Map of life expectancy at birth from Global Education Project.

Thursday, June 28, 2007

Could it finally happen?

Well, Sicko is getting good reviews, even in the corporate media. Arnold Relman has had the audacity to come out with a new book that, instead of asking what is politically feasible in our neanderthal nation, asks what would be right. May I have the envelope, please?

Universal, comprehensive, single payer national health care

In 2009, assuming Dick Cheney doesn't recruit some Young Americans for Freedom to dress up as Iranians and drive a 1969 VW bus into the Jefferson Davis Presidential Library,* we'll have a president and a congressional majority pledged to some form of health care reform. As I noted in an earlier comment thread, about the most radical proposal from the prez contenders (excluding nuisance candidates Kucinich and Gravel) is from John Edwards, who basically wants to give us a Massachusetts/Switzerland style system of mandated private insurance with subsidies for low income people, and an option to buy into expanded Medicare. The (hush hush) hope is that the expanded Medicare option will prove to be the best buy and will gradually eat the rest of the system.

Could this happen? And if it does, will it play out as hoped for? I would say that there's a heckuva lot that can, and will go wrong. There's no way that enough financing will go into the system in the beginning to make good insurance truly affordable for everyone; there will be no mechanism for cost containment or rational allocation of limited resources; and the insurance companies will bribe Congress into giving them bloated rates and all kinds of dodges and loopholes to avoid enrolling sick people. And they know damn well what the competition from a government-run option is all about and where it's supposed to lead. Those bastards weren't born yesterday. So it will be hobbled in some way, you can bet on it.

Still, granted all that, if we can just get a foot in the door and keep pushing, and pushing, and pushing, we might get a shoulder through, and then take a step. Might as well try it.

*A completely real institution, in Biloxi. Currently being restored after extensive damage from Hurricane Katrina, with the help of a $2.5 million federal grant.

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