Health Care Terror
By Paul Krugman
New York Times July 9, 2007
These days terrorism is the first refuge of scoundrels.
So when British authorities announced that a ring of
Muslim doctors working for the National Health Service
was behind the recent failed bomb plot, we should have
known what was coming.
"National healthcare: Breeding ground for terror?" read
the on-screen headline, as the Fox News host Neil
Cavuto and the commentator Jerry Bowyer solemnly
discussed how universal health care promotes terrorism.
While this was crass even by the standards of Bush-era
political discourse, Fox was following in a long
tradition. For more than 60 years, the medical-
industrial complex and its political allies have used
scare tactics to prevent America from following its
conscience and making access to health care a right for
all its citizens.
I say conscience, because the health care issue is,
most of all, about morality.
That's what we learn from the overwhelming response to
Michael Moore's "Sicko." Health care reformers should,
by all means, address the anxieties of middle-class
Americans, their growing and justified fear of finding
themselves uninsured or having their insurers deny
coverage when they need it most. But reformers
shouldn't focus only on self-interest. They should also
appeal to Americans' sense of decency and humanity.
What outrages people who see "Sicko" is the sheer
cruelty and injustice of the American health care
system - sick people who can't pay their hospital bills
literally dumped on the sidewalk, a child who dies
because an emergency room that isn't a participant in
her mother's health plan won't treat her, hard-working
Americans driven into humiliating poverty by medical
bills.
"Sicko" is a powerful call to action - but don't count
the defenders of the status quo out. History shows that
they're very good at fending off reform by finding new
ways to scare us.
These scare tactics have often included over-the-top
claims about the dangers of government insurance.
"Sicko" plays part of a recording Ronald Reagan once
made for the American Medical Association, warning that
a proposed program of health insurance for the elderly
- the program now known as Medicare - would lead to
totalitarianism.
Right now, by the way, Medicare - which did enormous
good, without leading to a dictatorship - is being
undermined by privatization.
Mainly, though, the big-money interests with a stake in
the present system want you to believe that universal
health care would lead to a crushing tax burden and
lousy medical care.
Now, every wealthy country except the United States
already has some form of universal care. Citizens of
these countries pay extra taxes as a result - but they
make up for that through savings on insurance premiums
and out-of-pocket medical costs. The overall cost of
health care in countries with universal coverage is
much lower than it is here.
Meanwhile, every available indicator says that in terms
of quality, access to needed care and health outcomes,
the U.S. health care system does worse, not better,
than other advanced countries - even Britain, which
spends only about 40 percent as much per person as we
do.
Yes, Canadians wait longer than insured Americans for
elective surgery. But over all, the average Canadian's
access to health care is as good as that of the average
insured American - and much better than that of
uninsured Americans, many of whom never receive needed
care at all.
And the French manage to provide arguably the best
health care in the world, without significant waiting
lists of any kind. There's a scene in "Sicko" in which
expatriate Americans in Paris praise the French system.
According to the hard data they're not romanticizing.
It really is that good.
All of which raises the question Mr. Moore asks at the
beginning of "Sicko": who are we?
"We have always known that heedless self-interest was
bad morals; we know now that it is bad economics." So
declared F.D.R. in 1937, in words that apply perfectly
to health care today. This isn't one of those cases
where we face painful tradeoffs - here, doing the right
thing is also cost-efficient. Universal health care
would save thousands of American lives each year, while
actually saving money.
So this is a test. The only things standing in the way
of universal health care are the fear-mongering and
influence-buying of interest groups. If we can't
overcome those forces here, there's not much hope for
America's future.
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