When I read this remark by Colin Powell, to the effect that the United States should adopt some soft of universal healthcare as is present in every other developed country:
Former Secretary of State Colin Powell said universal health care should be available to all Americans. He was speaking at a charity event for prostate cancer survivors in Seattle.
Powell told the audience that countries in Europe, Canada and South Korea offer universal, single-payer health care and said he often asks why the United States has not implemented the same system.
“Whether it’s Obamacare, or son of Obamacare, I don’t care,” Powell said. “As long as we get it done.”
it brought some questions to mind. Is universal healthcare primarily a cause or an effect? Why doesn’t the United States have a system of universal healthcare? It is politically easier to adopt such a system in countries with higher social cohesion?
I’ve favored some sort of universal healthcare in the United States for decades and have wracked my brain to understand why we don’t have one. My tentative conclusion is that universal healthcare is not primarily a cause of lower healthcare costs but that universal healthcare and lower costs share a common cause. The Scandinavian countries, famous for their cradle-to-grave welfare states, have scaled them back as they have become less socially cohesive as has France. To a certain extent the same is the case in the United Kingdom.
Since the United States is the least socially cohesive major economy, it makes a certain amount of sense that social programs would be more difficult for us to adopt.
The PPACA does not effect a system of universal care. It doesn’t even effect a system of universal insurance. Its advocates hope that, buoyed by the PPACA’s successes, we will be moved to expand on it and implement a system of universal care.
At this moment it appears that, if anything, the effect of the PPACA will be to put an official imprimatur on a tiered system of care with a lower level of care being available to people on Medicaid and those covered under the individual insurance market and a higher level of care available to those insured by Medicare or large group plans.