Sunday, July 10, 2005

Universal health care?

History repeats itself, wrote Marx - first as tragedy, then as farce (or something to that effect in the 18th Brumaire.) Let's hope this time he's wrong. Turns out that universal health care - remember that? - is on the radar more and more as of late, and it isn't just Hitler-loving queers talking about it. For those who can remember, the president who presided over our long national nightmare of peace and prosperity tried to do something similar; needless to say, certain interests voted with their money. (If you ever want to read a very good account of it, read Ian Shapiro's essay in Deliberative Politics, entitled "Enough of Deliberation: Politics is about Interests and Power.")

Paul Krugman had done a series of essays on the topic, in which he noted, paradoxically, that France - yes, France - pays less per capita on health care than we do and outperforms us on many macro-level health indices. I was deeply suspect - after all, they all talk like Maurice Chevalier. But it turns out that there are a fair number of people who don't think he's full of it. (Look at the big and interesting piece in the 3/7/05 New Republic, entitled "Health Care is not a Business.)

Food for thought: is there anything to this? On one level, as the article points out, I'm inclined to say no simply because the two states that seem to be serious about it are California and Vermont. However, I'm also inclined to say yes because one of those states is California. Simply put, California sets the standard in all kinds of things - emissions, organic labelling, whatever, just by virtue of its massive population and massive economy relative to the size of other states.

Big obstacle: money. In Oregon (2002) and California (1994), the usual suspects came out against it: "Both times, the proposals came under fierce assault from the medical, insurance and pharmaceutical industries." But there is some promise, when you have one of America's largest companies - GM - shelling out $1,400 a car on future health care costs. And the prices aren't going down - "Premiums for employer-sponsored health plans rose an average of 11.2 percent in 2004, the fourth consecutive year of double-digit growth, according to the Kaiser Family Foundation."

Bullshit talks and money walks in politics - you don't get much done by appealing to the sense of common good or morality of politicians, especially when they're the current crop of Republicans. What does make a difference is cash, and if someone is willing to ante up and pay to support these proposals - that is, go head to head with the big money of the pharmaceutical, insuranc, and health care industries - then this time it might not be a farce after all.

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