Saturday, January 8, 2011

ObamaCare 2.0.11

by Richard Crews
The United States is the only "First World" country (that is, the only advanced, industrialized country) in the world that does not have universal health care for its citizens. Tens of millions of our citizens simply cannot afford to get sick or injured. If they do, they have no trail of medical history--no ongoing record of how their health has been in the past, what (if any) treatments they have received, and how they may have fared as the results of those treatments. There is no single clinic or physician who knows them and their families and cares for them. When they get sick or injured--or just plain old and worn out--their choice is to suffer and muddle through as best they can, perhaps with the help of friends or family if they can get some help there--until death heals their pain.

Some, if they can afford it, have expensive, private health-care insurance--insurance that may take a fourth or more of their entire family budget; insurance that may fall short or abandon them if they get too "expensively" sick and begin to pose too great a financial burden on the insurance company. Some (many millions, in fact) rely on hospital emergency rooms where the care they get is expensive (it costs about twice as much as compared with care from a neighborhood medical clinic) and of relatively poor quality since the hospital is staffed and equipped for more urgent and emergent services and, in any event, has no ongoing record of their medical needs. The costs of this ER care are borne by the hospitals--by their foundations and donors, by their government grants, and by increased premiums paid by people who do have medical insurance (about half of the cost of medical insurance premiums goes to pay for people who have no insurance of their own).

The result is that although the U.S. has some of the best medical schools and medical research facilities in the world--and makes the best of medical care available for the rich and privileged--it has, overall, the most expensive and poorest quality medical care for the bulk of its citizens of any civilized nation.

Teddy Roosevelt, a century ago, was the first president to try to pass universal health-care laws for the U.S. He was not successful. And every president since then has tried--and failed--until last year. In 2010 President Obama, expending a tremendous amount of "political capital" (that is, wielding presidential influence and losing popularity), managed to muscle through Congress legislation establishing universal health care for the American people, legislation which is now gradually--and over the next several years--being put into place.

There have already been significant positive effects: stabilization of insurance premiums (which used to go up--sometimes drastically--year after year), refusal to let insurance companies drop people who get too expensively sick, etc. But there have also been problems. For example, several cases have gone to the courts challenging the constitutionality of the new health-care laws; one or more of these cases is expected to reach the U.S. Supreme Court in the next couple of years. Furthermore, serious errors have emerged in the difficult projections that were made of how many people would choose this or that provision of the new laws. In addition, implementation costs are proving significantly higher than expected in some cases. And--perhaps most significantly--several large unions and employers have decided that under the new laws it will be more profitable for them to dump sick employees onto the public rolls.

These problems will be patched and "healed." A new era of health-care responsibility is upon us--the U.S. is ready to join the rest of the civilized world in providing health care for its citizens. But the path to this goal over the next few years will be rocky.