Surprise! Single-payer healthcare is here. No, no, you say, it’s just a really badly run government insurance system which no one can join that has forced the cancellation thousands of existing policies. But I assure you, this is just a transition point.
Oh no! you say, if that’s the case, then surely this marks the beginning of the end of all things good and beautiful. Surely it heralds the end of the world or at least the new rise of Communism.
Well, no. The sky is not, in fact, falling. Are things going to be very different than what Americans are used to experiencing in the health care system? Most certainly. Is it going to be worse for a lot of people? Almost certainly. Is it going to be better for a lot of people? Absolutely.
The United States stands alone in the developed world in only providing health care access to the very poorest and the elderly. This is something about which most conservatives are very proud. Most of them resent providing access to the poor through Medicaid, though since a sizable number of them are over 65, they are very protective of Medicare.
When the US finally converts to universal access, it will be following the lead of those repressive totalitarian regimes in Canada, the UK, Australia, New Zealand, Germany, Norway… well, the list is endless.
Having lived for 12 years in one of these, perhaps I can enlighten you as to what you can expect in your future health care system. There’s the good and the bad. I’m just going to leave out the hysteria.
First of all, you will get used to it. Your children will think any other system unimaginable. I do not know a single conservative Christian (theologically, politically, or both) in the UK – and I know a lot of them – who would consider a different system as either ethically or morally plausible. To them, it is just as much a part of the social order as Social Security and Medicare are in the United States.
Doctors will still be the wealthiest professionals in society. Don’t you worry, they will take care of themselves. That part of capitalism will remain.
There will be the utterly shocking experience in the first couple of years of going into the GP clinic or the ER and not having to bring all sorts of paperwork with you and spending ages wrangling over whether your insurance covers this or that or how much you will have to cough up to pay the balance before you can leave. You will just see the doctor and go. I know everyone will hate that.
Of course this going to be bad for the business of bankruptcy lawyers. Other than credit cards, medical bills are most frequent debts that drive people to insolvency.
And it is going to be really bad for the bean counters at insurance companies. Administrative time and costs to doctors will plummet and they will actually spend time fixing people. But lots of people who work the other end of the phone line to deny or limit coverage will need to find jobs in the larger government bureaucracy. The Lord gives and the Lord takes away.
There will still be private health insurance, just like there is in the UK, Canada, Germany, Australia… you know the list. The rich and the well-employed will still get to jump the line. There will be doctors and hospitals that will only take private insurance. In that sense, the good ol’ American way will remain intact. It’s just that fewer companies and individuals will bother with it.
Sounds like the perfect world, right? Not exactly.
There will be rationing. If everyone can get access to the full range of medical care, then everyone except the rich will have to share. The government, in response to the taxpayer, will want to limit the amount it spends. Healthy voters aren’t motivated to make sure all the sick get the same treatment.
This means there will simply be a shortage of available beds, doctors and nurses. If everybody suddenly gets the healthcare they need, there simply will not be enough of it to go around. Some people will have to suffer. Until now, conservatives have been happy for the uninsured to be those people.
There won’t be rationing of primary care. That will be easy enough to handle. Every developed country in the world has demonstrated that. It’s when the need goes beyond a doctor visit and a prescription. Suddenly everyone who needs to see an oncologist will be able to do so. Everyone who needs to see an orthopedic surgeon will be able to do so. Everyone who needs cardiac care will be able to get it. There’s just not enough of it to go around, so people have to wait. In some cases the wait will be deadly. Lack of access has always been deadly, it’s just that it will no longer be a certain group of people who can’t afford insurance that die.
That’s where it will clash with our American ideals. In our system, the richer you are, the more you deserve to live. And if you have a good job that carries good insurance you deserve to live. People who want to live need to get a good job. If you don’t have a good job that comes with all the expected benefits, then clearly you aren’t working hard enough and you don’t deserve the nice things in life – like life.
Life and decent health are not entitlements (unless you are over 65). You have to earn them. That’s the American way. If you didn’t get a good enough job, too bad. It’s survival of the fittest. Just like in the Bible, right? I know Jesus said that somewhere…