SocraticGadfly: State-by-state 'national' healthcare?

November 16, 2015

State-by-state 'national' healthcare?

Color me skeptical of the wisdom of this.

Whether or not one even partially accepts the old saw, largely touted by states rights conservatives, that states are the laboratories of democracy, nobody ever said that should include being laboratories of financial management.

Yes, Obamacare has slowed the rate of health care costs modestly. Maybe moderately, if I'm generous on credit. 

But, no more than that. And, I understand quite well that it's verklempt for more and more people eligible for it because they can't afford to actually use it due to high deductibles.

So, while I applaud Coloradoans getting a ballot initiative for a state-wide single payer health care on their 2016 ballot, I at least somewhat question the wisdom.

I like the idea of public healthcare, but I don't think a state-by-state system is the way to go, just like I think we need a 200-day school year, but a  state-by-state system isn't the way to go, with the pricetag involved. Vermont's eventual "pass" on state-level single payer was due to cost control concerns.

Colorado backers might be able to sell the 10 percent payroll tax as cheaper than private insurance, if it is. However, they're also going to have to sell businesses on it, not just individual voters.

And, per my observation that the U.S. needs to contain costs before it adopts a single-payer national health care system, and the only way I see of doing that is nationalizing much of our current structure, a la the British NHS, I simply don't see how Colorado's going to control costs.

And, while the federal government could nationalize fair chunks of our health system, a state can't "state-itize" that at all.

I'm all in favor of a single-payer system. But, per my NHS/nationalization idea, I'm in favor of a single-payer system that's not going to bankrupt us all.

And, I'd also like a 200-day school year. Doorknob knows how cheapskatish the Texas Legislature would be with that.

1 comment:

paintedjaguar said...

There's also the issue of false advertising and the resultant poisoning of the well even in the case of a successful political effort like the ACA, which guarantees neither affordability nor care and is nowhere near universal. Likewise, neither the Vermont or Colorado proposal is actually a single-payer scheme, which is part of the reason they founder on cost control issues. For that matter, Medicare itself is neither single-payer nor universal.

Anyway, I'm like you in that I've come around to the belief that real reform in the U.S. would necessitate going all the way to an NHS system -- the profits uber alles model is just too entrenched on the provider side as well as on the insurance side of the industry.