A reader writes:
As a Canadian living in the States, it’s been interesting to watch as more and more Americans become aware of their deteriorating healthcare system. For me, it’s meant an ever-increasing trickle of people (of broader and broader political perspectives, I might add) who come to me to talk about Canada’s system. I begin every conversation the same way: Both systems have their flaws. You’ll find unhappy people in both systems. The truest non-empirical test I have is to point out that I have known many people who have lived in both systems (i.e., Canadian and American), and I still have never met a single person who preferred the American one.
The present system in the U.S. is simply unsustainable. From a Harvard study, we know that more than half of all personal bankruptcies are healthcare-cost-related. The scary thing? Fully half of those people–or one quarter of all personal bankruptcies– actually had health insurance. Health costs are growing far faster than the rate of inflation and even faster relative to wages (with the exception of perhaps the top 1% of earners). A piece on NPR this week pointed to a study that showed small businesses face 18% higher costs than their larger counterparts. More and more people are uncovered, and their unpaid bills are falling to fewer and fewer covered patients in the form of higher premium. This failure of markets will only accelerate with the current recession.
Healthcare reform is coming; it’s not a question of if, but when, and how significant the changes will be. The more I study this area, the more I am convinced that the debate is going to come down to the finessing of just two words: choice, and rationing. To get traction for significant change, the Obama must find a way to shoot down the canard about lack of doctor choice (Canadians have choice, by the way), and to blow up the myth that there is no rationing in the present American system (both coverage and services are rationed already in both systems). Watch in the coming months for those two lines of attack to be the centerpiece of the Republican resistance to reform. Hell, the Democrats even used these arguments against each other during the primary season. If my take on the political climate is correct, this will be a far more difficult dodge for Obama than he had with the socialist tag during the presidential campaign.
The Dish 