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Rationing Healthcare, Step by Step

By Hoar, William P. | The New American, September 15, 2008 | Go to article overview

Rationing Healthcare, Step by Step

Hoar, William P., The New American

ITEM: The Associated Press for August 9 touted the healthcare plank in the Democratic Party platform: "Democrats shaped a set of principles Saturday that commits the party to guaranteed health care for all, heading off a potentially divisive debate and edging the party closer to the position of Barack Obama's defeated rival, Hillary Rodham Clinton....

"Obama, soon to be the Democratic nominee, has stopped short of proposing to mandate health coverage for all. He aims to achieve something close to universal coverage by making insurance more affordable and helping struggling families pay for it. Advisers to Obama and Clinton both told the party's platform meeting they were happy with the compromise, adopted without opposition or without explanation as to how health care would be guaranteed.

"In return for the guarantee, activists dropped a tougher platform amendment seeking a government-run, single-payer system and another amendment explicitly holding out Clinton's plan as the one to follow. The party now declares itself 'united behind a commitment that every American man, woman and child be guaranteed to have affordable, comprehensive health care.'"

ITEM: Columnist Paul Krugman, writing in the New York Times for August 11, comments: "Can Democrats deliver on that commitment? In principle, it should be easy. In practice, supporters of health care reform, myself included, will be hanging on by their fingernails until legislation is actually passed.

"What's easy about guaranteed health care for all? For one thing, we know that it's economically feasible: every wealthy country except the United States already has some form of guaranteed health care....

"The politics of guaranteed care are also easy, at least in one sense: if the Democrats do manage to establish a system of universal coverage, the nation will love it."

CORRECTION: In terms of restructuring the healthcare system in the United States, Democratic presidential candidate Barack Obama differs from economist Paul Krugman only in a matter of degree. Not having to face an electorate that might be skeptical of having too much micromanagement imposed by Washington, Krugman doesn't hide his long-term intentions as well as the senator.


The economist actually believes and says publicly that other industrialized countries have better systems than does the United States and, given his druthers, he would establish a nationalized system immediately. The senator, who can't afford to tip his hand so candidly, has to take a piece meal approach.

Julie Novner, commenting on National Public Radio, gives the left-wing line, saying that what Obama is proposing isn't really government-run healthcare. His plan "doesn't even have a requirement for individuals to have coverage, like the plans offered by his main Democratic primary opponents, former North Carolina Sen. John Edwards and New York Sen. Hillary Clinton. Obama says that under his plan, if you already have insurance you like, you can keep it."

She quotes the senator: "But if you're one of the 45 million Americans who don't have health insurance, then you will have it available to you. No one will be turned away because of a pre-existing condition or illness." "If you can't afford coverage," says the NPR's healthcare correspondent, "you'll get a subsidy. Employers would have to offer coverage to their workers, but they'd get government help, too."

How all of this might be paid for is not mentioned.

In a valuable Policy Analysis published in March by the Cato Institute, entitled "The Grass Is Not Always Greener," Michael Tanner went into considerable detail about the problems as well as the strengths of healthcare systems elsewhere among developed countries. In essence, they do best when the market is allowed to work. Observed Tanner: "In countries weighted heavily toward government control, people are most likely to face waiting lists, rationing, restrictions on physician choice, and other obstacles to care.

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Rationing Healthcare, Step by Step


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