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August 23, 2007
Sick review
Yes, I read the book by Jonathan Cohn, a journalist. He writes with a journalist's instincts and style (whatever that means). It is an engaging book, leading the reader from one tragedy to another. Each chapter focuses on a person in a different geographic location with a different aspect of the socio-political problems in health care delivery.
Along the way, he gives some interesting history about insurance, various hospital systems and political maneuvering.
The Committee on the Costs of Medical Care met in 1926 and issued a report in 1932, concluding that the proportion of national resources for medicine must increase. This was immediately prior to FDR and the New Deal. And states had already begun to pass pension laws. But the foundation was laid. The author attempts to show that several opportunities for a single-payer system were missed.
After the heart-wrenching stories interspersed with historical and political vignettes and arguments, he finally asserts that the problem is ambivalence of public opinion, since most people have adequate health care and payment options. He further asserts that the problem cannot be solved by the private sector. Bush and many conservatives are confused by HSAs because they wrongly believe that “the fundamental problem with American health care today is that people have too much insurance.” P.221 He admits that this has some basis, but the HSAs solution focuses on the patient to the exclusion of the providers. Then the kicker: “How are consumers supposed to shop for good medical care when most experts still don’t agree on how to measure it?” Yet the proposal is a system in which the government decides what is good and the private sector provides it in cooperation. So what he proposes is a universal health care system, based on the French model, “quasi-independent sickness funds, which are overseen by the government."
He claims that in contrast to the “moderate conservative” principles which are short on comfort or hope, his “vision of universal health care—one traditionally articulated by liberals—offers optimism. To believe in universal health care is to believe that we can do more and do better, all at once—that it is possible to have hospitals full of high technology and emergency departments with room for all comers; that it is possible for people to choose their doctors and have a say in their treatments; that it is possible to make the economy more free and more efficient; and that it is possible to do all this for everybody, not just an economically or medically privileged few, in a way we can all find affordable.”
In a universal health system, maybe all the people he highlights that suffered under the current system might not have suffered or died, and the world would be a perfect place. But none of their problems could really be prevented, fixed, or definitively managed well by modern medicine. Each has components of individual responsibility and other social factors.
“To its critics on the political right, universal health care is an imposition on liberty that weakens individual initiative. But this is the classic bait-and-switch of modern conservatism—to make us forget that in a democracy, the government is merely an expression of our will and resources as a community. Universal health care is really about finding collective strength in our individual vulnerabilities." Is this not also a bait-and-switch? Isn’t finding collective strength in our individual vulnerabilities what Babel was all about? And God frustrated that plan, until the Rock cut without hands was come.
| By Robert Maddox | 08:16 PM