Even Bernie Sanders must wonder whether the United States is ready for a universal, single-payer health care program. Nevertheless, the independent Vermont senator proposed such a program last week in the Senate, along with 16 Democrat co-sponsors. But with Republicans in charge in the House, Senate and White House, Sanders’ plan probably has little chance of adoption.
Still, the battles over Obamacare have forced us to confront the shortcomings of health care in our nation. And the Republicans’ feckless efforts to repeal and replace Obamacare remind us that President Obama’s namesake was never more than a best-possible half-measure between effective universal coverage and the high-cost, low-coverage pre-Obamacare system. Whether we’re ready to adopt it or not, at the least Sanders’ proposal reminds us that the problem is still unresolved.
On Sep. 12, the day before he filed his bill in the Senate, Sanders laid out in the New York Times his case for single-payer health care coverage that doesn’t find its lifeblood in the profit motive. His arguments are familiar. Why don’t we find them more convincing?
For example, why doesn’t the fact that every other developed nation has been able to provide some version of reasonable health care to every citizen move us to do such a thing ourselves? After all, as Sanders notes, most of these countries are able to provide coverage at a much lower per capita cost and with better medical outcomes.
Evidence of these remarkable facts isn’t hard to find. For example, a recent Los Angeles Times article cites data from the Organization for Economic Co-operation and Development indicating that U.S. per capita expenditure for health care for 2015 was over $9,000; the expenditure in countries such as France, Britain and Japan was around $4,000.
Yet, by nearly every measure, other countries have better health outcomes. The same article cites an indicator known as “mortality amendable to healthcare.” According to the European Observatory on Health Systems and Policies, for every 100,000 people who died in 2013 before the age of 75, in the U.S. 112 died as the result of conditions that could have been remedied with more effective and timely health care. The comparative figure in France is 60.
Of course, interests that have a stake in maintaining the profit motive in health care will discount this sort of evidence. But they’ve never been able to answer this essential question: If most other countries are able to provide better and less expensive health care to every citizen, why can’t we find a way to do the same or better job of serving one of our citizens’ most essential needs?
Sanders makes a good case. But here’s why I’d like to see us set our minds to producing an effective, efficient, universal health care program: Our nation could benefit from a unifying project.
Except for the era surrounding the Civil War, it’s hard to think of a time when we’ve been more divided. The political chasms between — and among — our parties seem unbridgeable. The considerable gap between the well-to-do and the impoverished is growing. Even the shattering divisions of racism are re-emerging.
Our often-divisive country has a history of building cohesion around national, government-sponsored, unifying projects. Whatever you think of it now, a primary effect of a national postal system was to enhance our sense of nationhood by providing the same, low-cost delivery service to every citizen, rich or poor, and no matter how far-flung.
Our nationhood was enhanced by the programs that helped us recover from the Great Depression. By working together to win World War II. By national desegregation. By building an interstate highway system. By winning the race to the moon.
So suppose we said: Look, as a nation we are going to find a way to provide effective, efficient health care for every citizen. Whether health care is a right or a privilege is immaterial; what matters is that citizenship in our splendid nation bestows the most essential prerequisite for the pursuit of happiness, good health. Now that’s something that could, indeed, bring us together.
Impossible? Let’s not underestimate ourselves.
John M. Crisp, an op-ed columnist for Tribune News Service, lives in Georgetown, Texas, and can be reached at email@example.com.