Two years ago, when the Patient Protection and Affordable Care Act was plodding its way through the legislative process, the public seemed beset by far more questions than answers.
Isn’t this a government takeover of health care? When has a federal program ever saved the country money? Will I be allowed to visit my own doctor? Will my care be rationed? Is death panel member a full-time paid position with benefits and, if so, would my health plan require me to submit to a death panel?
By and large, these are legitimate and important questions, but perhaps the question we should have been asking is, "Why on earth would we want to retain a broken-down system that works so poorly and costs so much?"
ObamaCare may be a byzantine nightmare that frightens and confuses the public and has voters trying on Republican candidates like ugly bridesmaids dresses after a four-mimosa brunch, but it’s better than what we had.
Back in the ’70s, when America was making cars that burned almost as much fuel idling at a stoplight as they did when they were exploding (Ford Pinto anyone?), Detroit couldn’t afford to ignore countries that were simply building better cars.
So how is our health care system doing today, a full century after Norway first instituted universal health care coverage? Have we become the model for the rest of the world? Not even close. The simple fact is, we spend more on health care than any other developed country in the world, but we’re nowhere near the healthiest.
In fact, according to a 2011 study by the University of Washington, the U.S. ranks a dismal 38th in life expectancy, behind such economic powerhouses as Martinique and Costa Rica.
Meanwhile, we spend more per capita on health care – in many cases far more – than any country in the world. According to a 2011 Organization for Economic Development and Cooperation report (which used 2009 figures), we spend $7,960 per person on health care, while Norway spends the second most, at $5,352. Remarkably, Japan spends just $2,878 (a 2008 figure), while Canada, France, Sweden, Australia, and the Netherlands – all of which ranked in the top 10 in the University of Washington’s study – each spend between $3,000 and $5,000. And we’ve managed to achieve this yawning gap without covering everyone, as almost all developed countries do.
By all means, let’s fight tooth and nail to hang on to our current system. If we run out of countries to do worse than, we can always set our sights on medieval Luxembourg.
So if ObamaCare was less than an ideal solution, what would have been better?
In short, single-payer.
It’s easy to understand, and for a country that occasionally gets behind such regressive absurdities as the flat tax and the 9-9-9 tax, that’s no small point.
The government acts as the insurer. You go to the doctor and hospital you want to go to. The system, according to groups like Physicians for a National Health Program (PNHP), could be financed through a payroll tax on businesses and an income tax on individuals.
Unfair to small businesses? No. According to the PNHP, it would actually be a relief for most of them: "The payroll tax means a cost increase for businesses that are not currently insuring their workers. However, it is much less than they would pay at present for adequate coverage for themselves and their workers. For most small (and large) businesses already providing coverage, the payroll tax will mean substantial savings."
It bears repeating: We spend substantially more on health care than any other developed country in the world, but we lag far behind in health outcomes.
Now what responsible business owner could ever support that model?
Sign up for the free IB Update – your weekly resource for local business news, analysis, voices, and the names you need to know. Click here.