A hot summer's debate on health care

The debate that has just begun in Congress portends a long, hot summer, and it’s not about global warming. It’s the debate over health care and more specifically health insurance, American-style.

The Obama administration, with strong support from our Connecticut Senator Chris Dodd and Congressman Chris Murphy, is presenting Congress and the American people with the broad outlines of a national health and insurance system that is intended to cover all Americans, reduce health-care costs, modernize the health system, improve health outcomes, cover low-income families, and provide better long-term care.

The flash-point issue, of course, is Obama’s proposed approach to health insurance, which includes a government-run insurance option, sandwiched among a panoply of private and other plans. It’s a matter of choice — the freedom to choose. As the president likes to put it: “If you like the the coverage you have now, you can keep it. But if you don’t, you can choose a new, more affordable option.�

Opponents, well-meaning and otherwise, scream “No way, no dice.� They argue on essentially three interrelated grounds: First, it’s “socialized medicine,� and that’s bad. Second, private enterprise is always more efficient than public enterprise. Third, a public option would constitute unfair competition for private industry. The defect with these arguments is that they do not stand up to the universally observed facts. Indeed, the weight of the actual evidence is quite otherwise.

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Independent, objective professional analyses by the World Health Organization demonstrate that contrary to the above arguments, the facts are that in virtually every industrialized, democratic, “socialist� country in the world, and particularly in Europe (from France to Sweden) where they have national health insurance systems, the health outcomes for their citizens markedly outperform those of the United States, at better than 50 percent lower cost.

The evidence is that “socialist� health systems win the contest in the marketplace. The term “socialist� as used here means democratic cooperation for the greater public good. It does not mean central ownership of the means of production and wealth. That kind of jingoist rhetoric just doesn’t wash.

A moment’s reflection should lead to the realization that the second and third objections cited above are mutually self-contradictory. If private plans always outperformed public plans, then opponents should have little to fear from a public option. But the truth is that U.S. private insurance today is highly inefficient, with built-in incentives for medical providers and insurers alike to over-charge for services, over-prescribe, and in some cases actually engage in malpractice. In short, there’s an inherent conflict of interest between the profit motive and human health.

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The U.S. economy and existing health and insurance systems are so complex, with elements of both private and public health-care services (such as the VHA, Medicare and Medicaid), that it is unrealistic and unreasonable to expect the United States to implement a unitary single-payor system, at least any time soon. Therefore, the Obama administration is offering a brilliant, efficient and effective compromise, which blends some of the best features of private and public health care. It offers us the chance to realize what WHO calls “Health for All,� and at the same time to restore the competitiveness of the United States in a global economy.

As the summer progresses, the debate heats up and the fur flies — don’t get distracted by the rhetoric. Keep your eye on the central issue: the need for a government-provided health insurance plan — as a matter of free choice. It’s absolutely essential, and it cannot be, must not be, and will not be bargained or filibustered away. No social issue today in America outranks this one.

Sharon resident Anthony Piel is a former director and legal counsel of the World Health Organization.