Thursday, March 29, 2012

Healthcare and ideology really don't belong together

The USA never ceases to amaze me. At this moment, a political battle is playing out in the Supreme Court that essentially pits the political right against Obama's health care plan. The biggest irony is that the 'socialized medicine' against which the right is fighting so hard is based on a conservative plan, proposed in the 1990s by a conservative think tank, and subsequently adopted by at least one conservative governor (Mitt Romney) in his state.

Perhaps history will prove me wrong, but I think this will turn out to be one of the biggest miscalculations of the political right. Inasmuch as "Obamacare" is not perfect, it is a vast improvement over what existed before. It gives more Americans access to affordable health care. Those who have not had the experience of being locked out of every possible insurance plan because they suffer from chronic disease or terminal disease may not realize just how revolutionary this is. The pre-"Obamacare" trend is not sustainable, especially since America has some of the worst health indicators in the industrial world, and these are getting progressively worse. As Americans become sicker, affordable health care is going to become increasingly necessary.

If 'true American values' continue to move towards the right, as they have been doing for the past 50 or so years, then Americans will wake up in a dystopian society some decades from today. Basic health care (including vaccination, prenatal and antenatal care) will be out of reach for the average person. Perhaps only 10% of the population will have access to fresh fruit, vegetables, meat and dairy products. The rest will have to make do on heavily-sugared and salted food products. It sounds very much like the USA is trending towards "third world" status. Those of us from the "third world" who have seen what zero access to affordable health care for the majority of the population means in practical terms know that there's nothing ideal about it. The strangest thing of all is that the American public will have voluntarily taken itself in that direction because of its ideological investments.

I think the political right would have done better to embrace "Obamacare" as their original idea. After all, it did grow out of a conservative vision for expanded health care coverage. By contrast, a vision originated by the political left would have pushed private insurance companies out of the market and replaced them with a single insurer: the government. Seen from this perspective, many on the left could (and do) argue that "Obamacare" is too huge a compromise by the Obama administration to the right.

If the right had taken credit for "Obamacare" they would have had a more coherent platform to run on. They would have been able to paint "Romneycare," not as a blemish on Romney's record, but as a superior plan to "Obamacare." I have to wonder what lies ahead for American politics and American health care.

The best-thought out piece I have read on the American health care system lately comes from Fareed Zakaria: "Health insurance is for everyone". It is valuable for its comparative assessment of health care and insurance in different national contexts. David Paul's piece on the Supreme Court and the insurance mandate is also a good read.

This work is licensed to Rose Kahendi under a Creative Commons Attribution-Noncommercial 3.0 Unported License.


  1. The problem lies in the "Managed care" system.Think about LASIK eye surgery and cosmetic surgeries where there is no insurance accepted.Everything is out of pocket.
    You can see prices falling year by year in those segments. Similar scenario would exist if we let the doctor and patient deal straightly without getting a third party(insurance company) involved. You don't need insurance to visit a doctor. Insurance is for catastrophy. Not for simple doctor visit.
    Please think why there is no Autocare crisis in this country. Imagine if you use insurance to change your oil or tire. I am sure the cost would skyrocket in a year. The reason auto care is affordable and healthcare is not affordable lies in the fact that in the autocare you can see the market forces(competition, efficiency) in action. However, in the health care you have so much bureaucracy(from Insurance companies as well as Fed govt).
    We have to let the market forces work. Governmental control and more bureaucracy are not the solutions.They are recipe for disaster.
    mail me if you want to discuss samflorida123AtGmailDotCom

  2. Thanks for your comment.

    I actually think that the main reason for the difference between the healthcare system and the "autocare" system is a factor that you don't mention in your response: the pharmaceutical and biomedical engineering industries.

    Even if you did away with insurance companies, you would still have these industries. They happen to be dominated by large corporations. And those corporations can afford to lobby for their interests in Washington.

    Market forces are not objective forces that even out at the end of the day. They are influenced by the actions of people and by politics.

    I think the USA would be best off studying healthcare systems in other countries and seeing why they work or fail, and that's what Fareed Zakaria is pointing to.