Political will to spend for universal health care

The most serious objection, or query, relating to the provision of universal, national health insurance, including a public option as a matter of free choice for all Americans,  is the question of overall cost to a nation in recession, reeling from  decades of “laissez faireâ€� economics and foreign misadventures. What’s the cost of universal health care, and how can we possibly pay for it?

Back-of-the-napkin calculations suggest that the initial cost of setting up a national health insurance system with public option is on the order of $80 billion for the first two to four years.  (More serious analyses bear this figure out.) Thereafter, costs will trend towards complete financial self-sufficiency (no more taxpayer involvement) save for the continuing need to subsidize premiums for the truly poor.  Will Americans agree to pay the price to bring health care to all Americans, and help restore America’s position in the global economy?  

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American citizens have shown a willingness to allow their government, on false pretenses, to spend over $240 billion a year to kill Iraqis and destabilize the Middle East. That’s three times the cost of setting up national health insurance for all.  

Americans have also been willing to spend $880 billion over a two-year period, or $440 billion a year, to bail out the banks and businesses deemed “too big to fail� that brought us the recession in the first place. That’s more than five times the cost of introducing affordable health care for all Americans.

How did the government do it?  By printing money and borrowing from the Chinese — $680 billion a year.

Three plus five equals eight, that is, eight times the cost of universal health care.  Would Americans be willing to spend one-eighth of the above sums to establish a system of universal, affordable health-care insurance, for all Americans for all time?  Fully 72 percent of Americans say, Yes, we would.  Surely the U.S. Senate and House of Representatives can drum up, respectively, the 61 percent and 51 percent of votes needed.  It’s a matter of political will.

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How can the United States pay for all of this?  There are many ways to skin a cat. One way is to end the war in Iraq, right now, in 2009, and use one-third the money in 2010. Another is to reduce the corporate banking bailout and use one-fifth the money in 2010. If we had to, we could print the money or borrow it from the Chinese.  

Or would you prefer the cost be honestly included in the national budget?  No problem.  The solution is to close tax loopholes, cap deductions and ask the already wealthy to pay their fair share of Social Security and national health care.  

The point is, where there’s a will, there’s a way. The question is only whether we have the political will to do it.

Once the basic political decision is to go for “Health for All,â€�  the preference for a public option, as a matter of free choice, is obvious. It’s a “no-brainer.â€�  A well-designed public option has one-tenth the overhead, with no profit-taking, and more than 50 percent lower overall premium cost than current private insurance plans. No matter how the salami is sliced, between subscriber, employer or government footing the bill, the public plan costs less overall and delivers more for America. Private plans can co-exist, of course, but if they cannot keep up, if they fail in the head-to-head competition of the marketplace, well, so be it. They have other fish to fry.

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It would be a shame and a sham to pass a health reform bill without the public option.  A public option will keep the private health insurance industry honest.  A public option, unlike most private insurance these days, will not withhold coverage or fail to reimburse the subscriber due to alleged “pre-existing conditions,â€� or serious illness, or need for expensive treatment. No one, and certainly not a corporate executive, is to come between you and your doctor. The rules will be clean, clear and standardized.  As we work on them, we can disagree on some of the details, and we can amend those details as we go.  We can offer Americans a better deal.

Above all, you have freedom to choose.  Why not choose what’s best for your health?  Why not choose what’s best for America?  It’s all about political will.

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