat Racimora on October 11, 2008 at 4:19 PM in Barack Obama, Campaign promises, Health Care, John McCain
Health care costs are obscene, no doubt about that. I had a cortisone shot a few months ago that had to be performed in a hospital because my city has no private office with a fluoroscope. This meant a full dress pre-operative preparation. I was in the hospital for a total of one hour and 45 minutes, mostly waiting in a bed. Cost? $5,500 for one shot! I swear to God this is true.
This situation makes health care a red hot campaign issue. Obama focused heavily on this health care plan while denegrating McCain’s modest health care proposal during their second debate.
McCain’s policy, in all honesty, does not solve the underlying problem of soaring costs. But it does provide relief for a lot of people who can use that $5,000 tax credit to help purchase insurance. It may even cause insurance companies to lower rates as they vie for these new customers. But, mostly McCain’s plan has merit because it is actually doable!
Obama’s plan is no more than a campaign promise that will not be kept because it cannot be kept. So, if you are voting for him primarily because of his health plan, think again.
If Presidents could implement national health care, Teddy Roosevelt, Frankin D. Roosevelt, Harry Truman, Richard Nixon, Ronald Reagan, Jimmy Carter, John F. Kennedy, and Bill Clinton would have already seen to it that every American had at least some form of basic health care coverage. They all tried. There is even now a national health care bill that has been languishing in Congressional committees since 2003 (HR 676).
The truth is that many other factors must align, and the chances of that happeing anytime soon is about as likely as Ralph Nader winning the presidency by a landslide.
Here are some issues that currently stifle the possibility of having any form of government sponsored National Health Insurance (NHI) in the United States:
1. The complicated way our government makes decisions and does its business, including the ability of the minority (sometimes a single person or a very few people) to stifle the will of the majority, including the American people.
2. Successful lobbying against NHI by powerful for-profit stakeholders (e.g., managed care organizations, insurance companies, and the pharmaceutical industry).
3. The advantages available to the private sector created by our checks-and balances and two-party systems, purposely designed to limit the power and scope of government.
4. A public that polls as wanting NHI but is currently either distrustful of big government or apathetic when it comes to action.
5. Our culture of individualism that resists collective solutions.
6. The continuing (and mostly unspoken in public) prejudice of the working middle-class against supporting with their tax dollars no-cost resources to those they perceive as less deserving (e.g., addicts, loafers, high physical risktakers).
7. The inability of pro-medical care reform activists to agree on a specific proposal, and sometimes actively opposing each other.
8. Unexpected events that interrupt the legislative process (e.g., wars and scandals).
9. Personality clashes and ensuing haggling among the fragmented power players that influence the fate many attempts to reform anything, including health care. (This happens more often that you would think.)
10. Institutional bias that was designed by our founding fathers to pit alliances against each other as a way of protecting minority factions and limiting the power of government to control the individual and individual personal choice.
Some medical historians claim that timing will be the key, and that those rare opportune windows depend on a confluence of forces coming together “just right.” Is there such a window in the near future? Here are factors that must align for NHI to stand a chance. Unfortunately, almost all are nowhere in sight.
1. A unified political landscape. (Things seem less unified than ever right now, even rancorous splits within the two major parties.)
2. Ability of the President to pull people together. (Unfortunately, this campaign has divided people, especially Democrats, with wounds that will fester for some time.)
3. The people become more willing to give government a chance to do something right and competently. (We don’t see any evidence if this yet, in fact skepticism has devolved into cynicism.)
4. The medical establishment realizes that NHI is inevitable, so it is best to join the team to help shape it than to fight it. (This ultimately happened in Canada after years of strife, and it would take a long time for that to happen here, if ever.)
5. A resurgence of working class organizations and unions. (First we need jobs!)
6. Our foreign affairs concerns, if not solved, are stabilized. (This will not happen for a long while, no matter who wins the election.)
7. The economy is on the mend, such as more jobs, less reliance on foreign oil, and do on. (Clearly things are going in the opposite direction.)
8. Continuing advancements in medical science, medical technology, and pharmacological treatments, especially those that are cost-effective and detect early or prevent disease. (We are moving forward, but the wars and the economy has already drastically reduced federal grant funds available for medical research. In addition, the cost of early detection for risks is overwhelming since everyone is at risk for something, but we can’t give everyone every risk test..)
9. Demands for NHI from the majority of powerful social or political groups. (That hasn’t happened.)
10. A weakening of current health care markets, such as an increase in “high profile” criticisms of for-profit managed care operations. (There was a brief period of exposure of the profit-making business of health care, but criticisms, though still valid, have waned.)
11. A rise (or resurgence) in national pride and a return to the exercising of fundamental values such as caring for others. (Most Americans are furious our country’s leadership–and that includes the Democratic congress–and having trouble caring for their own families let along anyone else’s.)
12. Some substantial degree of healing between Democrats and Republicans and so-called red and blue states, or at least a strong bipartisan agreement that NHI must be enacted. (Highly unlikely in the near future.)
13. Meaningful lobby reform, cutting off to some extent powerful interest-group access. (This is far easier said than done.)
14. Public financing of elections, reducing the influence of powerful interests. (McCain is doing it, Obama reversed his promise.)
15. Agreement on the shape/scope of the plan from among various health care reformers. (So far the majorities favoring health care reform have been unable to coalesce around a single plan and are sometimes openly antagonistic towards each other.)
16. A significant external shock, such as skyrocketing health care costs threatening the collapse of our economy, a major health care scandal, a plague or natural disaster or attack that injures large numbers of young and the healthy middle and upper-income Americans, and other unfortunate occurrences that force change. (This is a scary scenario—we pray that this is not the reason we ultimately get NHI.)
In conclusion, McCain won’t solve the problem, but he has a functional plan that should help some people. As for Obama and national health insurance, I wish I could conclude differently, but no. It’s just another promise that cannot and will not be kept.
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