Gary Dorrien

Gary Dorrien on Health Care

The Christian Century has an article by my old advisor, Gary Dorrien, on the health care public option. It is uncharacteristically short (although that is probably The Christian Century’s fault), but it is still a good, clarifying read. He starts with:

Longtime advocates of single-payer insurance like me are thrilled, anxious and deflated simultaneously by the state of the debate on health-care reform. The debate that we wanted has finally come, and it is coming with a legislative rush, but the plan that we wanted is being excluded from consideration. Should we hold out for the real thing, or get behind the best politically possible thing?

I am for doing both: Standing up for single-payer without holding out for it exclusively; supporting a public option without denying its limitations; and hoping that a good public plan will lead eventually to real national health insurance.

Single-payer basically means Medi care for everyone, without the copays and deductibles of the current Medicare system. It is not socialized medicine, as in England or Spain, where doctors and hospitals work for the government. It does not violate the takings clause of the Fifth Amendment, which bars the government from taking private property for public use without appropriate compensation, since it does not nationalize any private firms. The single-payer plan is a system of socialized health insurance similar to that of Canada, Australia and most European nations. Essentially it is an extension and improvement of the Medicare system, in which government pays for care that is managed and delivered in the private sector.

We don’t need private health insurance companies. We certainly don’t need a system that wastes $450 billion per year in redundant administrative costs and leaves 45 million Americans without health coverage. We could do without a system that excludes people with pre-existing medical conditions and limited economic resources. We don’t need a system that cherry picks profitable clients and dumps the unprofitably ill in HMOs featuring lousy care and little choice. Businesses and other employers would do much better not having to provide health coverage for their employees, who often end up underinsured. We could do better than a system that ties people fearfully to jobs they want to leave but can’t afford to lose because they might lose their health coverage.

Health care is a fundamental human right that should be available to all people regardless of their economic resources. A society that takes seriously this elementary principle of social justice does not relegate the poor and underemployed to second-class care or status. The only Western democratic society that doesn’t even try to live up to this principle is the United States. When wealthy and middle-class people have to rely on the same health system as the poor, as they do throughout Europe, they use their political power to make sure it’s a decent system.

But single-payer deliverance is not on the agenda for President Obama and this Congress. The insurance companies are too powerful and politically aggressive to be retired in one legislative stroke. The House bill that calls for replacing for-profit insurance companies has only 79 cosponsors, and the Senate bill has only one—Bernie Sanders.


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