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A public health scheme for the US?

The New Republic Online editorialises about the need for a US universal health care system that guarantees every US citizen access to affordable medical care. Alone among wealthy countries, the US has 16% of its population- 46 million people – without health insurance:

‘Studies … suggest that thousands of people, maybe even tens of thousands, die prematurely every year because they don’t have health insurance. And even those who don’t suffer medical consequences face financial and emotional pain, as when seniors choose between prescriptions and groceries – or when families choose between the mortgage and hospital bills’.

Medical care in the US is

‘…inequitable and inefficient. The US pays more for its health care than any other nation… 16% of our national wealth…. That’s an exorbitant cost … But, perversely, our extra spending doesn’t seem to buy us better medical care. According to virtually every meaningful statistic… Americans are no healthier (and … frequently unhealthier) than the citizens of countries with universal health care’.

‘To conservatives, …the private sector can deliver health insurance better than the public sector. But the only benefits the program delivers effectively, it seems, are enormous subsidies to insurance companies. But the Medicare drug benefit is just a taste of things to come. The right’s real hope for health care is to radically transform health insurance altogether, so that risk is gradually transferred … onto individuals’.

And:

‘Insurance works best when large numbers of people share risk, so that modest premiums from a large number of healthy people cover the very high medical costs incurred, at any one time, by just a few. Enacting the conservative agenda would unravel such arrangements, shifting the burden of paying for care back from the healthy to the sick. The worst-off would be those left to buy insurance on their own, directly from insurance carriers rather than through their employers or the government, since they will be at the mercy of underwriters who screen out bad medical risks.

Providing health insurance is a job the public sector has already proved it can do very well. The most popular health insurance plan in the US is Medicare-which, except for the drug benefit and a few HMOs that contract for the business, is a government-run health care program. And Medicare isn’t only popular. It’s also efficient’.

‘Nearly all of the money that goes into the program, via taxes and the premiums seniors pay, goes back out to purchase actual medical services. Private insurance, by contrast, inevitably diverts a much… which means less money for the beneficiaries. In theory, insurance companies should be competing to provide their subscribers with the best, most cost-effective medical care. In practice, they compete over who can enroll the healthiest patients, …the surest way to improve profit margins’.

‘Government isn’t the best way to provide all Americans with health security. It’s the only way. And it’s time for liberalism to say so openly’.

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