The correct choice for America to make next is to adopt National Health Insurance (also known as socialized medicine).
I know the knee-jerk response to that statement: “I am not a socialist. Socialism is terrible and has blown up in the faces of those who instigated it!”
If you recall my last post on Socialism, you know my response: we’re all socialists, to some extent. All of us believe that the government or society in general ought to be put in charge of some institutions. Not all of them. Some of them. We don’t want to replace all our fantastic private sector restaurants with McSoviet, a government-owned chain restaurant I just made up for laughs. We all agree, however, that it’s a good idea for the government to control the military, the police force, among other things. I only have the modest suggestion of adding health insurance to that list, and I have arguments and observations to support it, so here we go.
It’s been difficult for me to figure out exactly what the satisfaction rate of Canadians (who have national health insurance) is. I’ve done some research and gotten some disparate results, but here’s what I’ve found: US News says that Canadians are more satisfied with the healthcare they receive than Americans are. A recent gallup poll came to a similar conclusion. Everywhere I’ve turned, the bulk of the research points back to the same conclusion: most people who live with national health insurance like it. This concurs with own personal experience in the matter: every individual that I have personally known who has had a first-hand experience with national health insurance likes it, including a few who have lived in the US and in another country (which allows them to make a sound comparison since they’ve seen both with their own eyes). My fellow bloggers Chris Hallquist and Ask-a-Korean! like it, Youtuber Shwanerd uploaded a video to show his support for it to his American viewers, and everyone that I’ve had a chance to ask myself agrees.
Unless we’re going to believe that there is some sort of mass delusion going on in Canada, South Korea, and Great Britain, such reports are pretty good evidence that national health care is just plain better than private. This is a conclusion that won’t sit well with a lot of people, so I think it’d be best if I go a little further. Let’s entertain the idea that healthcare satisfaction in these other countries is more of a perception than a reality, that somehow these people have gotten the idea that their healthcare system is great when it isn’t. I tend to think that majority opinions, when based on first-hand experience, are usually right, but just to be sure let’s check to make sure this isn’t an exception to the rule.
So, here are some summarizing quotes from some studies I located:
“Conclusions: NHI [National Health Insurance] was associated in a reduction in deaths considered amenable to health care; particularly among those age groups least likely to have been insured previously.” (1)
“In multivariate analyses, US respondents (compared with Canadians) were less likely to have a regular doctor, more likely to have unmet health needs, and more likely to forgo needed medicines. Disparities on the basis of race, income, and immigrant status were present in both countries but were more extreme in the United States.” (link, emphasis mine)
“A comparison of studies examining the quality of primary care in America and Great Britain. A computerized search for relevant studies was conducted in the PubMed and CINAHL databases, from January 2000 to February 2008. This review includes systematic and observational reviews.
“The American authors of the first study conclude that on average, Americans receive about half of the recommended medical care processes required according to their individual needs. The British authors conclude that the quality of care for all three conditions studied increased substantially in association with the systems based strategy of clinical governance.” (2)
The Big Fallacy Plaguing Our Debate On Healthcare
When I’ve watched John Stossel’s special Sick in America, Michael Moore’s Sicko, or any number of news reporter discussions, I have seen each of them point to several people who have been screwed over by social health care (or private healthcare, depending on the bias of the one doing the talking) and apparently come to the conclusion that because of those cases, the social (or private) health system is broken and we should dump it in favor of the alternative. Look, neither system is perfect, and probably no conceivable system will be perfect. That much is for sure. What we need to focus on is which system has the fewest problems. And socialized medicine seems to be the likely answer.
What About ObamaCare?
In my home state of Alabama, it is required by law that all drivers must have auto insurance. This law makes a lot of sense when you think about: without it, lots of people will choose to drive uninsured, and when they get in a wreck and fuck themselves and someone else up, they can no longer work and will be stuck with a big debt that they often cannot pay. With it, the financial damage due to car accidents can be spread out via the insurance companies and the medical bills/automobile replacement costs that come with a bad accident can be paid for. Obama’s plan is to make health coverage mandatory, and with this we won’t have the unpaid medical bills (which drive everyone else’s costs up) that result from stupid people who can afford coverage (but don’t get it) who wind up in medical catastrophes with no way to pay their huge medical bill. I think it’s a big step-up from what we’ve got now. I do not feel that it is as good as universal health care. For one thing, there are a ton of people who will be in dire financial straights when they have to begin purchasing insurance (and what will we do with those who honestly cannot afford it?). It would make more sense to fund universal health care with tax money and increase the taxes we pay based on how much we earn. Taxes shouldn’t increase much (if at all) for the poor and working class, they should increase somewhat for the middle class, and increase appreciably but not drastically for the rich. Unfortunately, we can’t do what we ought to do because roughly half of Americans would grab their pitchforks if Obama tried to institute such a plan (and it probably wouldn’t be passed because of the deep-seated aggression so many people have for it). If only American politics weren’t a mud-sling of rhetoric between two parties who both cling to semi-religious dogma rather than following the evidence wherever it leads. Is there any hope for America’s future? I’m skeptical. I think at this point the best thing to do is to voice my opinion, try to fill other people in on the facts, and lead by example through fearlessly following the evidence wherever it leads. That’s my story.
1. Yue-Chune, Lee, Huang Yu-Tung, Tsai Yi-Wen, Huang Shiuh-Ming, Ken N. Kuo, Martin McKee, and Ellen Nolte. 2010. “The impact of universal National Health Insurance on population health: the experience of Taiwan.” BMC Health Services Research 10, 225-232. Academic Search Premier, EBSCOhost (accessed August 23, 2012).
2. Brzezinski, Nicole. 2009. “Does a universal health care system cause a decrease in quality of care?: A comparison of American and British quality in primary care.” Internet Journal Of Academic Physician Assistants 6, no. 2: 5. Academic Search Premier, EBSCOhost (accessed August 23, 2012).