My automobile’s engine was sputtering. The mechanic called to report that it had been repaired; however, a glance under the hood revealed that the engine had been expanded with more cylinders and carburetors, but still ran raggedly. “It would have been cheaper to replace it, but we wouldn’t have made as much profit.”
The Patient Protection and Affordable Care Act [PPACA], last year’s Federal health care reform, is like that jerry-built engine. It will reduce the number of people without health insurance, but in the most costly manner possible. The House of Representatives recently voted to repeal the legislation, yet they ignore the most efficient way forward: a single payer system.
Health care in the U.S. costs more than anywhere else in the world, but our life expectancy ranks 49th (according to that radical group the CIA). Generally, nations with higher life expectancy have truly universal coverage and, unlike ObamaCare, private insurance plays only an ancillary role.
If health care were privately delivered but had one payer, hundreds of billions of dollars wouldn’t be wasted on paperwork, advertisements, and administration. Doctors, hospitals, and clinics like Health Care for the Homeless wouldn’t worry about which clients were eligible for what services. Rather we could use our limited resources to deliver the care that people need.
The PPACA does not replace, but rather expands the existing dysfunctional system. Everyone will be required to pay for the enormous paperwork costs and profits that grow as private insurance expands.
An audacious idea: consider health care as a public good like fire protection. A scene in Martin Scorsese’s Gangs of New York demonstrates the point: rival firefighters allow a building to burn because the owner didn’t pay either of them. Our ancestors eventually discovered that rather than being a profit center, fire protection ought to be a public service. We have learned the same lesson with the police, education, and food safety. Let’s apply it now to health care.
In health care as in so many other aspects of our society, we need a complete overhaul, not just a larger, but still dysfunctional, system.
