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Tuesday, June 14, 2005

Medicare For All

As many of us know, there is a serious health gap in America. People of color get sick more often, get treated less often, and die much younger than Whites. Some pertinent numbers:
  • Life expectancy for the White population exceeds that of the African American population by 5.5 years
  • Life expectancy for African American males is 68.6 years vs. 75.0 years for White males
  • Life expectancy for African American females is 75.5 years vs. 80.2 years for White females
  • Age-adjusted years of potential life lost before age 75 for African Americans was 12,579.7 years vs. 6,970.9 years for non-Hispanic Whites
  • Age-adjusted death rate for the African American population was 30.6% higher than for non-Hispanic White population
  • 287,709 African Americans died in 2001
So how do we fix this problem? Paul Krugman suggests we extend Medicare to cover every American, from the cradle to the grave:
A system in which the government provides universal health insurance is often referred to as "single payer," but I like Ted Kennedy's slogan "Medicare for all." It reminds voters that America already has a highly successful, popular single-payer program, albeit only for the elderly. It shows that we're talking about government insurance, not government-provided health care. And it makes it clear that like Medicare (but unlike Canada's system), a U.S. national health insurance system would allow individuals with the means and inclination to buy their own medical care.

The great advantage of universal, government-provided health insurance is lower costs. Canada's government-run insurance system has much less bureaucracy and much lower administrative costs than our largely private system. Medicare has much lower administrative costs than private insurance. The reason is that single-payer systems don't devote large resources to screening out high-risk clients or charging them higher fees. The savings from a single-payer system would probably exceed $200 billion a year, far more than the cost of covering all of those now uninsured.
Making sure that everyone has access to health care would go a long way towards bridging the health gap. What else should we do to increase the health of our communities?


Emancipated by Athanasius @ 1:07 AM

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My question is how do we get into the economics and moral issues surrounding health care?

American business pays a cost for our system not having more comprehensive coverage, in terms of higher worker costs relative to businesses situated in other countries. There are global competitiveness issues.

All kids should be covered. Period. And they are the least expensive group to cover. If you have a job with health care benefits, you could cover yourself but not your child. But you couldn't do it the other way around. Cover your child for peace of mind, but not yourself. It doesn't make moral sense.

It doesn't seem right that you could be employed continuously for 30 years, get laid off tomorrow and lose health care.

The best thing I think Black folks can do is focus on the morals and the practical economics of health care, and not get dragged into the ideological dreams and wish lists that typically characterize this issue.

Posted by Blogger Quintus Jett @ Tuesday, June 14, 2005 8:14:00 AM #

The point around which morality and economics converge is an acknowledgment of the perfect inelasticity of the demand for health care. If you have Sickle Cell Anemia then it doesn't matter if the cost for treatment is $50 or $50,000,000 - you will want to be treated. The Law of Supply and Demand fails when the Demand Curve is perfectly inelastic, so health care should never be subject to market forces, just like police protection is not subject to market forces, just like fire protection is not subject to market forces. Government has a moral obligation to provide services that the free market cannot reasonably provide, and health care should be foremost amongst the list of things for a civilized society to provide for its citizens.

Like Howard Dean used to say, even Costa Rica has universal health coverage. One of America's most sacred documents says, "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness." How can you live your "Life" if you do not have your health? How can you have "Liberty" and be free to do anything if you do not have your health? How can you pursue "Happiness" when you are flat on your back, sick with no hope of getting better? If America actually believes what it declares then it has a moral obligation to provide health care for all of its citizens - from the greatest to the least of these our brothers and sisters.

Posted by Blogger Athanasius @ Tuesday, June 14, 2005 11:35:00 AM #

But health care *IS* subject to economic considerations.

There are people under the age of 30 with no kids who opt of their employer's health insurance because it is still too expensive relative to their income.

They'd rather take their chances with getting sick or injured, and keep the money in their pocket. They tolerate more risk, but if they get a trip to the emergency room we all pay.

I'm suggesting the some people don't want morality talked about in their economics, while others don't want economics talked about in their morality.

I think we should open the hood and look at both together.

If we don't look at the moral dimensions of health care, where are we? If we don't look at the economics of health care, where are we?

Where we are now: a system where both moral and economic aspects of health care are getting ignored, and there's no political will to do anything about it because each side wants to focus on morality or economics in isolation.

Deal with both! :-)

Posted by Blogger Quintus Jett @ Tuesday, June 14, 2005 12:19:00 PM #

Economics and morality do indeed converge when we talk about Inelastic Demand Curves - while people will make decisions based on their income, it is morally wrong to subject people in an inelastic market to market forces. That will *always* put consumers at the mercy of the suppliers, and it is the role of government to protect the powerless from the predatory nature of the powerful. Without government intervention, suppliers will milk every penny that they can get out of consumers in an inelastic demand market, and that is morally wrong even if it makes good business sense (maximize profits).

We absolutely have to get some morality into our economics - I'd like to see some Biblical morality involved no less. You see, the same Bible that declares homosexuality to be a sin also declares that every 7 years all debts are to be cancelled. If nothing else, bringing this up will make for some interesting squirming from the Religious Right.

Posted by Blogger Athanasius @ Tuesday, June 14, 2005 12:58:00 PM #
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