Promoting Universal Health Care, The Really Big Progressive Mistake

Advocates of universal health care have made an enormous mistake, one that more than anything else explains why most Americans are balking at adopting the kind of comprehensive health coverage present in every other advanced democracy. It is a failure to make it the top priority to communicate to the middle class the information pertinent to what they care about the most, their money. More specifically, the incredible amount of dollars each person stands to save if the United States makes the switch to a universal system.    

The basic facts are these. When conservatives claim, as they are wont to do, that America already enjoys the best health care system in the world so why go to radical lengths to fix it they are, well, lying. We know this because it is no secret that America suffers from the shortest lifespans and highest juvenile mortality rates among the top twenty 1st world countries, American death rates are no better than seen in some 2nd world countries. Matters are getting so bad that the US is falling behind other prosperous democracies.  The Danes and Irish used to die younger than Americans but now live longer. In some states lifespans are actually decreasing, a shocking societal failure all too like the shortening lives of Russians. In the academic literature I have used technical analysis to show that this is not, as apologists sometimes claim, due to high levels of population diversity and immigration; some 1st world countries have higher levels of both and the citizens are living longer. It is not possible to correctly claim that American medical care is the best when we have the worst mortality states despite a very high per capita income. Something has gone terribly wrong.    

Liberals tend to focus on the practical and especially moral need for America to do what every other advanced nation is doing and provide high quality health care for every citizen. After all, Americans have universal access to largely government operated police and fire services. If free markets are not good for police and fire protection, then why is so great for health protection?

Bill Moyers is a premiere example of a liberal who is prone to emphasizing how all good and decent Americans must embrace the moral call to care for every citizen. These arguments may be correct, but they are politically naïve. Naïve because most middle class Americans are self absorbed, and really care only about their own finances. As I and other researchers have shown, middle class Americans are under an exceptional level of chronic financial insecurity and stress, the American Way being the most Darwinian, survival of the fittest arrangement in the west.

And Americans also think that extending comprehensive care to everyone will increase costs overall and raise their taxes while increasing the national debt. Appeals to the morality sensibilities of the American majority simply will not do the job. You have to appeal big time to their pocket books.    

This brings us back to the statistical facts, financial in this case. It is well known that the same non-universal American system that is killing off the citizens is incredibly expensive. It’s the worst deal in the 1st world. And this is where the pro-universal care crowd has missed the PR boat. On average people dwelling in other advanced nations spend $3000-4000 dollars a year on their health. In the US the average cost is around $7000, almost a sixth of personal income. Universal systems not only are efficacious in saving lives, they are far more cost efficient than the Rube Goldberg affair we have been stuck with so far. Universal systems are more rational, coordinated schemes that keep costs in line while delivering quality care.

Now, I will ask you, the reader, what I ask audiences during presentations on the comparative socio-financial situation of westerners. It is a question no one seems to know the answer to. It is a shocking lack of basic knowledge because neither the mainstream press and media nor universal care advocates have bothered to tell folks about this stunning fact. Do you know how much money Americans spend — and in large portion waste — for no good purpose over a lifespan on their own health? Well, let’s do the math. Average western European or Canadian spends $3500 a year, over a say 75 year lifespan that’s in the neighborhood of quarter million dollars. The typical American outlays $7000 a year — right there we could all be saving a cool few thousand a year if we went down the universal care path. Multiply the $7000 by 75 and that’s about half a million over a life. In other words, for the privilege of living shorter lives Americans are literally being ripped off to the tune to a quarter of a million bucks that they could keep if only we did what the Europeans and Japanese are doing!

That, dear supporter of universal health care, is the one thing that if all Americans knew — that they could save up to six figures over a lifespan – that could push enough Americans to opt for an all out universal system. Far from paying higher premiums and taxes if a full-scale universal system is put in place, or worsening the national debt America as a nation and especially most Americans as individuals would cash in big time. As it is we are already spending about as many tax dollars for medicine as do other westerners, the extra costs involve the private side of the cost equation. And the damage being done to the finances of the middle class by the transfer of wealth into that private side of health care is terrible.

Every year about 8% of a typical American’s income is being sent to the medical, drug, insurance and credit industries with no practical return in services, the money ending up in the pockets of the elite. It’s a classic pyramid scheme. Charging hundreds of millions of Americans a few thousand beyond what is needed for quality medicine on a yearly basis — and driving many into interest demanding debt in the process — is one way the fiscal elite are transferring huge amounts of wealth up the economic pile as they absorb an increasing share of the national economic pie. It is nearly a trillion dollars a year. That average Americans are being defrauded of a quarter million over their lives helps explain why their wages are stagnating, why they are having trouble saving for retirement and for college, and why the regular family is feeling so hard pressed, with many going into bankruptcy in part because of overwhelming medical bills.

That Americans would save up to a quarter mil if the United States goes down the universal care road should be proclaimed at full and constant volume by its advocates. This is so obvious that one wonders why it is not already the standard procedure. The first item that visitors should see headlining the websites of the leading proponents of universality should be how Joe and Jane Doe stand to gain six figures. Yet Health Care Now!, Health Care for America Now!,  Physicians For a National Health Program, and Single Payer Action fail to do so. Nor is it being explicitly pushed on Olbermann, Maddow, Stewart and Maher. Little is said in Newsweek, The Nation, Harpers, American Prospect, Mother Jones, The Progressive, et al. Same for the Congressional Democrats who are for a comprehensive system.

This particular example of lack of progressive political astuteness stems from the tendency of liberals to perceive and promote the absence of universal care as an ethical failure to care for the downtrodden, rather than as a key to solving the financial problems of the middle class. The result of this error is that the opponents to deep reform have been left free to be all too successful in deluding most into thinking that universal medicine will cost big bucks. To win the political struggle will require progressives to emphasize the financial advantages over the moral. 

Some additional points. Although an initial step in the right direction, the health reform that is likely to pass now that Democrats are opting for simple majority votes along party lines is not the fully universal system that will dramatically reduce costs whether or not a public option is included. And life saving, cost efficient health systems are not always single payer.  In a number of first world nations insurance and medical suppliers are tightly regulated to achieve the low costs. No medical system is perfect and all universal versions could use improvement. As T. R. Reid notes in his excellent comparison of national systems, The Healing of America, modest increases in funding would largely solve their problems, yet still cost far less than what we’ve got.

Conservative claims that those poor Canadians have to come to the states to get needed treatments are grossly exaggerated. Few Canadians can afford American medicine; most who come to the states are covered by their system so they can receive treatments not available in the smaller system north of the border. Universal care enjoys strong majority support in Canada and other modern democracies. What anti-universalists do not mention is that increasing number of American live in Mexico in order to obtain the care they cannot get here, or travel to Auckland or Bangkok to undergo procedures at a small fraction of the expense — they often still go into debt and bankruptcy, but at least they can cough up the funds to get the treatments beyond their reach in the states. It’s called medical tourism. The charge that the “death panels” supposedly integral to universal care terminate old folks lives are absurd when the elderly enjoy longer lives after 65 in those systems than here in the states.

The widespread absence of insurance, plus the denial of coverage by insurers, mean that rationing is at least as high in America. The tort reform advocated by conservatives is likely to have only a marginal effect on total costs. The same is true of drug and insurance company profits.  As inflated as they are they make up a small percentage of the trillion going to waste per annum. It is the far lower cost of necessary medical procedures and drugs, the sharp reduction of unneeded treatments, and the diminution or elimination of outlandish overhead costs of insurance companies, that are mainly responsible for sharply reducing expenses in universal schemes.

Claims that America is too big to apply a single system across the entire country can be dealt with the same way the Canadians do, on a regional basis. Contending that the homeless must be able to receive quality care because it’s the decent thing to do is the right thing to do, but it is not enough. Nor is explaining how the current arrangement is helping wreck the economy and leaving even some in the middle class uninsured, bankrupt, and occasionally dead. The rallying cry to the middle class majority that has the votes must be “Save up to a quarter million over your life with universal medicine!”

Gregory Paul is an independent researcher on subjects dealing with paleontology, evolution, religion and society. Books include Predatory Dinosaurs of the World and Dinosaurs of the Air. Read other articles by Gregory.

15 comments on this article so far ...

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  1. lichen said on March 10th, 2010 at 2:37pm #

    The key word here is single payer, not “universal.” Indeed, one of the main problems is people like you that use the vague term “universal” which just easily describes the crappy bill in congress that mandates people to buy private insurance plans.

  2. Max Shields said on March 10th, 2010 at 2:56pm #

    I would disagree with the remark that Bill Moyer is just saying “universal” (or more clearly and regularly stated – single payer) is the right thing to do. I think the “right thing to do” is a great argument, but may not be the most effective.

    He has had many guests who have spoken to the cost/benefits of single payer. Most recently Dr. Marcia Angell presented what I think is the most cogent and thoughtful argument. What makes Angell’s argument particularly compelling is how she defines the problem and then the cause. It is a classic case of deep systems thinking that provides a holistic solution to bear. I think she was on last week.

    lichen is right about the important distinction between single payer and universal health care.

    Frankly, my issue is we keep looking to the most out of touch entity – Washington DC, to provide the most personal solution to this problem. It’s clear why one would go there for a comprehensive solution, but it is at once a contradiction in terms to think that a place called Washington could deal with this personal issue in any serious way.

    Single payer should be taken to the state, local level. Model solutions and let them catch on. There’s no way this montrocity of a nation-state can get its “arms” or “mind” around this problem and provide a solution. The system won’t, can’t solve this. In fact, the system as it is can’t really solve any problems.

    As long as we think that Americans think first and foremost about money, than the problem’s solution is out of reach. That mind set must and will change.

  3. bozh said on March 11th, 2010 at 8:25am #

    On occasion i have been also using the term “universal health care”. I see now that some people are not satisfied with this term. And i think that they are right.
    The term “full or rightful healthcare” might be a better term.
    Because, as i see it, each person has the right receive any medical treatment paid by all of us.

    I am not saying that some people do not abuse present health care system we have in canada. In any vicious, unjust, uncaring society there always may be some abuses.
    I do affirm that in an idyllic society in which trust, caring, love of it wld be in high demand, few people wld be abusive in any way or in any usage; whether it be water, gadgets, cars, or healthcare.

    But in iniquitous societies in much of the world with some people being so abusive and blood thirsty, etc., it is no wonder we have thiefs, liars, murderers.

    Systems in which we now live demand lying, deceiving, warfare and not only merely allow it. That’s the root cause for all our maladies. tnx

  4. rosemarie jackowski said on March 11th, 2010 at 9:39am #

    Let’s face it. USers hate each other. The proof – they stand by while 45,000 die each year. Those are preventable deaths, but too few care.

    In addition, USers might be the most gullible people in all of history. They have been consumed by misinformation. They actually believe that the US has the best health care, the best educational system, the best economic system, the best of everything.

    Seen on a tourism poster – ‘VISIT THE USA NOW….IT WON’T BE AROUND MUCH LONGER’.

  5. Max Shields said on March 11th, 2010 at 10:05am #

    Rosemarie, there is not “USers”. There is only your neighbor, and your neighbor’s neighbor. The roads and walk ways you travel regularly, you place, the one that serves coffee and breakfast, the movie theater, the local bakery…these are where “we are”.

    The problem has always been the aggregate notion of USA and its capital thousands of miles from almost all of the citizenry they claim to represent.

    In this fact you’ll find your health care problem and solution.

  6. rosemarie jackowski said on March 11th, 2010 at 10:44am #

    Max…I get your point BUT there is a big influence coming from the culture of the US. It enslaves many who live in the US. I am often in awe of the way those in other countries/cultures relate to one another. I have often said that I would happily wear a burka for the rest of my life if only some aspects of the cultures of other countries existed here.

  7. dan e said on March 11th, 2010 at 12:13pm #

    Max is a typical USer: people in less liberal states than his can go to hell, while he and his more enlightened “neighbors” enjoy single payer healthcare. Meanwhile said “neighbors” will continue as the 21st edition of Good Germans, i.e., USers.
    What is Max’s ideology but NIMBY extended to the rest of the planet?

  8. Deadbeat said on March 11th, 2010 at 12:23pm #

    To understand “USers” is to understand Capitalism and how racism and Liberalism has conservatized the working class. The American people are very atomized and what is needed is to come up with ways for people to be able to arrange themselves in a manner that will enable people to live and work together. For example — DEBT REPUDIATION.

    It’s easy to say that USers hate each other and many especially whites who benefited from racism clearly had an affinity with the Capitalist system. They benefited materially and when they say they want “their” country back what they want is a restoration of the benefits of whiteness. They don’t understand that the Capitalist see them as the next level up the pyramid to rip off as Capitalism MUST transfer wealth to the top.

    The current arrangement within the system of debt and mortgages and bills atomizes Americans so each American are more worried about their immediate survival and maintenance of their standards of living. The problem is trying to find “solutions” withing these constructs and constraints of atomization. In other words maybe people ABSTRACTLY cares about their neighbors but they care MORE about paying their bills and maintaining their standard of living. This isn’t something to be ridiculed as the author seems to be doing. This is a dynamic that needs to be identified and understood so that strategies can be devised that takes that into account.

  9. Max Shields said on March 11th, 2010 at 1:45pm #

    rosemarie, do you live in Vermont? I’m sure you’re very aware of the Middlebury Institute – Vermont Second Republic. I see some validity in secession (I won’t delve into it here), but I don’t think that’s what’s called for in the US. I prefer a kind of flip between Washington, regions and localities where DC plays a restricted role and democracy is played out at the local level. I wouldn’t remove the Feds entirely, reduce their power to where it’s most appropriate and helpful.

    The nations you mention are relatively small in land mass and population compared to US. That makes a big difference.

    dan e, as far as the claim that I’m in a liberal state and would have “single payer”, my answer is first, I’m not and I’d have to fight for it; but at least I’d know exactly who I’m fighting.

    Today, dan e, we live in a nation that has massive discrepencies between states and regions. The feds don’t/can’t change that. We are a nation that needs to wear flags on our cars and labels just to remind ourselves what nation we’re living in. Not much else connects us. That’s an observable fact. It’s not a liberal fact, a NIMBY fact, a zionist fact, a Republican fact, a Democrat fact, a socialist fact or a fascist fact. It’s just a FACT!!!

  10. dan e said on March 11th, 2010 at 2:09pm #

    max you exaggerate the differences between US regions. Yes there are differences but the Patriot Act applies everywhere, even overseas. DHS is active everywhere. The MSM reaches every corner, even up there in the backwoods of New England.
    Local businesses are controlled by Wall St just as much as GM, or maybe more since GM & Ford have tentacles outside US jurisdiction.
    The kind of food and medicines available are controlled by massive conglomerates, often working through their stooge “regulatory agencies”.
    At least you have the sense to realize that “write your congressman” is not the answer, but hiding your head in a NIMBY cocoon doesn’t answer anything either.
    Reality is a worldwide class struggle, which often takes place in forms that appear to be based on nationalism, religion, ethnicity etc, but the underlying motive force springs from the different ways people connect to the means of production, and the different ways people have access to what is produced which spring from different access to means of production.
    We are all, whether USer, Chinese, Iranian, European, Latino, African, whoever, we’re all embedded in one planetwide system of production & distribution. All of us except the handful of Taoist monks who betake themselves to remote regions and survive permanently on roots & berries, acorns etc. I do admire such people but find it impossible to imitate them; so do 99& 44/100% of everybody else.

  11. rosemarie jackowski said on March 11th, 2010 at 2:15pm #

    Max…Yes, size matters. You commented on my article on this site about size/health care
    About the secession movement, I support it but most people here are not even aware of it.

  12. rosemarie jackowski said on March 11th, 2010 at 2:20pm #

    Deadbeat…I agree with what you say about USers being ‘atomized’. Yes, we are in survival mode, most of us. That does not change the fact that most of us, don’t really like the rest of us. Maybe our culture is designed to remove any hint of empathy – sort of makes it easier to turn us in to the killers that the military needs. Just take a walk through any toy store.

    The news of the day about the little boy who saved the lives of his family when he called 911 when some men with guns broke into his home…too bad the little boys in Iraq/Afghanistan can’t call 911 when men with guns come breaking into their homes. Heroes or killers, it all depends on your point of view.

  13. Max Shields said on March 11th, 2010 at 8:49pm #

    dan e we are looking through different prisms that much is clear. Exaggerate? I would concede that there are clusters of states – regions each of which have much in common culturally and economically, but as one peruses the larger landscape the difference become much more accentuated.

    Yes we are on one planet and there is interdependency throughout the globe. In no way is that in disagreement with my point. I’m simply saying that reality has multiple dimensions, but most pressing is human scale, thus real, and as we abstract from that more immediate reality we move into what has been described as the Fallacy of Misplaced Concreteness. This is when the general fails to match with the specific; the larger world with the local community. Such misplaced concreteness frequently leads to misunderstanding of problems and solutions as they pertain to our everyday life.

    A perfect example is the Gross National Product. It has essentially zero correlation to economic welfare. So, when you have this thing called the USA you have only the illusion of some vague abstract object that we talk about as if it exists.

    Of course it touches us with media and various public agencies. But all of this is meant to provide the illusion of connectedness. Much as I said the flag on a lapel does; a symbol of unity: e pluribus unum as displayed on the dollar bill another abstract symbol of value.

  14. Deadbeat said on March 12th, 2010 at 2:18am #

    Max Shields writes…

    I would concede that there are clusters of states – regions each of which have much in common culturally and economically, but as one peruses the larger landscape the difference become much more accentuated.

    I agree with dan e it sounds NIMBY to me. States are also artificial constructs that have regional differences as well. Who says that within any specific state that is has a common culture and economic base. This embrace of smallness is better by Max Shields is exactly the fallacy he describes in his prior post. There are huge disadvantages with “smallness” or parochialism. One of which is the LACK OF SCALE. In order to defeat Capitalism you are going to REQUIRE scale.

  15. Max Shields said on March 12th, 2010 at 5:32am #

    The problem Deadbeat is that it doesn’t appear you think so much as repeat how much you agree with dan e.

    Lack of scale is like saying a fly lacks weight and so is disadvantaged even though it’s been on the planet eons before humans and will probably exist long after homosapiens vanish.

    Deadbeat you aren’t going to “defeat” anything. Afterall, you’re a self described Deadbeat…with or without “SCALE”.