The whole point of free speech is not to make ideas exempt from criticism but to expose them to it.
Sunday, September 13, 2009
Sam Hurst delivers the definitive health care argument.
Please read this. The whole thing. To further pique your interest, here's an excerpt from Sam's suggested solution — a REAL long range health and wellness plan. The driving moral thesis is that health care is a fundamental human right. But again, please read his entire argument, not just the excerpt. Many of your presumed possible rebuttals are covered there as well. I'd like for us to advance Sam's idea, not just rehash it:
We might begin by dumping the "public option" that Democrats hold to so tightly as a pale vestige of "Medicare for all", and move to an approach that honestly balances cost control with a revitalized commitment to social responsibility. Create a new battlefield.
"Medicare for every child in America." The current health system in America is upside down. The highest quality, lowest cost, gold plated system is reserved for the elderly. Children are the future, but their potential is framed by their parents' ability to pay if they are middle class, or navigate a complex of poverty programs that punish some children and promote others based on how poor their parents are and which states they live in. No one ever talks about children. They have no political voice. And yet children are the engine that could drive universal health reform. No principle of civilization is more universal than the belief that children are at the heart of a nation's social responsibility. Your children (or grandchild) are my future.
Abolish the Children's Health Insurance Program (CHIP), and state bureaucracies that administer CHIP and Medicaid for children. Remove children from employer-based health insurance programs. Take children out of the private health insurance system for those families that are self-employed.
Cover all children with Medicare until the age of eighteen, or up to twenty-five if they are full time students. Young adults living on their own would be given the choice to pay premiums into Medicare if they are satisfied with the quality of their care, or opt out of Medicare into a private plan or employer coverage. The most important new reality for young adults would be that their choices of health insurance would not be based on pre-existing conditions that were a legacy of inattention as children.
The current system of health delivery is built around the inefficient, expensive delivery of specialist care. We are a nation that celebrates the most complex, hospital-based health problems, but neglects the most preventable problems. The roots of this upside-down system lay in the fact that Medicare was created to serve the elderly, who at the end of their lives have the most complicated (accumulated), specialized needs. From the beginning Medicare favored specialists over primary care physicians.
If controlling costs is imperative, we must move to a preventive, primary care system, but creating such a system for middle aged Americans at a time when chronic long-term disease and health conditions are just beginning to emerge, is the least efficient, most expensive way to do it. Children, on the other hand, whose life style choices can still be influenced, are a perfect group to lay the foundation for a primary care system.
No single aspect of health care is more critical than addiction (including tobacco and alcoholism). Broadly speaking addiction intersects with myriad social costs, including the most expensive, fatal, and hard to manage chronic diseases such as cancer and heart disease, obesity and diabetes. Addiction is also at the center of worker productivity, domestic abuse, the public costs of state prison systems, and even foreign policy (the war on drugs, Mexican drug gangs, and Afghanistan opium poppy farming). Trying to address addiction in middle-aged patients is the most expensive, least effective way to confront the problem.