We have made two huge mistakes in our tortured history of health care: 1. We decided during WWII that employers, flush with cash from the war, should provide benefits rather than install a socialized medicine model. So we now have an employer benefit model of medical insurance. The consequences vastly outweigh the benefits of this error. Employers immediately became adversaries with workers over health care of all things, constantly negotiating lower and lower benefits relative to costs, to protect profits and sometimes to stay solvent. As time wore on, benefits were often what prompted strikes not pay.
Meanwhile in the rest of the world, employers did not have the cash to even consider paying benefits for health care: their economies were in ruin . So all over the globe "industrialized" nations were forced to adopt various forms of single payor or socialized medicine, at low level of coverage (only basic services could be afforded).
Meanwhile America's economy boomed, making the poison pill of health benefits grow and grow; and lure insurance companies of all things (they were invented for fire, theft and life insurance) into the market of health care.
And, science meanwhile was making huge inroads into vaccines, polio for example, eradicating diseases that had kept the life expenctancy rate to about 48 years. The drug companies grew quickly, riding the wave of one "wonder drug" after another, rising prices as they went, making a multi-billion dollar industry.
Suddenly medicine, that had NEVER been a major "industry" in America became one: with insurance companies, hospitals, doctors and drug companies making much more money than ever before.
And then, in the 80s, when the rest of the world had rebuilt from WWII (we always under estimate how important that is), their more efficient and less costly single payer/socialized medicine began outperforming the American market based model. No longer was America the economic power house of the world and had to compete with Japan for example, and Germany (whose economies had been flattened) in manufacturing: and they did so with single payer/socialized medical benefits.
And that resulted in a huge advantage labor cost wise.
Americans stopped buying American because labor costs were passed along by American manufacturers that included increasing health care benefits costs.
2. We allowed lobbyists of the health care monster that we created to have access to our legislatures, and they have basically bought them. The Public Interest, as presented in the Preamble to the Constitution ("provide for the genereal WELFARE") has been distorted into "free markets that drove America's rise to economic power will work miraculously to drive down health care costs".
Meanwhile, thanks to the medicines and medical care, and in spite of an American lifestyle of self abuse through over consumption (do you know anyone who is under weight?), the life expectancy rose to the mid-eighties. (Which ironically is lower than other single payer/socialized medicine systems).
And we are stuck arguing about a vital issue in the wrong terms. We argue that health care is not a right (the Constitution basically SAYS it is a right) but a privilege that is STILL anchored to employment.
So, according to conservatives, if you are not employed, you are not "earning" your health care. Conservatives have tied their very political theory to this; and that transfers into the sick are lazy and brought it upon themselves so "tough luck".
And liberals, aware that it was their party that was in power when this whole mis-step happened (the New Deal screwed up and should have installed Medicare for all in 1946), now push for the solution that the economically strapped Europeans did years ago. And vital to making this work is tax and spend, which opens them up to fatal politcal attack.
Coupled with an increasing aged and ill population (fat, ill and very expensive) and you have the perfect storm.
The solution is complex (Trump finally stated that) and dangerous politically. It has paralyzed our political process. Americans are being told the choice is stark, economical health care must basically be rationed or it won't work. And part of that is true. But then solution makers go to the extremes, declaring that our political liberty is economic liberty for insurance and pharmaceutical companies.
On the other hand, 80% of Americans get medical insurance benefits, their employer pays health insurance for them. And herein lies part of the solution. This has to stop (that's right stop) and the benefits paid must be paid directly in salary to the workers (and mandated by he way for a time, you just can't cut the benefit because companies will take the difference)....then taxes have to be increased for a lifetime (that's right even tax social securiity some) to run a single payer system in the entire United States.
The wellness provisions of the ACA and the required coverages need to be continued but wellness even more stressed; our aging just has to be healthier or none of this will work: diabetes from over weight is an epidemic right now and is simply caused by a high carb and sugar (beer) diet.
And none of this is possible in any kind of free market system....it simply has to been enforced through common government action and oversight.
Yes taxes must increase and rather than get rid of the ACA we need to gear it to include the "public option" with private insurance for those who want more and better coverage....Austrailia's model is worth looking at).
And we probably won't come close, because we have built a monster that now, if the ACA is actually gutted, will bankrupt us all.
Again....the Reckoning..our politcal system is broken so bad by those on the right who feel economic liberty includes punishing the sick for being sick and on the left, who feel economic liberty means a socialized medical system that in effectively punishes the health care providers for treating the sick.
We need to copy Austrailia!!!!
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