Richard Quinn writing HumbleDollar| Oct 27, 2021. Has anything gotten better?
“I SORELY MISS the peace of mind that comes with universal health coverage.”
Those are the words of a 32-year-old woman from Canada, who is currently a PhD student residing in the U.S. When I read them recently in the comment section of a blog, they changed my thinking about health care.
I’ve been involved in health benefits, health insurance and health plans of various types since 1962. I’ve designed employer plans. I was on the boards of four health maintenance organizations. I negotiated physician contracts and health benefits with five unions.
I lobbied Congress for changes during Hillary Clinton’s attempt at health care reform, and keenly observed the Obama-era changes. I was shocked by some of the unrealistic promises made—and the spurious claims opposing—the Affordable Care Act.
Wherever we travel, I embarrass my wife by asking people about their health care. I’ve asked people aboard the ocean liner QE2, on a tour bus in Costa Rica, pretty much anywhere—it doesn’t matter.
I’m aware of the issues and claims regarding cost, rationing, waiting times, freedom of choice and all the rest. I know that no system is perfect. Every system struggles with costs, and some systems can’t deliver care in the timely manner we might expect.
But I also know from my interviews that many people in other countries are satisfied with their health systems. Why? From their perspective, the low or minimal costs they’re charged when they receive care provide them with “peace of mind.”
My retired friend in the U.K. now pays no premiums or copays for his care. He’s convinced his health care is free. That isn’t accurate. Still, he enjoys peace of mind about his health care costs.
In the U.S., 34% of the population is currently covered by a government-run system. Yet, if I mention universal coverage—even Medicare—there’s instant controversy. It makes you wonder, what do Americans want?
There will never be a perfect system—one that has no out-of-pocket costs, unlimited and immediate access to care, and no taxes paid to support it. But there’s also no logical reason the U.S. can’t have some form of universal coverage with a public-private partnership. Nudged by the Canadian PhD student’s comment, I think it’s time we provided peace of mind to every citizen.
Sometimes, when I discuss the idea of universal coverage with people who are adamantly opposed to changes, I’ve taken to saying, “Give me your ideas for something better.” I’m still waiting.
QUINNSCOMMENTARY 
Medicare is in big trouble financially so if we expand it how do we improve it’s financial condition? Just how does this public private partnership work? Wasn’t Obama care supposed to provide care for folks not covered by a plan? After initial failure I understand the exchanges now do a solid job.
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We have universal coverage in America today.
Every lawfully present individual can enroll for health care coverage. That has been true for the past 11 years.
So, not sure what you or others are talking about.
When people in Canada or the UK or Costa Rica say they like their health care system, it is, in part, because they either are benefitting from other people paying taxes which subsidize their cost of coverage or they are paying too much for the coverage they receive, perhaps for the convenience of access without point of purchase cost sharing (deductibles, copayments, coinsurance, etc.)
Perhaps you forget the famous quotes from Jonathan Gruber, one of the architects of the Patient Protection and Affordable Care Act of 2010 (Health Reform, Obamacare). Gruber confirmed that Health Reform became law only because lawmakers and voters didn’t know what was in the law or how its financing worked. That is, as Nancy Pelosi once said: “We have to pass the bill so that you can find out what is in it.”
Among the many other things that Gruber said:
“Lack of transparency is a huge political advantage.”
“Call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.”
The law was “written in a tortured way” to avoid a bad score from the Congressional Budget Office.
“If CBO scored the [individual] mandate as taxes, the bill dies.”
“If you had a law that made it explicit that healthy people are going to pay in and sick people are going to get subsidies, it would not have passed.”
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Al Lindquist:
Yes, I remember Gruber and the quotes were great. Had forgotten the name but I think he was at MIT.
Brother Quinn has issues with ignorance and misinformation so this is just another example for him to quote when discussing issues.
Appreciate the good work.
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I suppose this young Canadian woman had “peace of mind” because she was young and healthy. If she needed in depth care for a serious condition or conditions would her peace of mind still be in place. Would the necessary equipment and trained medical staff be available and within in a reasonable distance to be of value.
We need more doctors, more staff, more equipment in reasonable distances from spread out populations to be able to say we have a Medicare for all. What we spend now won’t cover it. The US has a large sick population or I should say unhealthy population. Your experience was negotiated contracts for employer-employee deals. The whole population is a different animal. I wish we had what you propose but I just don’t see the money or resources available.
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