Universal coverage

There’s quite a bit of discussion of the Edwards healthcare proposal. Ezra Klein’s first blush reaction to the plan is that he likes it; Steve Verdon isn’t completely negative on the plan although he does provide some useful criticism; Balloon Juice and Newshog are both critical of the plan because it doesn’t remove insurers from the picture.

I’m sure everybody is tired of my opinion of how we need to reform our healthcare system by this time (short version: cost control must come first) so I’m going to take a different tack. The problem of people without healthcare insurance is, indeed, a problem but it isn’t a national problem. It’s a local problem. Just two states account for more than a quarter of all the people without healthcare insurance: Texas and California. Both states not only have a large number of people without healthcare insurance, they have a large proportion of people (25 and 19%, respectively). When you add just a handful of other states with high proportions of uninsured (Florida, Georgia, Louisiana, Nevada, New Mexico, North Carolina) it accounts for nearly half of the total.

When half of the total problem is in just eight states with less than half the total population, that would suggest to me that local conditions are the issue that needs to be dealt with.

If you add a solution to the free rider problem, the problem of people without healthcare insurance begins to become a much more tractable one.

Whatever solution is arrived at should be tailored to the problems we actually have.

2 comments… add one
  • Ian Coull Link

    Universal health care – motherhood – apple pie, all good stuff in moderation. The more complete phrase is ‘universal health care insurance’, and glossing over the last word does not serve us well. Insurance is intended to ameliorate catastrophe – it cannot be a prepayment scheme for the ever widening cornucopia of ‘health care’ services that exist. Whenever a communal purse is opened, there is a need to apply adequate checks on the disburesment of benefits, and herein lies one of the barriers to making such an insurance scheme work. There was a time in the recent past when a finite amount of technology put natural limits on the cost [in terms of human and other resources] of medical/health care. Fast forward to the present – we could now probably spend the entire gross national product on the technologically spectacular interventions that are available to improve ‘health’. The old physician’s credo of ‘doing everything in our power’ to ‘save’em’ is a formula for fiscal disater. Someone has the very difficult job of saying what procedures can be covered, and which cannot; a question related to that very tricky business of determining what a human life is worth. I think this concept of limits to the list of covered services needs to be addressed as a fundamental component of any viable insurance scheme.

  • Unfortunately, Ian, I don’t believe that most people understand the concept of insurance. They look upon it as a sort of savings plan.

    It’s not savings; it’s gambling. And a universal healthcare plan that covers everybody for everything isn’t insurance at all.

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