Wednesday, February 08, 2023

Health insurance - the legitimate object of government

by Sen. Jim Elliott
| November 1, 2007 12:00 AM

"The legitimate object of government is to do for a community of people whatever they need to have done but can not do at all, or can not so well do, for themselves in their separate and individual capacities."

A. Lincoln

In Lincoln's day the endeavors that would benefit the individual and nation together were such things as national defense, protection of commerce, and providing for the public safety. Obviously, the American government still provides those services today, but we are able to provide them with tools which would amaze the people of Lincoln's time.

What hasn't changed is the principle that when a significant majority of the American people wants their government to provide a service for them, it should be incumbent on their elected officials to see that it is done. I am here to argue that government guaranteed health care insurance for every American is "a legitimate object of government".

When a CBS/New York Times poll in March of 2007 asked the question, "Do you think that the American government should guarantee health insurance for all Americans…?" Six percent of the respondents said "yes."

That's a pretty hefty majority where I come from but I don't think it will change things much. We will hear that there are just too many problems to solve before we can do something that sweeping.

Politicians haven't really been eager to deal with sweeping health care change after the Clinton health care plan debacle of 1996.

But what was the substance of that debacle when it comes right down to it? It was the monolithic unwillingness of the behemoth American Health Insurance industry to sacrifice profit for the common good.

Their mantra has been, then and now, "let the system work, let the 'market' take care of it; we don't need government interference." But in eleven years since the Clinton plan sank to the bottom of the ocean there really hasn't been an appreciable change in getting Americans heath care coverage.

There has been a change in the health insurance industry, though. Fortune magazine lists it as the fourth most profitable industry with 35 percent growth in profits over the past 5 years.

Whatever changes have been accepted, whatever ideas have been floated, have had one fatal flaw in common, they have all been expected to work within the parameters of a failed system. In short, as long as the Health Insurance Industry can keep making a profit we can try anything, but whatever threatens that profit is a non-starter.

At some point the profit motive has to yield to the National interest.

American government is on record as supporting the idea of government guaranteed health care coverage: 86 million Americans over 65 are covered by Medicare; 52 million poor and disabled Americans are enrolled in state Medicaid programs; 4 million kids are covered by the Children's Health Insurance Program; and 25 million Veterans are covered by VA health care.

That is 40 percent of the citizens of the United States of America, and given the alternative of not having any insurance coverage, I don't hear a lot of people in those programs grousing about them. In particular I don't hear complaints about the coverage provided to our United States Senators and Members of Congress by the Federal Employees Health Benefits program.

New ideas are defeated by the "death of 1,000 cuts". The method is to create uncertainty about so many issues so that the whole issue seems just too complicated. There are too many unknowns, too many possibilities of failure; it is anti-business, anti-consumer, and anti-American.

We are warned about the danger of "unintended consequences", which denies the "consequences" intended or not, of the current system.

We are fed horror stories of Canadians who can't get elective surgeries done in a reasonable timeframe. We are not told about ordinary Americans who can't get life saving surgeries done at all.

We are told that it will raise taxes. We are not told it would also lower the amount that individual Americans pay for health care. (In that same CBS/New York Times poll 62 percent of the participants were willing to pay more in taxes for universal coverage.)

We are told that government can't run a government insurance program successfully, but Germany has had national health insurance since 1883.

The American Medicare system works well. It would work a lot better if Congress and the President were willing to fund it adequately so that health care providers would not go broke providing services for it.

I believe in Capitalism, make no mistake about it. The Market does a great job of providing goods and services most of the time; But Capitalism fails when the Market cannot provide the necessities of life at a price the purchaser can afford. That's called "market failure" and that's what we have in health care insurance coverage today.

Instead of trying to maintain some version of the status quo, health insurers should be looking at bold ways to correct that failure, and one of those ways, maybe the only one, is to work within the framework of government guaranteed health care insurance.