Patchwork health proposals show the need to think big.
Minneapolis/St.Paul Star Tribune Editorial
Published: January 28, 2007
For Americans who hope the United States might one day have a health care system that makes sense, this is an exciting time. Massachusetts has adopted a plan to achieve universal coverage, and California Gov. Arnold Schwarzenegger has pledged to do the same in the nation’s most populous state. Last week President Bush committed himself to a radical overhaul of federal tax subsidies in a bid to hold down health care costs and expand insurance coverage.
Yet the closer you look at these ambitious plans, the more you see they are mere patchworks. In Massachusetts, which will require most residents to buy private insurance, policies are coming on the market with higher prices and less coverage than experts hoped. Economist and columnist Paul Krugman points out that the Schwarzenegger plan will require big new state bureaucracies to regulate insurance companies and police individual behavior. As for the president’s plan, even the White House admits it will cover only 5 million of the nation’s 46 million uninsured; that’s because it relies on tax deductions, which aren’t much use to low-income families who represent the bulk of the uninsured population.
It’s good to see political leaders think boldly. But the lesson is that they aren’t thinking boldly enough. It’s time for the United States to think about just making the leap to single-payer insurance.
This radical notion would seem unthinkable, except that every other civilized nation already has thought about it and embraced it — from conservative societies such as Japan and Australia to nanny states such as Germany and France. Every one of them covers more people, produces better medical outcomes, wastes less revenue on overhead and marketing, and spends less money than the United States.
The biggest argument against a single-payer system is it’s “politically unrealistic” in a free-market society like the United States. We think that gives too little credit to the impatience and common sense of American voters. But then we won’t know until a leader has the courage to find out.