EDITORIAL: Imagine actual health-care reform
Reason defines itself as a
Despite the fact that the
It's also no wonder that the prospect of losing insurance coverage frightens many Americans, including those who have shown up at town halls around the country to tell heart-rending stories of families on the edge of ruin because of disease or disability. The soaring cost of medical care puts the vast majority of Americans within one major illness of financial disaster if insurance, Medicare or Medicaid doesn't step in first.
But Suderman does a good job of describing dysfunctional elements of the current system as well. A mish-mash of employer-provided private insurance and government programs for the elderly and poor, the sum of the parts has a Rube Goldberg quality to it. "The result is an unequal system in which health insurance is understood more as a way of prepaying for medical care than as a protection from financial risk," Suderman writes.
"No one starting from scratch would design a system that looks like this."
Even if we can't start from scratch, Suderman proposes that
Their current plans, essentially to reshape the federal budget by taking from the poor to give to the rich, appear purely venal -- doing the bidding of the Republican donor class so it will continue to finance their campaigns.
But
It is easy enough to talk about universal coverage, but even Obamacare didn't get there, in large part because there are not enough incentives for young, healthy people to buy insurance they may not need for years. Similarly, it is easy enough to talk about solving these insurance-related issues by calling for a single-payer system, Medicare for all, without addressing the fact that Medicare and Medicaid are themselves unsustainable at their current rates of spending growth.
This is not a theoretical problem. Entitlements and military spending are fueling a national debt on the verge of passing the
Reforming our health-care system to make universal coverage sustainable would require politicians to take on the massive pharmaceutical and insurance lobbies that help to finance their campaigns. This includes many
So long as
American workers should not have to depend on their employers for health care. The fact that employer-provided health insurance is not taxed also insulates employees from the true cost of that coverage. And, as Suderman points out, it discourages job switching and entrepreneurship. In the aggregate, the current system offers too much help to people who don't need it and not enough to those who do.
It is no doubt wishful thinking in the current political climate to imagine a bipartisan, constructive effort to reform the existing morass of conflicting incentives. But it's encouraging to see a conservative acknowledging that such a reform is necessary. Liberals, too, will have to take on some sacred cows if they are to help defuse the bomb now awaiting the next generation.
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