“Health Care Excuses” – Krugman 11/9/07

Last Friday (before taking a sick day Monday?), Mr. Krugman offered a quick rebuttal to four of the favorite talking points for apologists of the current American health care industry. Krugman does a good job of deconstructing these four arguments into recognizable one-liners that reverberate through contemporary American culture:

1. No Insurance, No Problem
2. It’s the Cheeseburgers
3. 2007 is better than 1950
4. Socialized Medicine! Socialized Medicine

Point #1 is a true statement, if by health care you mean emergency care at a hospital. It is not true, however, if you are attempting to seek preventive care from most clinics or if you are seeking mental health treatment. This isn’t to say you can’t get this care without insurance, but the vast majority of Americans without insurance (the working poor) cannot afford it. Krugman highlights some of the other flaws with this logic:

We’re told, for example, that there really aren’t that many uninsured American citizens, because some of the uninsured are illegal immigrants, while some of the rest are actually entitled to Medicaid. This misses the point that the 47 million people in this country without insurance are an ever-changing group, so that the experience of being without insurance extends to a much broader group — in fact, more than one in every three people in America under the age of 65 was uninsured at some point in 2006 or 2007.

The “they are all illegal immigrants” and the “they might be coverable by Medicaid” are both arguments used to prop up a failing national health care policy. Are some of the 47 million uninsured in this country illegal? Probably so. Are others eligible for Medicaid? Almost undoubtedly. Do these two groups sum to 47 million? Definitely not. I know I spent a portion of 2006 uninsured, as I’m sure many professionals in between jobs or returning to school can attest – there are a lot of uninsured Americans out there who have no viable method of securing health care coverage.

Point #2 illustrates the argument that our health care costs are higher because we take on a heightened amount of risky behavior and lifestyle choices. We eat too much and don’t exercise; We drive to fast; and We saturate our lives with stress. This sounds like a great reason for an expensive health care system, but a McKinsey Global Institute report begs to differ. The report finds Americans are not significantly sicker than other countries studied.

As to #3, well to be as kind as I can be --- that is just stupid. Of course we have improved health care immensely over the last half a century, but we’ve have an even more amazing increase in knowledge and ability regarding computers and that has led to more access and lower costs.

Point #4 is the final corner of retreat for at least a quarter of all American politicians on any issue – “Program X is socialist, commie, pinko, over-regulated, inefficient, non-market based, abandons individual responsibility, and is bad for the economy.” These politicians will continue to spew this vitriol about these programs, until you bring up Medicare. Then they talk about how it’s such a wonderful program for our elderly population.

We have both supply and demand issues in America’s health care policy, but maybe it is time to start considering solutions instead of continuously giving heed to reactionary politicos and pundits who haven’t been without health care in at least twenty years (if ever). America already pays for premium health care, isn’t it time we give access to it to all Americans?