Healthcare in America — The Next Conversation Part 7 – The Elephant in the Room – Video
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- Healthcare for all
Part 7 – The Elephant in the Room
So now we’ve come around the mountain and discovered that we may not need to rebuild the entire healthcare system after all.
We have most of the infrastructure already. We have the people, the hospitals, the medical technology, the knowledge and the need. We are already spending enormous amounts of money on healthcare.
So what are we really talking about?
Insurance.
And that is where I think the real battle begins.
I’m going to admit something here. When I started this series, I said I wasn’t going to make it about politics. I was wrong.
Not because this should become a partisan argument. It shouldn’t.
I’m talking about something bigger than Republicans and Democrats. I’m talking about the political machinery itself and the enormous amount of money and influence surrounding healthcare.
Healthcare should not be a political football. It is too important, and it affects too many people. This country exists because of its people; the people do not exist to serve the political system.
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The Money Is Already Here
This is where Part 5 comes back into the discussion.
I don’t want to pretend that I have figured out the exact tax structure or financing formula. I haven’t, and I don’t think I should pretend that I have. Those are the kinds of questions that people who actually understand federal taxation, budgeting and public finance need to work through.
But I do think we should stop talking as though America has to suddenly find an enormous pile of money that doesn’t already exist.
We already spend trillions of dollars every year on healthcare.
So perhaps the first question shouldn’t be, “Where are we going to find all this new money?”
Maybe the first question should be:
How much are we already spending, where is it coming from, where is it going, and what are we getting for it?
That’s a different question.
It also leaves open the possibility that some of the money already being spent could be redirected, consolidated or used more efficiently.
And there may be other sources of public wealth worth considering as well, such as the public-resource investment idea we discussed in Part 5.
I’m not claiming that oil royalties or a national investment fund will suddenly pay for American healthcare.
I’m saying we should be willing to ask the question.
If a portion of the nation’s natural resources creates wealth, should some portion of that wealth be returned to the people who collectively own the resource?
Maybe.
That’s a discussion for people who know how to design those systems.
My job here is simply to put the question on the table.
And Then There Are the Insurance Companies
If we are going to create a new federal medical insurance program, we cannot pretend the existing insurance industry won’t notice.
They will.
There is an enormous amount of money involved in American healthcare, and private insurance companies are deeply embedded in the way the system currently operates.
I don’t think we should underestimate the fight that would come from that industry and its lobbying organizations.
We’ve seen this before.
Look at the tobacco industry. We knew for decades that nicotine and tar were dangerous. Yet an industry with enormous financial resources fought regulation, influenced public policy and worked to protect its business interests.
I’m not comparing tobacco companies to health insurance companies.
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The program needs to belong to the people who are paying for it and depending upon it.
That doesn’t mean politicians disappear from the process.
It means the basic healthcare structure should be harder to manipulate for short-term political purposes.
Start Small, Learn, Keep Going
I don’t think we can accomplish this in one pass.
We shouldn’t even try.
The idea would be to start with basic medical coverage, build the system, test it, find the failures and fix them.
Then we could add additional services as the system becomes financially and administratively stable. Dental and vision are obvious candidates. Mental healthcare needs considerably more attention. Physical therapy and rehabilitation, specialist care and other services can be evaluated as we go.
The point is not to create a perfect system on the first day.
The point is to create a system that can improve without collapsing.
I’ve been thinking about those domino demonstrations where one little piece starts a chain reaction and, if everything is positioned correctly, the entire thing works.
They look simple when you watch them.
But behind that simplicity is an enormous amount of planning. Every domino has to be in the right place and the sequence has to work.
Healthcare is like that.
We can’t see the entire chain from where we are standing. There will be pieces we get wrong. There will be things we didn’t anticipate. There will be unintended consequences.
So we need safety mechanisms.
If one piece falls the wrong way, it shouldn’t bring down the entire system.
And that brings me back to where I started this series.
I said at the beginning that I wasn’t going to have The Answer.
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How do we build something that can survive us?
Not just one president. Not one Congress. Not one political party. Not one generation.
Something that can be adjusted, repaired and improved as the country changes.
Because if we are going to call it healthcare for all, then perhaps the commitment needs to be for all of us, including the people who haven’t been born yet.
And that’s a much bigger commitment than putting four words on a campaign sign.
| Healthcare For All, The Evolving Series |
