One Little Goal for 2006
The Universal Healthcare Tradeoff

Healthcare is a Human Right

category_bug_journal2.gif Get a cup of coffee or your beverage of choice and settle down at your computer. Today’s post is about four times longer than average and you need to think about this stuff. It is important to your health and well-being and it is important to the health and well-being of our country for decades to come.

The mid-term election campaign begins today. Yes, Congress is on vacation until later in the month, but those senators and representatives are not idle. They are back home in their states beating the bushes of their constituencies to figure out how best to get themselves re-elected in November.

Personally, I think we should jettison every member of this do-nothing, rubber-stamp, 109th Congress and start from scratch. (What a powerful message to politicians it would be for citizens to take back the government in that manner.) But there may be an exception or two - Pennsylvania’s John Murtha comes to mind – and we need to be well-informed before we vote.

All 435 representatives are up for re-election along with 29 of the 100 senators. Elders, particularly in mid-term elections, vote in much larger numbers than younger people. Therefore, we can make a difference in the outcome of the 2006 election, and it is incumbent upon us – as elders and therefore, presumably, more informed by the experience of our years than younger folks – to make wise choices.

Those choices cannot be made selfishly. With the recent media blitz on the oldest baby boomers turning 60 this year, already there is an undercurrent making its way from certain quarters accusing elders of being greedy geezers. That is not always off-base, though it is more often unfounded, and the accusation will spread in coming months and years. But it does not change the fact that as elders become a larger percentage of the population, some will need medical care and it must be provided no matter how many there are in need.

As the system stands now, many – though not all - elders are adequately covered by Medicare, but many millions of younger Americans, including children, go without health care because they cannot afford it. This must change.

How to do that is a complex issue that our elected officials, whose job it is to anticipate and solve such problems, have pointedly ignored since the first year of the Clinton administration. Time is now of the essence before the numbers in need of care overwhelm the system.

There are a lot of big political issues to concern us: the Iraq war, domestic spying, energy prices and resources, government secrecy, torture, the federal deficit, incompetent political appointees, hurricane rebuilding, global warming, immigration, terrorism.

And Mr. Bush will probably create a new one early this year by pushing for tax reform. Watch that one carefully; his proposal will seek to further enrich the wealthy while harming the poor and middle class or, what’s left of it.

All of these are important. But after a couple of months of research, reading until my eyes water, weighing many ideas and points of view, and thinking hard while shuffling hundreds of notes on 3 x 5 cards, my number one priority in considering my vote for anyone running for federal office has come down to this: universal health coverage – enacted in the next congress, after the mid-term election and before the presidential election in 2008.

I hope it will become your priority too because by relieving every American of the fear of financial ruin caused by catastrophic health problems, by getting health coverage off the backs of employers (who are in the process of divesting themselves of that obligation anyway), and by giving each and every American access to healthcare, we can also make a good-sized dent in other public financial problems.

You probably know the facts in the list below, but they bear repeating:

  • 45 million Americans are without health coverage
  • Each year, fewer employers offer a healthcare benefit
  • Corporate pensions and promised health coverage in retirement are being cut back or eliminated
  • Private health coverage is out of reach of average Americans
  • The population of the U.S. is aging; a larger percentage of us will require more healthcare than in the past
  • More physicians are establishing “boutique” practices for wealthy patients only, creating an unfair, tiered healthcare system
  • Many elders take lower dosages of prescribed medications and some never fill their prescriptions because they cannot afford to and also eat
  • Pharmaceutical manufacturers spend more money marketing their drugs than they do developing them
  • In a last-minute, stealth inclusion by Senator Bill Frist of Tennessee (a physician!) to the 2006 Defense Appropriations bill, pharmaceutical manufacturers of flu vaccines were granted immunity from liability if the vaccines sicken or kill anyone
  • The U.S. ranks 36th in the world in infant mortality
  • The U.S. ranks 48th in life expectancy at birth
  • The U.S. is the only first-world country without universal health coverage

All of this is on track to worsen if we don’t fix our broken healthcare system, and the only possible solution is universal healthcare.

The most recently touted idea by government and corporate America to solve the healthcare crisis is health savings accounts in which, in exchange for a tax deduction, individuals can put money aside to pay for future healthcare needs and thereby rely less on insurance. There are many things wrong with this idea, most importantly:

  • No average individual can save enough in an entire lifetime for heart surgery
  • The accounts become tax-shelters for the rich
  • The accounts don’t solve the problems in that long list above

The current savings rate in the U.S. sits at 0.2 percent. Average income in the U.S. is about $44,000 a year, before taxes, and workers’ salaries have lagged behind inflation for the past decade.

In addition, the federal minimum hourly wage has been stuck at $5.15 an hour - $10,300 a year for full-time workers - since 1996. Economists say that a family of four needs $34,920 to cover housing, food, health and childcare (no extras and no big medical bills).

So a minimum-wage, two-income family with two kids lives below the poverty line. Asking them to add another savings account to what little they can set aside now is not reasonable, possible nor could it be large enough to cover even a few, simple medical tests which, these days, can amount to hundreds of dollars before you can blink.

Our healthcare system is headed for a train wreck – sooner rather than later – and for Congress to put off the admittedly hard work to create a universal system is criminal.

It’s not easy to do. Americans have been lectured on the evils of big government and the miraculous efficiency of an untrammeled marketplace in healthcare since at least the Reagan presidency.

And Congress members, in weighing, debating and writing a universal healthcare bill will be lobbied unmercifully against it by powerful special interests who contribute to their campaigns. These will all be rich people who don’t need universal coverage. Many misguided, ordinary citizens will campaign against it too, some on the basis of that mid-20th-century bugaboo, “socialized” medicine. Some physicians may object as it will undoubtedly reduce their income.

But it will become economically essential for the U.S. to adopt universal healthcare eventually and the longer we wait, the harder and more expensive it will be.

No plan will be perfect. Such huge public programs never are. But it will be better than what we have now and if done with reasonable thought, it will ensure basic and catastrophic coverage to every citizen of America.

There are already universal coverage ideas and proposals from many sources. Try typing - “universal healthcare” proposals – into any search engine and you will find hundreds. And there is also the experience of every other industrialized country to guide Congress.

And here's a thought worth considering: we already have partial universal healthcare in the form of Medicare for elders, and it works pretty well. Why not expand it to everyone?

[I would be most appreciative for any Canadians, Britons, French and other nationalities who have read this far to jump in here in the comments section and tell us about your countries’ healthcare systems: how they work, how well they work, what doesn’t work, how they have been tweaked and changed over time to work better, and what it costs - your government and yourselves. Don’t worry about length; space is cheap in the blogosphere. And here’s a converter to help readers translate from your currency to U.S. dollars.]

Universal healthcare, for me, takes precedence over every other campaign issue candidates may raise this year. I want to hear them talk about it. I want preliminary proposals in their speeches and position papers. I want them to discuss the problems and potential solutions. I want tradeoffs to be offered. (Eliminating $27.3 billion in pork projects, as Congress passed in 2005, isn’t a bad start.) I want opposing candidates debating the best way to enact universal healthcare.

And then I want the follow-through in the 110th Congress, prior to the 2008 election. Two years is plenty of time to create a universal healthcare program and the bonus, when they do it, is each one can be pretty well assured of easy re-election from a grateful electorate.

Elders are in a unique position to push candidates into working on this legislation. We vote in large numbers and according to The Wall Street Journal [paid subscription required] on 15 December 2005, in a report on a survey done with NBC, we are “a pretty cranked up bunch” who are angry with Congress and incumbents are running scared:

“By a 65% - 19% margin, Americans 65 and above disapprove of the performance of Congress…Moreover, their unhappiness extends across the political horizon beyond issues traditionally of concern to senior citizens.”

We can put our anger and our voting power to use this year for the good of all Americans.

When I was a child, diphtheria, whooping cough, measles, tuberculosis, small pox and polio were still terrifying, potential killers and every year when school began, one or two classmates had been lost to one of those diseases. Parents and grandparents, in those days, were fond of saying, “As long as you’ve got your health…” meaning that all else is irrelevant if you don’t.

And they were correct. Science and medicine have made enormous advances in just my lifetime but those advances are unavailable to millions of Americans.

I believe that healthcare is a human right and a public responsibility we all share. It is our moral obligation, individually and collectively, to ensure that every citizen has access to healthcare and if we do not guarantee that, if it is available only to the rich, we have failed as human beings and as a nation.

U.S. leaders of all stripes and every era like to remind us that we are the richest country on earth. Although the current federal deficit (let us not forget that President Clinton handed over a surplus to the Bush administration) makes that an open question for the future, we are not lacking in the resources to make universal healthcare a reality.

All it takes is the will of our legislators to reallocate those resources, and the will of the people – you and me – to demand it.

The Universal Healthcare Tradeoff
Politics, Religion and Universal Healthcare
The Right to Healthcare - A Dissent
Bipartisanshp and Healthcare


Right on, Ronni!!! And comparisons with and information from other countries could be very helpful. Just two tidbits: My sister recently had an accident in Paris and got excellent medical care for free - so no more French-bashing, everybody.
And my British friend's aging parents, in order to visit him and his family, have to spend more on medical insurance for a two-week stay here than they pay for their plane ticket! Our healthcare "system" is scandelous. Susan

Excellent analysis and presentation! I'm on-board and will be following through with contacts to my Congressional reps promptly. I may use some of your words since they are more succinct than any I might use to paraphrase.

What an extraordinarily enlightening comparison (and shame for the U.S.) between the U.S. and France, Takoma.

Winston, if it works, my words are yours to use...

Your ideas are right on. However, with the current administration I cannot see anything reasonable happening. The new Medicare drug "benefit" being an example.

I happen to agree with kendra2, but if we don't try, it'll never happen for sure. So lets do what we gotta, to make it happen.
Right on Ronni.

Thanks for a great analysis and statement of the problem. I think about this frequently. Although I am healthy and take no medication, I became obsessed with the dysfunction of our healthcare system about 15 years ago when I was self-employed and had trouble getting incurance. My concerns are reinforced when I go to the doctor and see more office staff involved in insurance related administration than in medical care; when my doctor makes decisions based on insurance coverage or pharmaceutical hype; and above all, when I think about the Rubin Museum in New York City. I love the museum, but I am always aware of the fact that it was built with health care profits. Donald Rubin, its creator, was the founder of Multiplan, Inc., a managed health care network. I deeply resent that someone can make so much money from "health administration," that we have made health a profitable business and that our decisions about care and medication are based on profit rather than need and humanity.

The idea of separating health insurance from the employer is indeed of utmost importance. I would think Bush could tout this as helping the economy as new businesses would not have this burden. I have a son who has Type 1 diabetes and I see his options limited when he is thinking of changing jobs. I, for one, will vote with this in mind.

Sign me up!
As you point out, there are very rich/powerful lobbies in opposition to healthcare reform... and, especially in national politics, money talks. People need to get the facts and get out the vote.

Eloquent, articulate post (of course)! I'd also like to link it on my blog and email a link to others. I live in Tennessee where Frist is not seeking re-election, thank goodness, and agree with everything you wrote.

Healthcare is a major concern. The insurance nazis have too much power and need to be replaced.

Thank you for the time and effort that went into this post.

I am for medicare extended to everyone and those below a certain income ($35,000/yr) can be subsidised by decreased military and weapons spending. It is not supposed to be self supporting system. With some increased medicare payments, doctors will be happy too.

I'm with you. I don't think there's an single issue more important than this. I don't want to hear anymore halfway solutions either. Even the candidates I've supported have come out with plans that will cover more, but not all Americans. Full medical coverage needs to be extended to every American, regardless of age or means.

As a Canadian who has only known a system with universal healthcare, it's easy to become blase and focus on the flaws within our own country. Reading your article reminds me why we need to protect the basic principles behind universal care - as you so eloquently stated:

. . . healthcare is a human right and a public responsibility we all share. It is our moral obligation, individually and collectively, to ensure that every citizen has access to healthcare and if we do not guarantee that, if it is available only to the rich, we have failed as human beings and as a nation.

Canada has problems with the current system - long waitlists, question of monetary sustainability - but I blanch at the thought of going to a US system, as some are proposing.

It is unfathomable to me that a family could be bankrupted because they need life-saving surgery.

For the benefit of Americans reading this, here is a rundown of our healthcare premium costs. Everyone is covered and the premiums are on a sliding scale based on ability to pay, or income, if you will. My husband and I pay a family premium of $96 CAD per month (approx $82.50 USD/month). Our income is such that we don't qualify for any subsidy, so you can view this $82.50 as the maximum for a couple of baby boomers. This includes all office visits to doctors (including surgeons and specialists), hospital stays, trips to the emergency room and any necessary follow-up. I should also add that there is no restriction to which doctor or clinic you choose to see or which specialist your GP refers you to.

My two sons are full-time students and on a limited income, so their premiums are subsidized on a sliding scale. At the moment, they are below the minimum income level, so are fully subsidized, but will change once they graduate or increase their income.

Over the years, my husband has had cancer surgery and treatment, my sons have had the usual visits to emergency with broken bones from snowboarding, cuts from hockey, etc. I never once, worried about how to pay, only that they got better.

We have American relatives who are astounded that we receive the services we do without belonging to a well-funded HMO.

Excellent article! "Health" insurance and access to care have been issues with me for a long time. I currently have health without insurance. Too much of my little SS stipend is going to the dentist at present, and I have to live with others to survive.

While big pharma is largely uncontrolled and medical services are 'for profit', it will be very difficult to work out the economics of a 'health' system for all. It may not be possible, or fair, for the feds to pay the high costs currently being charged.

I couldn't agree more. I have healthcare coverage through my employer at no cost to me, but we can't afford to add any of the rest of the family. It is frightening to think about, and I know we are just an accident/serious illness away from total bankruptcy.

I guess what I most fear is that our government would again botch up any kind of real universal healthcare. The poor and middle class patients would receive second-rate and pisspoor care while the wealthy would be given top-notch service.

At this stage of the game, even second-rate and pisspoor are better than our own family's non-insured state.

Rather like ell, I have never known life under anything other than univeral health coverage for all - in my case, the UK's National Health Service. The creation of the NHS was, in my opinion, one of the finest political achievements in the UK in the last century - and while successive Governments (of both flavours, Conservative and Labour) have tinkered with it, usually detrimentally, the fact remains that anybody who needs urgent or life-threatening treatment will get it - but for less urgent conditions, they're probably going to have to wait.

Unlike Canada, there is no separate premium for individuals - the NHS is funded by the Government, out of the public purse - which means that I pay in the form of some of the Income Tax and National Insurance for which I am liable.

The NHS is not ideal - long waiting lists for non-urgent treatment (non-urgent in the eyes of the NHS, which may not be how patients view their treatment) are common. The Conservatives wreaked havoc with their attempts to introduce market-led economics into the NHS - while Labour, focusing on "increasing choice" and reducing waiting lists sometimes give the impression of, how can I put it, "creative" manipulation of statistics. The fact remains, though, that if I need treatment, I will get it. Without having to bankrupt myself.

As a transsexual woman, I await sex reassignment surgery - which some view as an abhorrence, some as a whim, some as cosmetic surgery, some as essential surgery to allow a reasonable quality of life (*and* continued economic productivity). Not surprisingly, I fall into the latter camp. I am entitled to this surgery under the NHS - in a month or so, when I expect to receive my second and final approval for surgery, I will start to get a picture of how long I will have to wait for that surgery, under the NHS. If the wait is too long, I have the option of paying to have it performed privately - I'd prefer not to! :-)

I cannot imagine *not* having the NHS - it doesn't bear thinking about. I have the utmost sympathy with the campaign to achieve universal healthcare in the US.

I am thrilled to see you covering this. As two self employed healthy 50 year olds all we can get is either a 5,000 deductible policy for about 5500.00 a year or a 10,000 dollar deductible for about 4800.00. By the time we are 64 we will probably not have any insurance at all. This insurance covers nothing under 10,000 or dentist, eye doctors, glasses, check ups etc.
We need a better solution. I wish we had kept going north and moved back to Canada! 82.50 a month for full coverage for a family!
There is so much to the issue. A great big thanks for your writing on it. Among all my friends there are many tough stories because most of them are self employed.

Being a 21 year old college student i am not in the demographic this was written to, but i think my personal story might have some relevance, at least shed some light on the sort of choices that get made. Like i said, i am a college student. My studies are in field biology, i want study nature. My motive for doing this is to help the rest of us make better choices when it comes to the way we live, and the sustainability of our actions. i picked this field because i want to make the world a better place for generations to come. i am on the verge of getting my degree and going off to do field research. i have grown up poor. This has not been all bad, i am humble because of it. i have no desire to become rich, a desire of most of my classmates. i have seen far too many work far to hard and recieve much less than they deserve because it was lining anothers pocket, this has made me desire no more than i need. My intelligence and a small gov't grant allow me to go to college for free, if this were not the case i could not go considering my income. The area i live in, my home, is very economically depressed. There just aren't enough jobs to go around. i live in the old iron furnace and steel belt of Appalachia. More people here than there is employment. Getting an employer who will work around your college schedule (field classes vary in times but most are afternoon) is next to impossible. Getting one that does that and provides benefits is impossible. My father a currently disabled Vietnam vet, and my mother a medicaid baby boomer, both on fixed income have been unable to help with any finances for college. From coming of age on i have had no healthcare. This was unsettling to me of course. But i have always been pretty healthy and athletic so it was only a back of the mind issue. Then my former fiance and i found out we were going to have a little baby girl. i was very close to finishing my degree and being able to support my little girl and provide for her in my given field. In the mean time her and her mother could be covered under the healthy child program. We decided this was wiser in the long run than dropping college and taking on a labor job in the area, which are often subject to layoffs and would be a somewhat precarious way of providing health benefits to our child. Especially since i was so close to the degree. About halfway through her pregnancy i began to have swelling and a lump develop in one of my testicles. Now i am not saying what i did was the right choice, but living very poor it's the sort of choice i see alot of parents make especially in my area. i chose rather than to bring certain debt upon my new child who then would certainly live in inescapable poverty, to not get treated or even examined until medical coverage could be achieved. In my case i was lucky. i did not have a cancerous tumor. However, if i had, by the time i attempted to begin treatment it would have likely been leaning towards a bit too late. i see these choices being made all the time. And yes it is easy to say what i did was foolish my child could have ended up without a father, but to recieve treatment back then would have meant my child may (almost certainly) have ended up without a chance at something better. It is hard for a parent to not be self sacrificing. Living in a very poor area i've seen this choice get made time and time again, in both directions, and pretty much being a game of russian roulette. What's harder for me, having spent a large portion of my childhood in Canada is i know it doesn't have to be this way. These recent events have made it very hard for me to have discussions with economic conservatives about this issue, having my life and the future of my child in my hands judging the worth of the two because of the way our system exists. i know first hand who the system as it stands now serves, and just who it doesn't.

What about housing, clothing and food? Obviously, if I these are not human rights, then we could die from exposure to the elements, or starve?

And those health savings account things? Imagine these people expecting me to save for my own medical care expenses?

If only you and I were stranded on an island, I would still be able to and should still be expected to provide you with your right to life, liberty and the pursuit of happiness. Please explain to me how I could be expected to provide you will a drug benefit or a CAT scan? If I can not be expected to provide these things in all circumstances, how can it be a right?

We provide education to every child but education is not a right but a privilege and a gift. It behooves society to provide this education as it makes our society stronger. It is in our best interest. It is still not a right. Just because something is good for everyone to have or even needed by everyone does not make it a right.

I see every comment in response to your article except the last two short ones is defending and supporting your flawed, incorrect commentary. Way to go, loser. Cherry-pick the responses you post and you can always look as if the majority are in support of an idea or opinion. Government-run healthcare is the REASON the present system is so expensive, don't you see? Take off your rose-colored glasses or blinders, and try to think from an objective perspective. not everyone in life is a winner. Not everyone in life is motivated. Not everyone in life is your or my or someone else's equal. When the return on one's efforts are disconnected from those efforts, as is the case in any level of socializing a society (take from the wealthy and give to the poor) the incentive to improve one's situation is removed. It is sad that you don't [or simply refuse to] understand the action/reaction, cause/result of reward matching efforts or ingenuity, and the difference between that which is a human right and that which is properly classified - if accessible - a privilege. That's why I like driving a car with a manual transmission - I want to know exctly what is happening to all the power that leaves the engine... With a manual transmission, the relationship between the engine and the tires is constant and predictable, unchanging except for shifts and the potential for a slippery clutch. A socialized medical system which you defend is akin to having an automatic transmission built by a committee that taps the car's power for redistribution to other cars, no matter how hard you press on the gas. And your power-redistribution transmission has leaks and added losses of power power in the process of tapping and redistributing the power. Then there's the mountains of documentation and red tape t assure that the power is distributed "fairly" - which is an oxymoron, since it became unfair the moment power was remoed (taxed) from the transmission with the intent of giving it to others who did nothing to deserve it. Move to a Communist country, fool.

Here is some "required reading" for you misguided, shallow people who think healthcare is a right. (It indeed is NOT a right) You have no clue what the difference is between a right and a privilege. The pursuit of happiness does not mean a right to happiness - which includes health. It means you have the freedom so SEEK these things. That is all. Here is some reading for you:
Cut and paste, then go read, do your best to actually think in an objective, open-minded way about the things these links have in them, and then try to reformulate your erroneous concpts into proper ones. Socialism can kiss my free to succeed, free also to fail, patootie.

Sorry, some of those links got chopped. Here are those same sebsites, converted to short huyperlinks by

Now please, read, think and come back with a better understanding of Socialistic Marxism versus American-styled freedom, which embraces the free market system. Oh - And now even CHINA is adopting this, even though they have a HUGE problem managing and respecting intellectual property rights.

Read and learn:

I'd think healthcare was more akin to Life than the Pursuit of Happiness. For that matter, it's also closer to Liberty. Anyway, I think it's important to think outside the box and think of rights as more than things that a particular government tells you you may or may not have. Thank you, Ronni, for your excellent post. Shall we discuss Hillary?

I certainly agree that healthcare is a very serious consideration in the next election and that it is a complicated issue.
I have friends who live in the US, but are Canadian citizens and who live here because of the healthcare system in Canada(won't even get into the postal system). One friend who lives in Calgary needed a special hip surgery and was put on the waiting list. The waiting time was two years. He gave up and went to England to have it done.
Hillary and Obama's answer is to expand the Veteran's Administration system. I don't know about you, but I know veteran's (family members and friends) who won't go near the VA. To me that just means bigger government and more government workers with nice jobs that once they get will never leave, whether they are good at their jobs or not.
McCain's answer is the private sector. Individuals would get insurance by buying in through group plans offered to employees or maybe even Chambers of Commerces of towns/cities.
Neither way will please all of us and will fulfill all of our needs. I can afford health insurance, but I have a disabled son who is a low wage earner who can not.
I don't know the answer, but I do know either way it won't be free, nothing is. It'll just mean higher taxes. I think the insurance companies and the Pharmaceutical companies are managing our lives as far as healthcare goes or maybe it's our deaths.

Healthcare is a Human right, because in many minorities have higher rates of infant mortality, cardiovascular disease, diabetes, HIV infection/AIDS, cancer, and lower rates of immunizations and cancer screening.

I am completely at a loss for words each and every time I come upon the emotion draped but illogical argument that healthcare is a 'fundamental human right'. To whom? To those who want it, I guess. The only rights guaranteed to us are set out plainly in the Constitution: the right to life, liberty, and the pursuit of happiness. There is a difference between a right and a need. Human beings NEED food, clothing and shelter and we have the RIGHT to pursue those needs. The elements that work together to make healthcare unaffordable for the minority do not change this basic construct and can be dealt with in ways other than creating another entitlement that we, as a nation, simply cannot afford. The problems with our health care system are not the result of too little government intervention, but rather too much. Contrary to the claims of many advocates of increased govt regulation, escalating costs do not represent market failure. Rather, they represent the failure of the govt policies that have destroyed the health care market, e.g., HMO Act of 1973.

Obama recently expressed his view that we must reform healthcare and treat it as a right, because that is the 'moral' thing to do. But what is moral about stealing from others in the form of wealth distribution in order to make this so? Forced charity cannot be equated with morality.

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