Kevin Drum seconds Alex Massie that a British-style nationalized health system is not a politically feasible option in the United States. Indeed, even Democrats don’t want that:
[W]ith the exception of a few outliers, the liberal community really, truly doesn’t want a fully government owned and operated healthcare system like the NHS. We want a government-funded healthcare system like Medicare or most of the world outside of Britain. And unless I’m mistaken, this isn’t a ruse in any way. That’s really what most of us want: basic care funded by taxes, with additional care available to anyone who wants to pay for more. France and Holland, not Britain or Canada.
I do think that’s what most want. HillaryCare was a single-payer system. That’s what ObamaCare would be, too, if it were politically viable. Since it’s not, he’s willing to settle for a “public option,” essentially a government-run insurance program that would “compete” against privately run insurance companies. And he might have to settle for less than that — a system that expands Medicaid and/or Medicare and patches some holes in the existing system.
For a variety of reasons, the public simply doesn’t seem to understand these distinctions. First, Canada and the UK are the logical comparison points in that they’re fellow Anglosphere countries and the ones with which we’re most familiar. Second, those who oppose the reform for various reasons have a strong incentive to elide the differences and capitalize on fears people reasonably have about an NHS-style system. (To say nothing of the silly fears of the “They’d let Stephen Hawking die!” variety.)
Many of the leaders of the pro-reform side are rather dishonest in their presentation, however. They insist that what’s written in the bill should be the limit of legitimate debate when, as Kevin admits and Obama once did, single-payer is the ultimate goal. The current “as much as we can get” measure is not only a step in that direction but one that will make it inevitable over time as it kills off the existing system of employer-financed insurance. So, while it’s dishonest to argue against the proposed legislation as if it were NHS-style “socialized medicine,” it’s perfectly legitimate to treat it as HillaryCare Returns.
An honest debate on this is vital. The current system is on a collision course with collapse because the rate of growth in health costs is unsustainable, especially with so many about to hit the retirement rolls. And there really are significant problems with our hodgepodge public-private system where those of us not on the government dole are reliant on the vagaries of care by whatever provider our current employer offers.
I’m naturally more skeptical than Kevin of government-run anything. But I’m prepared to be convinced that a French- or Dutch-style system would be an improvement over the status quo. But pretending that we can simultaneously cover everyone, cut costs, not ration, and retain the current private system for those who want it isn’t a very effective method of persuasion.
