6.14.2005

one nation, uninsured

Since we've been talking about health care in light of the recent Canadian Supreme Court decision, here is Paul Krugman's recent column about the state of the US non-system.
Harry Truman tried to create a national health insurance system. Public opinion was initially on his side: Jill Quadagno's book "One Nation, Uninsured" tells us that in 1945, 75 percent of Americans favored national health insurance. If Truman had succeeded, universal coverage for everyone, not just the elderly, would today be an accepted part of the social contract.

But Truman failed. Special interests, especially the American Medical Association and Southern politicians who feared that national insurance would lead to racially integrated hospitals, triumphed.

Sixty years later, the patchwork system that evolved in the absence of national health insurance is unraveling. The cost of health care is exploding, the number of uninsured is growing, and corporations that still provide employee coverage are groaning under the strain.

So the time will soon be ripe for another try at universal coverage. Public opinion is already favorable: a 2003 Pew poll found that 72 percent of Americans favored government-guaranteed health insurance for all.

But special interests will, once again, stand in the way. And the big debate among would-be reformers is how to deal with those interests, especially the insurance companies. These companies played a secondary role in Truman's failure but have since become a seemingly invincible lobby.
Read the rest here.

Krugman's vision of "a radically unequal society, in which all but the most affluent Americans face the constant risk of financial ruin and even premature death because they can't pay their medical bills" is already status quo for many. Every year, more Americans tumble into that category, and can't get out.

43 comments:

G said...

Public opinion is already favorable: a 2003 Pew poll found that 72 percent of Americans favored government-guaranteed health insurance for all.

And here so many are in Canada whining about the need for a privatized system ... they should be reading this and realizing what it is they have got.

"a radically unequal society, in which all but the most affluent Americans face the constant risk of financial ruin and even premature death because they can't pay their medical bills"

No one can put a price on life, but I can certainly say mine is worth every cent of the tax $ that go towards our National Health Care system.

Lone Primate said...

That's fascinating. I hadn't realized there'd ever been a concerted effort in the United States to create a Medicare system. And so early, too. Almost another generation passed before Canada did it, and even then we only did it because so many other Western countries had. It's a wonder we pulled it off at all with the US next door. I guess it just goes to show there is some value in independence, and that even for Canada it doesn't have to be just for show. It can be real. And we can set an important example for our friends to point to.

RobfromAlberta said...

Although I am often critical of some aspects of the Canadian health care system, it is clearly superior to the American approach (unless you are wealthy). It is bewildering that so many Americans want universal health care, yet can't seem to bring themselves to vote for a change. In some ways, Americans are very timid.

L-girl said...

The biggest obstacle is the insurance companies' stranglehold on American politics. They donate heavily to election campaigns and flood Washington with lobbyists - and so many senators and congresspeople are shamefully in their pockets.

Another is the bizarre American fixation on anything that could be called - however erroneously - socialism. And American distrust of government and government programs. (Even though huge corporations are the beneficiaries of most of the welfare, but that remains largely hidden from public view.)

Another obstacle is that, until fairly recently, those most effected by the health care problem were poor - i.e., powerless. Now that it's more of a middle class problem, it's revived the old talk of fixing the system.

I'm sure there are some obstacles I'm missing. The AMA (doctors' assocation) used to be a big force against change, but now that their practices have been ruined by insurance companies, many docs are more open to the idea.

Since national health insurance has been talked about since FDR's presidency, and has never come close to happening, I don't think it ever will. Perhaps that's a failure of my own imgagination, but I don't see any trends in that direction.

Lone Primate said...

Another is the bizarre American fixation on anything that could be called - however erroneously - socialism.

The real irony of the piece is, has there ever been a bigger socialistic, state-owned-and-funded organization in the history of the world than the military of the United States? Patriotism is the blinkers that keep folks from seeing that, of course.

Sass said...

This topic is pretty important to me, especially since I feel like crap this week because I can't afford my $190 prescription. No, that's not several that total $190--that's the one medicine I can't do without, I got rid of the others. And that one is $190 for one month. I make a little more than that every two weeks. You do the math. In Canada, the same medicine costs $60 w/o prescription coverage. But I can't afford to fly back to Canada any time soon, and I would have to since all my prescriptions I had up there have run out. Normally I go up and get 6 months worth of meds at a time (something you can't do here either) so I guess the next 6 months won't be too fun. Cross your fingers for me that I find a job with health insurance. It's times like this that I wonder why I'm living in the States at all.

Lone Primate said...

It's times like this that I wonder why I'm living in the States at all.

I see you live in Boca Raton. Swing by and visit us next February and I believe you'll get a pretty good idea why. :)

Okay, shallow, but... the grass is always greener where there's actually grass...

L-girl said...

LP, Sassycat is Canadian. She knows about the weather.

I personally loathe the weather in Florida (as well as loathing Florida!) and don't know why it's thought of as preferable to Canadian weather. Seriously.

L-girl said...

Sassycat: fingers crossed. The job-for-benefits trap is so hard. Best of luck.

Lone Primate said...

LP, Sassycat is Canadian. She knows about the weather.

D'oh!!

Well, well enough to leave, in any case... :D

Lone Primate said...

I guess it's the frustration with the winter driving that does it for me. The older I get, the more it wears on me, not less.

I'd like to move to Vancouver, myself. Okay, it's not quite a nice as California, but it's Canadian, and it hardly snows there. That's hard to get your mind around. I'm amazed more people live here than there. The things that stop me are I don't have a job there, and I guess the better weather isn't worth giving up my family and every friend I've got. Cruel winter is the price I pay to have people to hang with the six weeks of the year the weather's nice.

RobfromAlberta said...

I personally loathe the weather in Florida (as well as loathing Florida!) and don't know why it's thought of as preferable to Canadian weather. Seriously.

I must admit, the idea of betting my house in the Hurricane Sweepstakes every summer doesn't hold much appeal for me.

L-girl said...

I could see the long winter becoming annoying. I may feel that way eventually. Still, no matter what the climate, trading Canada for Florida?? Yikes.

(I say that without fear of offending Ms S Cat, because if I recall correctly, she didn't make that choice, a parent did.)

It's amazing, tho, how many liberal Americans say they'd move to Canada "except it's so cold". 90% of the time, that's a flippant excuse. If that was the only thing holding you back, would you let it?

RobfromAlberta said...

I believe it's getting warmer. This winter, we had only one week of really cold weather (i.e. -30C) back in early January. It was so mild for most of the winter, I felt like a bit of a fraud claiming to be a tough Canadian. People in Minnesota or Wisconsin have way worse winters than us.

Lone Primate said...

I felt like a bit of a fraud claiming to be a tough Canadian. People in Minnesota or Wisconsin have way worse winters than us.

Ditto Buffalo. Man, those folks are just on the wrong side of the Lake. Or the wrong side of God. The wrong side of something, anyway.

Anonymous said...

Re Buffalo, I'm always telling people (Americans) that Toronto weather is not as bad as Buffalo's, that Toronto has the good side of "lake effect". I'm hoping that's true... I like winter, but Buffalo winters are ridiculous.

L-girl on iPAQ

David Cho said...

Bush looks to be in trouble.

The skyrocketing health care costs as you say, the debacle in Iraq, the mediocre economy, his ss proposal which looks dead on arrival, falling poll numbers, etc. etc.

Democrats should see have a huge opening and smell blood with the 2006 midterm elections looming, but liberals have to ask if this thing is on.

Bush looks to be even more vulnerable than Clinton was before the 1994 GOP takeover. Say what you will about the Contract with America. At least New and Co. had a message which clearly resonated with at least with the party's base. I doubt Dems will blow through the opening I see, but the opening is huge.

redsock said...

All those things about Bush are true, but they are not being shown to the public in any meaningful way by the media. So for most Americans, they simply do not exist.

And the large majority of Democrats **still** seem scared to say anything anti-Bush.

Plus, as Laura says, if they see an opening, the Dems are likely to plug that hole up.

There is also the HUGE issue of fair elections. There were many fishy aspects of the 2002 mid-terms.

I have no reason to believe the 2006 elections will be on the level.

G said...

On T.O. Weather:

It's generally true. You'll get your big snow dump once every winter, where travel anywhere is impossible for a day. Otherwise, not too bad at all. Just chilly.

I used to prefer Nova Scotia to BC (amount of rain is the same but I like the calmer pace of Halifax as opposed to the bustle of Vancouver) but lately there's been too much snow there in the winter. As in record falls each of the past 3 winters ... literally bringing the city to a standstill and trapping people indoors. So maybe BC it will be after all ... that is until the earthquakes start happening.

Crabbi said...

Florida sounds scary - giant flying bugs and hurricanes and heatstroke. Shudder. But what do I know? I've never been there. Canada's weather sounds wonderful - to me, heat is way over-rated. Give me fog and rain any day!

L-girl, You're right about Americans' morbid fear of anything socialistic. I think we're inching closer to universal health care, but for so many years we've heard horror stories about the quality of care deteriorating, ling lines, people not being able to get kidney transplants after a certain age, etc. This usually comes from people with great health plans. I'm sure those are exaggerations, but if we have to make a few sacrifices so that everyone is covered, fine with me.

Lone Primate said...

Bush looks to be in trouble.

The skyrocketing health care costs as you say, the debacle in Iraq, the mediocre economy, his ss proposal which looks dead on arrival, falling poll numbers, etc. etc.


Has anyone else ever noticed this particular charm? It seems exclusive to conservatives. They somehow mesmerize the electorate just long enough to win a second mandate, and once it's secure, the curtain falls and everyone realizes they're stuck. Same thing happened in 1988 with Mulroney in Canada. I don't know how they do it, but it's amazing to watch.

L-girl said...

On T.O. Weather:

It's generally true. You'll get your big snow dump once every winter, where travel anywhere is impossible for a day. Otherwise, not too bad at all. Just chilly.


Pretty similar to New York, then - just colder. (Yay!) I'm really hoping for more mild summers.

...for so many years we've heard horror stories about the quality of care deteriorating, ling lines, people not being able to get kidney transplants after a certain age, etc. This usually comes from people with great health plans.

That's exactly what I always say. To people with great coverage, who can see good doctors whenever they want, without feeling a pinch in their wallet - never mind having to take out a second mortgage or cash in their retirement accounts - the idea of [gasp!] rationing is anathema. But the percentage of Americans who can boast such coverage is ever decreasing.

Lone Primate said...

Boy, we had some weather here last night. It was on us a like a cat on a mouse. I couldn't see down into the Don Valley; trees bending down, horizontal rain. Tornadoes and funnel clouds reported to the north. Seems to be more common these days, but last night was impressive.

Lone Primate said...

Pretty similar to New York, then - just colder. (Yay!) I'm really hoping for more mild summers.

I lived on the east coast myself as a kid and I can tell you one thing: the summers here are hotter than they were there (amazingly, there seem to be more thunderstorms here too). It's the humidity. On the coasts, the breezes off the ocean stir the air a lot. But on the Great Lakes, there's a huge amount of evaporation but nothing much to move it around. On the weekend, the temperate was in the low 30s but with the humidex, it hit 41 downtown. That's the equivalent of 106 degrees Fahrenheit. I was down there for the Blues Festival at the Distillery District, and I can tell you the air was pretty heavy.

L-girl said...

Wow, funnel clouds! I've never seen one - would like to.

I lived on the east coast myself as a kid and I can tell you one thing: the summers here are hotter than they were there (amazingly, there seem to be more thunderstorms here too). It's the humidity.

No. Do not tell me this. Where did you live? Please don't tell me you lived in NY, Philadelphia or Washington DC. Please don't tell me it's more humid in Toronto than those cities. Maybe by east coast you mean literally the Atlantic coast? It's always cooler and less humid on the coast. Please please please....

Lone Primate said...

Where did you live? Please don't tell me you lived in NY, Philadelphia or Washington DC.

I lived in Nova Scotia. As I recall, weather got "interesting" there in August, when we'd get the tail ends of the hurricanes. But you're right, it was fairly mild there where humidity was concerned because it was close to the ocean. So's New York, which must help. Toronto, though, is not. In fact, the place is famous for air that sits for days till something nasty comes along out of the Midwest to move it... which is what happened last night. It's noticably more comfortable today.

I haven't seen a tornado myself either. I nearly did; I was stuck in traffic on the 401 years ago, inching towards spiral updrafts just off the side of the road. It was probably the most scared I've been in my life, give or take. The tornado itself developed about half an hour later, several miles to the east.

L-girl said...

So's New York, which must help.

Nah. New York is not close to the ocean in terms of weather. Long Island, yes, but Manhattan, no.

I must block this information from my mind. Must escape humidity... must escape humidity...

Lone Primate said...

Nah. New York is not close to the ocean in terms of weather. Long Island, yes, but Manhattan, no.

If you can catch a bus and see the Statue of Liberty in about an hour, that's "close to the ocean" in my books. :)

Yes, I'm sorry; it is humid here. But on the other hand, since they're so... well, "great", the Lakes never freeze in winter, which helps ameliorate the temperature (and, unfortunately for Buffalo, enhances snowfall if you're situated in a prone area). And, in summer, you can go swimming without fear of shark attack. You take the good with the bad.

L-girl said...

If you can catch a bus and see the Statue of Liberty in about an hour, that's "close to the ocean" in my books.

Well maybe in your books, but not in our actual weather. NYC weather is not affected by the ocean. It's just not.

Yes, I'm sorry; it is humid here.

Damn. Damn damn damn.

We don't have shark attacks here either. But I don't go to the beach, so even if we did, I wouldn't be missing much.

David Cho said...

So you guys wanna talk weather.

Fine. Here in Southern California ... Oh what a beautiful day with no humidity, gorgeous beaches up and down the coast ....

Lone Primate said...

Here in Southern California ... Oh what a beautiful day with no humidity, gorgeous beaches up and down the coast ....

I wish I could type that steadily with the ground shaking under me. :)

David Cho said...

LOL! Nice comeback, Lone primate.

It's just that we get bashed so much, I take every opportunity to brag about our weather.

Did you see LA Story? I love the part where the ground starts shaking at this restaurant, but nobody flinches except for the guy visiting LA.

Lone Primate said...

Did you see LA Story? I love the part where the ground starts shaking at this restaurant, but nobody flinches except for the guy visiting LA.

I haven't seen it, but I've kind of lived it. I visited a friend in Canoga Park not long after that huge quake that pancaked the double decker highway and things. One night there was this little tremor and I damn near crapped myself. He came running in to see what was wrong and I said "Earthquake!" He just gave me this look, turned off the light and went back to his room.

Yeah, let's see him drive in snow. Punk. >:)

Lone Primate said...

We don't have shark attacks here either.

Man... isn't anybody going to make a lawyer joke? <:)

L-girl said...

Has anyone else ever noticed this particular charm? It seems exclusive to conservatives. They somehow mesmerize the electorate just long enough to win a second mandate, and once it's secure, the curtain falls and everyone realizes they're stuck. Same thing happened in 1988 with Mulroney in Canada. I don't know how they do it, but it's amazing to watch.

I meant to respond to this earlier.

If all else fails, they can let some big planes fly into some big buildings, make cowboy talk into a bullhorn, and start a war. Works wonders for the approval rating.

L-girl said...

Did you see LA Story? I love the part where the ground starts shaking at this restaurant, but nobody flinches except for the guy visiting LA.

That was great. I also remember them driving to the house next door, and the muggers at the ATMs.

L-girl said...

Man... isn't anybody going to make a lawyer joke?

You'd think Redsock or I would, considering we've worked for lawyers for the past 15 years or so. The big-money corporate variety, too. But you know how it is, when you really know something, you know the stereotypes are mostly silly.

Mostly.

redsock said...

Here is a great GIF of Commander Cuckoobananas's popularity polls.

It's only to late summer 2004, but the general downward trend has continued.

(GIF Note: Someone tried to figure out if terror alerts were announced when his numbers dropped. It sure seemed to be the case in real time, but I'm not sure if it was true. The alerts were all bullshit, anyway, regardless of when they were issued.)

David Cho said...

That was great. I also remember them driving to the house next door, and the muggers at the ATMs.

The muggers at the ATMs? You will have to refresh my memory on that one. But how can you forget the part where Steve Martin feels Jessica Parker's (SanDeE* LOL) breasts and says, "they feel funny" to which Parker responds, "Because they are real." LOL.

L-girl said...

The muggers at the ATMs?

There were lines of men holding knives, waiting politely for people to finish at the ATM. People would withdraw their money, then take two steps, hand over the cash to a man with a knife, say have a nice day, and continue on. :)

Anonymous said...

ALPF Here...

Hey don't panic about the humidity here in the Golden Horseshoe, it's not like it's hot and humid all summer!! The average temp in the summer is around 23-24 degrees. Yes we get stretches of stinky hot weather but it usually only lasts a couple days at the most. Hell, last year it never got really hot all summer. Most of the time summer is very pleasant here when you live close to Lake Ontario, it can also get downright chilly during this time of year.

L-girl said...

Thank you thank you thank you. Much better now.

I mean, it's not like I was cancelling my visa, but... :-)

Lone Primate said...

ALPF's got a point. Last summer was pretty moderate. I guess I letting the influence of the last few days (up to yesterday, anyway) colour my views. :)

At Port Credit, you'll be living right on the Lake. It should be pretty pleasant for you.