Posted by JeffSingleton - Tue, Nov 10, 2009, 11:53 A

Health Care Politics: The 85%

There have been a number of interesting posts on this corkboard about the health care issue, particularly the role of the market as opposed to government in providing health care for all at a cost that is affordable. But the fact of the matter is, the U.S. has had a mixed public-private system of health care provision since the late 1940s. It is not perfect but it does cover about 85% of the population. The trick now is to cover the other 15% and to try to get costs under control. I'm not convinced that requires resolving all theoretical problems, interesting as they may be (although it will probably involve some sort of rationing without admitting it).

I feel that the problem is mainly political and a certain irony is often ignored. We cover 85% of the population so why is going the extra mile such a monumental task? Part of the answer is that everyone on all sides has decided it IS a monumental task and that all questions re public v private health care must be resolved before we help the last 15%.

The other big problem is that 85% already have health care. Thus what hat should be a small problem creates a big problem.

The fact is, opponents of so-called "big government" have been very effective in scaring Americans with the idea that any significant change will undermine their own health care. This works because in fact most people have it (health insurance or a "public option" like Medicare. Meanwhile, the supporters of universal coverage have not been able to mobilize their constituency because.... well most of their constituency belongs to groups that already have health insurance or are in public options too. While they theoretically support universal coverage, they descend into rather narrow, interest group politics at the drop of a hat, ignoring the big picture.

The result is that the opponents of "government controlled health care" (a typical Fox News fantasy) mobilize their supporters (see Tea Party activists) while the liberals on the left stay at home complaining about abortion (see Martha Coakley's outrageous stance which is mainly appealing because she and her supporters..... are part of the 85%!) or that American reform is not the Canadian health care system. The political center in Congress is intimidated and will not vote for change. 1994 redux.