OPINION: Pondering the potential of national health care

Baker City Herald (OR)

March 31--I'm beginning to believe it's time to let the federal government take over the health care system.

Not because that would solve all of the system's myriad problems, of course.

Putting the feds in charge of one-sixth of the world's biggest economy strikes me as roughly equivalent to giving a couple of 17-year-old boys the keys to a Lamborghini with a full tank of gas

And throwing in a no-limit credit card because, well, Lambos don't exactly sip fuel. Especially when you're turning their rear tires into clouds of expensive and fragrant smoke.

But the thing is, we've tried other approaches with health care and it's still a mess, most particularly an expensive mess.

I figure we might as well step aside and watch the politicians and the bureaucrats muck around with it for a while.

If nothing else we'd have somebody to blame besides the insurance companies, which is unsatisfying. You can't vote against insurance executives, for one thing. And if you barge into their offices to ask questions -- "Did your mother ever have any children who lived? for instance -- you're apt to be arrested.

Skeptics of nationalized health care might argue that our experiment with Obamacare, a sort of ersatz national system, proves the essential flaws in the concept.

I think this is unfair. Obamacare seems to me the halfhearted strategy typical of government. The law requires people to buy insurance or pay a fine regardless of whether they actually want (or need) insurance, or whether they can afford the premiums. But the law didn't pick up the tab for everybody so inevitably its effects varied widely among the populace.

I think it might well be more onerous to have the government punish people who don't want to buy a product sold by private companies -- I shudder at the prospect of having to stock up on leafy green vegetables under pain of federal penalty -- than to simply have the feds run the whole system.

Hence the support, which is widespread if not overwhelming, for a so-called "single-payer" system.

(Which, whatever its potential merits, might be the most unctuous euphemism I've come across, with its implication that an individual, Santa-like being will take care of everything. In reality, of course, tens of millions of taxpayers will constitute the "single" payer. Even Bernie Sanders, among the more enthusiastic singers in the single-payer chorus, acknowledges the large tax hikes his vision requires; you just have to go a bit deeper than the town hall sloganeering to get to the troubling details.)

Proponents of a national system inevitably cite, as evidence of the concept's efficacy, the dozens of countries that, with varying degrees of success, provide health care to their citizens.

It is a compelling argument.

These countries generally support their health care systems with taxation that is by American standards confiscatory, to be sure.

But the idea can't be blithely dismissed by arguing that what works in, say, Sweden or Norway, countries with vastly smaller populations and comparably puny economies, is not applicable to the U.S.

Germany, for instance, presents a rather more difficult case to refute.

The debate in Washington, D.C., these days, of course, centers around the Republicans' push to reduce rather than to expand the government's role in health care. Their campaign to repeal Obamacare and replace it with their own law has generated predictably hysterical responses.

I've heard, for instance, that doing away with Obamacare will exacerbate America's already deplorable position among nations as regards our health care system.

People who believe this often cite studies showing that although America spends considerably more on health care per capita than other developed countries, most of which have nationalized health care, Americans don't live as long as people in those countries.

The implication, of course, is that we'd live longer if the government were in charge of our colonoscopies.

This is a ridiculously simplistic analysis. Life expectancy among a nation of 330 million people is too complex a topic to be explained by any single factor -- in this case, national health care versus our current system.

The difference is not great, in any case. The average American dies at 79, just three years earlier than the average for a group of nations that includes Germany, Belgium, the United Kingdom, the Netherlands, Austria, Canada, Sweden, Australia, France, Japan and Switzerland.

I'm inclined to think that we Americans kick off a little sooner not so much because the government doesn't pay our doctor bills but because we live in the country where both the Big Mac and the Big Gulp were created.

We also like our cars and our guns more than most other countries, and although I happen to think this is on balance a good thing, these affinities turn out badly for some of us, and at a greater rate than most anywhere else.

Frankly I fear that some of us might succumb even earlier, from exasperation-induced hypertension, if we were suddenly confronted with a sheaf of government paperwork every time the toddler gets the sniffles.

But that's just my timid side talking.

It's not as if the red tape that's draped all over our current, multi-tiered health care system isn't capable of putting you into the sort of predicament that would have had Houdini sweating a bit. My own plan includes a debit card whose function mystifies me, although I'm usually capable of conducting basic matters of commerce. Once I tried to use it to buy a part for my ailing stair-stepping machine. The customer service representative was sympathetic, in the way that a psychiatrist is sympathetic to a client who is clearly deranged and potentially dangerous.

Anyway, America is a big place with a tradition of taking on big challenges and succeeding through ingenuity and sheer doggedness.

I don't doubt but that we can lick this health care problem too.

We would, of course, have to accept the realities required to make such a radical change as switching to nationalized health care.

Many of us would have to pay more in taxes. And although single-payer acolytes contend that those taxpayers would end up ahead financially because they wouldn't have to buy insurance premiums, many experts believe those assumptions are about as realistic as expecting the Tooth Fairy to cover your mortgage.

I'll concede that my curiosity about nationalized health care is prompted largely by my frustration at our inability as a nation to address the most vexing (and related) problems -- cost, and people who lack insurance.

And as I suggested above with the teenage-boys-driving-exotic-cars analogy, I understand that proposing the federal government as the cure for any problem might be not merely naíve but dangerously misguided.

I don't think I'm naíve.

I'm certain that a single-payer health care system would not be -- indeed, could not be -- a magical panacea.

But could it be better than what we have now?

This seems to me a question worth pondering at some greater length than posting a comment on a Facebook page or a website. Which have, through some insidious process, become dominant forms of public discourse. This might not be as deleterious to our health as saturated fat, but I doubt it's helping.

Jayson Jacoby is editor

of the Baker City Herald.

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