Monday, September 7, 2009
Why The US Doesn't Have Universal Healthcare
Healthcare reform may not happen this year. If it does, it’s likely to be a watered down version that displeases most Democrats. Why is universal healthcare so difficult to achieve?
Ever since the New Deal, Democrats have been trying. Truman, Carter, and Clinton all saw their efforts fail. Even the talented and charismatic Obama is having trouble.
I think there are two main reasons Democrats struggle. The first is that most people are satisfied with their private insurance. Now, none of this is to say that people should be satisfied with their healthcare. Many of the people who are currently satisfied aren’t sick, and so haven’t had to fight with an insurance company to make sure their treatment is covered. So we’ll see how satisfied they really are if they get cancer, and need expensive treatment that would bankrupt them if the insurance company succeeds in denying care to save money.
Second, most Americans are shielded from the true cost of their healthcare. This is because Americans tend to get insurance from their jobs. They think they’re getting free doctor visits, medications, and surgeries. In reality, high healthcare costs lower workers’ wages and cut down on the amount of capital a business has to invest. The upshot of this is that reform based on lowering costs doesn’t resonate with many Americans, because they don’t see in their personal lives that cost is a problem.
So that leaves most Americans feeling that there’s nothing in health reform for them. In fact, they could easily feel that healthcare reform will make life worse for them. They’ll have to pay higher taxes, and change doctors, they reason.
What will it take to make people embrace change in the system? In the next few years, healthcare costs are set to go through the roof. That will make providing health insurance prohibitively expensive for many companies. If workers want coverage, they’ll either have to purchase an individual plan, or switch to a much less expansive employer-based one with higher deductibles and co-pays.
When more people have to pay for their own insurance, or go without, they’ll be more inclined to see rising costs as a problem that has to be addressed. Then universal healthcare can be sold as a middle class entitlement, which is easier to pass, and harder to repeal.