In the very unscientific polls I placed at DailyKos and The Chronicle’s non-tenure-track forum, a 3/4 majority responded to the question “Which Dem candidate’s health plan?” with “Neither — we need a single-payer system.” This appears to reflect at least one of the candidate’s own judgments: Clinton appeared to acknowledge in the last debate that single-payer was preferable — just not, in her view, politically feasible.
The best overall conversation on the subject was held on adj-l, the very important discussion list on which major contingent organizers such as Jon Curtiss, Joe Berry, Craig Smith, Keith Hoeller, Elizabeth Hoffman — and AAUP past president Jane Buck — all weigh in regularly.
One adj-l correspondent, Steve Street, himself a faculty member serving contingently and a cancer survivor, who understandably calls this “his issue,” pointed to the timely Paul Krugman column that strongly favors Clinton’s plan — which is, he notes,
more explicit about affordability, promising to limit insurance costs as a percentage of family income. And it also seems to include more funds for subsidies.
But the big difference is mandates: The Clinton plan requires that everyone have insurance; the Obama plan doesn’t.
Mr. Obama claims that people will buy insurance if it becomes affordable. Unfortunately, the evidence says otherwise.
After all, we already have programs that make health insurance free or very cheap to many low-income Americans, without requiring that they sign up. And many of those eligible fail, for whatever reason, to enroll.
I have to say that I find Krugman’s observations regarding the absence of mandates in Obama’s plan convincing. On the other hand, a Daily Kos correspondent accurately observed that “Congress, not the President” will significantly shape the plan that either candidate brings to the table. While in theory this means that single-payer or universality could be scripted into an Obama proposal after election, I guess I’m a bit skeptical. That said, I’m none too enthused about the “consumer price consciousness” built into the multi-tiered care made in the Clinton proposals. Um, yeah, I’ll choose the “kill me quick” plan for a 10 percent discount, please.
My favorite moment in the adj-l conversation was sparked by the evidently well-meaning forwarding to the list of the “free-market cure” videos by frequent Fox guest commentator Stuart Browning, who describes himself as offering “health-care commentary from a pro-capitalism perspective.”
In response, long-term Michigan AFT organizer Jon Curtiss wrote an eloquent post that I’m including in its entirety for the benefit of nonsubscribers:
This bit of free-market propaganda by Stuart Browning does not change my mind about the need for a single-payer health care system in the USA.
Does this little film even make an argument? Not really. “One guy in
Canada might have died if he hadn’t come to the U.S.A. for an M.R.I.”? (Or
maybe it’s “A well-off white guy who could afford to pay $30,000 for
surgery didn’t get treatment the moment he demanded it.” That’s a scary
one!)
But let’s break it down. Even if the anecdote were presented openly and
honestly, does it really tell us anything about the Canadian system?
Does it tell us anything about the U.S. system? (See details of the story here.)
A charitable summary of the logic of the film would be this: “People may
suffer or even die when health care is rationed or subject to government
policy. We do not want people to suffer or die. Therefore, rationed
health care is bad and government should not play a role in health care.”
I’ve heard worse arguments, I guess, and I certainly don’t want people
to suffer or die. But let’s take the next step. How do we do it in the
U.S.A.? We don’t “ration,” technically, because there’s no thought put
into it, but the fact is that heath care in the USA is rationed; it’s
RATIONED BY THE MARKET. You have the money, you get the treatment; you
don’t have the money, you’re out of luck. The bottom line is that in the
USA, about 18,000 people die a year because they don’t have health insurance.
So which is a better system? The free-market feels better because no one takes responsibility. In Canada, and all other industrialized countries, though, the Government, yes, takes responsibility for the health of citizens, and formulates a rational policy for how to ration health-care resources. That means it’s easy to point a finger: “This man suffered and almost died because of your policy!”
But ethically, it’s the right thing to do, of course — the same way that we use our government to formulate all kinds of rules and regulations that protect us from all kinds of things. In the end, you don’t have to agree with that philosophy, you just have to want to reduce suffering and death to the greatest extent possible given the resources we have.
Thanks to everyone who contributed to this thread. As always, see more at howtheuniversityworks.com
