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Wednesday, April 29, 2009

Right Response to Pandemic Swine Flu: Universal Health Care

When I talk health care, some commenters complain that paying for health care through the government is really theft, forcing them to pay for other people's health problems and getting nothing in return.

So what do you get from universal health coverage? How about not dead from swine flu?

The Marketplace Morning Report just ran a commentary from Robert Reich that provoked this realization. The Berkeley prof and former Labor Secretary was simply complaining that the folks who view a possible swine flu pandemic as an economic problem are missing the point, that taking care of people always trumps concern over this abstract thing called "the economy." We simply cannot afford to have 44 million of our fellow Americans uninsured and millions more just one diagnosis or layoff away from losing their coverage, says Reich.

That triggered the connection in my head: right now we have millions of people who won't go to see a doctor because they can't afford it. Even a lot of folks with insurance are carrying high deductibles and thus are more likely to delay or skip doctor visits.

So suppose a thousand uninsured/underinsured people around the country feel under the weather. Without universal coverage, there are that many more of those folks who will look at their thin wallets and say, "Ah, it's just stress or something I ate. I'll be fine." They wait a day, or two, or three, until they're so under the weather they decide they can't wait any longer.

And during that wait, their swine flu has spread to that many more people and created that much bigger of a public health problem. Public health problem, as in impacting the entire public, every taxpayer.

I suggest that universal health coverage and the increased preventive care it would bring could be a first line of defense against pandemics. There will still be outbreaks. There will still be cranky people like me who don't like to go to the doctor even my taxes have already paid for the visit. But a health system where anyone, rich or poor, can walk into a hospital for a check-up and a prescription without incurring a sudden, unexpected expense would strengthen our ability to fight swine flu and other public health crises.


  1. This argument for universal health care is below you CAH. No need to stoop to fear mongering.

  2. Stooping to fear mongering? Why not! It is the decidedly Republican thing to do!

    The argument that your dollars would unfairly fund universal health care is specious. Your dollars already fund the uninsured anytime one utilizes health care in the US. That is why the US has far and away the highest costs.

  3. Oh good grief. No one has died here from swine flu except sadly a little Mexican kid who had it in Mexico, came here and died. Not the same thing as a person living in the US dying.

    We already have access to health care to prevent and treat swine flu. No one is going to be turned away if ill with this whether or not they have insurance.

    To use this to promote universal health care is following Rahm Emanuel's playbook of "never let a good crisis go to waste." Obama is certainly following this line of thinking with his agenda so far and it is working. But this tie-in is completely off the wall.

  4. Right on, Cory. If we had national health care like England has that little boy would have gotten the care he needed earlier. How long are we going to ignore our fellow human beings and fulfil the right to health care for everyone?


  5. Corey:

    Offer just one shred of evidence that there will be no deaths from swine flu if we have socialized medicine. You can't because it will happen.

    The first death in the US from swine flu announced today was a child from Mexico. The better solution at least for now is to close the border.

  6. Also, just a bit premature to be calling this a pandemic.

    Tony, you are right this is just fear mongering.

  7. [Tony, Tony, do you remember nothing from policy debate? We need death on the flow to outweigh the nuke war disad! :-D]

    No stooping here, and you'll notice, Firebird, that I claimed neither pandemic nor panacea. Specifically, I said (like pretty much everyone else) that a pandemic is possible. I then make the statistical point that, if health care is available and affordable for everyone, more people will seek preventive care and early treatment, which would mitigate the spread of disease. Why not plan ahead and build a system that makes it harder for a pandemic to take hold? It's just another practical justification for universal health care, right along with lower costs, moral obligation, and the end of rationing by wealth.

  8. And Anon 10:55, I didn't say the hospital will turn you away if you come stumbling in with swine flu (but might they, if you lack insurance and can't pay up front?). I said that people with high deductibles or no insurance at all are more likely to delay going to the hospital, thus risking getting sicker and spreading the disease faster. Therefore, if you want to make a national health security argument, we keep our country safer from pandemics by creating a universal health coverage system.

  9. Corey
    I have talked to Canadians and people from Britain. They pay 5o% income tax and they say their healthcare is pathetic. That sounds like a great deal to me. The Canadians even told me that if they get something serious they are going to come to the United States for treatment.

  10. Unverifiable Anon: My wife Erin and I have lived in Canada, interacted with Canadians daily, maintained friendships with Canadians. They love their health care system and refer to the "American health care system" with horror and disdain in their voices. We've had American friends suffer accidents, go straight to the hospital, get immediate care, and walk out without filling out a form or paying a dime. If I get something serious, I might have to move to Canada to keep from going bankrupt. There, we're even on anecdotes... plus mine has a verifiable named source, and universal health care is still more moral (and more Christian, if that's your worldview).

  11. Your argument for universal healthcare depends entirely on whether the system would actually be effective on providing this preventive treatment or not.

    The fact of the matter is that if you have everybody coming in to the hospital every time they get the sniffles (which you admit to some extent will happen when you claim "more people will seek preventive care and early treatment"), pretty soon the hospitals will become overwhelmed and patients will have to be dumped on the waiting lists. The waiting lists grow long enough and soon any 'preventive treatment' that could be provided would become worthless, anyway.

    For example, see the Canadian health are system and massive waiting lists.

    And think of the cost? Do we really want our stolen money paying for people to visit the doctor every time they feel a little under the weather? The vast majority of 'preventive care and early treatment' will be unnecessary, expensive, and counterproductive because they tie up valuable medical resources that could be used to provide treatment for people who actually need care and aren't just in it for the freebies. Universal health care not only steals taxpayer money but it decreases the efficiency of the healthcare system: it is worse than theft.

    (I am the same anonymous commentator from our previous discussion. From now on I will use the pseudonym 'P. Chirry' to identify myself.)

  12. Push the swine flu aside and if you want and just think in dollars. Imagine how much more productive we would be as a nation if we were all healthy. Think of all the lost time. Think of wanting to start a small business and having to pay for health care. Think if you got sick and wanted to change jobs. You need portability. Imagine loosing your job. Do you want to loose your life savings too? Not having a health care plan is beneath us.

  13. No seriously. Let's do what the Democrats want to do and have universal healthcare for two months during this Pandemic.

    Then we can finally show you all what universal healthcare will look like. Every idiot with a cold will show up to the ER thinking they have swine flu... people waiting in ridiculous lines and people with more serious conditions being forced to wait while someone with a sniffle steps in front of them.

    This is what is going on in Canada and Europe every day.

  14. I pay for my own insurance. I have a high deductible. I don't let my kids ride skateboard or other high risk activities. I take care of myself by working out at the Community Center and eating right. I stay out of the bars and don't smoke. I go to the doctor when I need to.

    If Democrats and Republicans would actually step up and take some personal responsibility about their health, we wouldn't be having this discussion.

  15. Hey, my first thought as I read your comments is that national health care does not make it free. Of course you still need a sliding scale for medical appointments to keep personal responsibility as part of the deal.

  16. It's not free: under the Canadian system, you still pay a premium, but to the single payer, the province.

    And 6:07, I admire every step you take. It's for exactly people like you that I want universal single-payer coverage, so that people like you who have done everything right don't end up bankrupt just because you lose your job or get cancer or have a child born with some serious illness or some other problem that is no fault of your own but will break you at the hospital. You deserve better than the current system.

  17. Regardless of whether it's free or just reduced the principle is the same: there will be a direct relationship between your 'preventive care' that allegedly provides a 'first line of defense' against pandemics and unnecessary doctor visits/long waiting lists. You can't escape it.

    See Canada.

  18. A Canadian was interviwed on TV today, a lady that has written a book on it, stating that their health care system is pathetic if you really get sick. That is why many of them head for the US to get timely care. And they are worried if we go to nationalized health care that they won't have a better option when they really need timely good care.

    Once this passes, the 95% he promised would pay no more taxes will get the surprise of their lives!

  19. Am I the only one old enough on this blog to remember getting a "swine flu" vaccination while in high school back in about 1973-4? Everyone was required to get the "swine flu" shot. The reason I remember it so well is some of our football players passed out which was hilarious. That was during either Gerald Ford or Jimmy Carter's leadership, but it was nationwide. Is there some history available on that vaccination program?

  20. My big problem with universal health care is that it rewards those who abuse their bodies by drinking and smoking and other risky activities. Why should I have to pay for their stupidity?

    When I was a child, my family took care of aged relatives. There was no talk of the nursing home. We had four generations in the house many times as my elderly aunts would come for extended visits.

    We need not look to the government to solve all of our problems. We need to take care of each other in our own communities. We can do that without legislation, approval from Congress, or deepening the national debt.

  21. Corey:
    You could not be more wrong in your comment(but might they, if you lack insurance and can't pay up front?). I have been in health care for 30 years, so I know of what I speak. If you seek treatment at a health care facility that accepts medicare payment, you can not be turned down for ANY reason. As a matter of fact if you are seen in the ER, the hospital CAN NOT talk to you about financial responsibility until AFTER you have been treated.

    A question for anyone to answer. If the Canadian health care system is so great, why didn't Peter Jennings return home to Canada to be treated for his lung cancer?

  22. I remember the other swine flu shot too. I was working in SF and trotted down to get my shot like everyone else because we were scared by the powers that be tht it was coming. Well, it didn't come. I remember feeling uneasy about that shot, the only one I ever felt funny about receiving. And turns out I was right. It actually made some people ill iwth Guillain-Barre, a disease that killed some and paralyzed some. Turns out the vaccine was rushed thru without "vetting" properly and it hurt more than it helped.

    No one outside of Mexico (and I don't count the US death as actually a US death but a Mexican one) has died from this swine flu, have they? And yet the threat level is up to six. Seems to be more hype than substance. Why?

  23. But FireBird, I'm assuming a lot of Americans will be like you and me and prefer not to use the emergency room for regular care. We stay away from the hospital because we know it will cost money. A lot of folks only go for that free care in the ER as a last resort (there is a lot of personal responsibility out there). The big issue I want to solve is removing the fear of sudden personal financial disruption due to an unexpected health issue. That doesn't happen in Canada.

  24. [For Anon 8:40: here's a link to an article on the 1976 swine flu vaccine. Enjoy!]

  25. Coming from a reservation, I know how free health care works. Every single headache, stomach ache, baby crying, and hangnail ends up in the emergency room, all at the taxpayer's expense. When the IHS clinic is closed, these patients end up in other hospitals for these petty issues, tying up doctors, nurses, and staff...which prevents them from attending to actual medical emergencies. Looking at the VA and IHS, as well as national health care in other countries, I don't foresee any positive aspects of the government running health care at all.

    Besides, look at the wonders the government is doing for GM and Chrysler! Barry-O is announcing bankruptcy for Chrysler in the morning, and the blood of Pontiac is also on Obama's hands. Makes a person wonder just what exactly is next.

  26. I can't believe that no one has noted that Mexico HAS universal health care, which completely invalidates everything in this post.

  27. I too received the Swine Flu vacination in the 70's. However this is a different 'swine flu' virus and the vacination would be inefective

  28. I don't really see what's so pathetic about the Canadian health care system, it works. I live in Toronto and I rarely hear any complaints about our system. Anytime I hear someone comparing it to the US one, Canadian comes out as the winner. Just the number of people uninsured in the US is staggering and that speaks for everything. You may have the best doctors and equipment in the world but it's kind of pointless if it's available only for a certain percentage of people, not for all.

    Take care, Lorne

  29. Oh, Alexa, if only you could win the argument that easily.

    1. What you say invalidates nothing in this post. I never claimed universal health care means no pandemics. I claim universal health care can mitigate the impact. To invalidate anything in the original post, you need to get rid of swine flu, dismantle the Mexican public health coverage system, reintroduce swine flu, and see how many people die.

    2. Mexico, with less than a third of our per capita GDP, passed its "Seguro Popular" program to provide coverage for 50 million citizens who lacked coverage. The program has been a smashing success at reducing health care costs for poor families.

    3. Interestingly, Seguro Popular has not caused an increase in utilization. That might invalidate my original argument... but it also invalidates
    Anon's hearsay about those darn Indians and government health care causing overutilization.

    4. Mexico's health care system has been drawing all sorts of "medical tourism" from Americans who can't afford care here. U.S. hospital chains are building facilities in Mexico to cash in on medical tourism.

    Consider this: the only folks who seem interested in keeping America's patchwork private ration-by-wealth system are the insurance companies making money off it and folks trying to protect their ideology by ignoring evidence. but what about Canada, the U.K., France, and all the other industrialized countries (remember, that's all of them except the U.S.) that have universal health coverage: If all the commenters' claims here were true (they're not, but entertain me for a moment), what would be motivating those countries to keep such atrociously ineffective systems? Whose interest in Canada is served by keeping a system that doesn't work? Who would be the nexus of political pressure that keeps such bad policy in place?

  30. And then a Canadian insurance agent speaks up and says the Canadian system is better than the U.S. system. There's something to shake my worldview! :-)

  31. Well, this pandemic has killed a total of SEVEN people so far, and the threat is at next to highest by WHO! What will be the next pandemic - the common cold? It's probably as dangerous for some people. This was hyped to get Sebelius confirmed emergently. (Don't let a good crisis go to waste, you know.) I really don't see how it can be used to push his nationalized heatlh care, but O will try anyway. Let's see now how well O is doing.

    Claimed we had to bail out the car companies and that gov't was the only one who could save them. Yeah, that's working fine (actually is for O because now he and the unions pretty much own the companies, so maybe this is a bad example)

    Hyped this pandemic - seven people died. So much for that! But it did get O's choice of Sebelius confirmed quickly, so guess he did win again.

    The trouble with his winning - the American people keep losing.

  32. Corey
    When my taxes double that isn't exactly going to be free is it? You're worried about economic disruption do to illness? It won't matter what your economic status is if your dead due to bad healthcare.


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