Missing the Point

Bernie Sanders may have enjoyed Cervantes’ Don Quixote (Don Quijote de la Mancha) a little too much in his youth. Then perhaps he read or saw it more recently.  Either way, the Romantic view that he fashions himself as the leader of a “revolution” speaks more of windmills than of reality. 

That doesn’t discount the value of his opinions.  Bernie has garnered substantial support because he has addressed, with authenticity, systemic problems that our current divided government is incapable of addressing.

Nevertheless like most politicians, he presents these problems with little substance.  He’s heavy on the what and rather light on the how. A case in point is healthcare, which he doesn’t even address as an “issue” on his website.

I find that disappointing since Sanders is the only candidate with the courage enough to advocate a single payer system.  It’s disappointing because in the real world healthcare has no equal for stressful issues that impact our daily lives…our actual lives. 

People can stress over terrorist attacks, gun use, runaway germs, environmental deterioration, bad parents, puppy farms, you name it, but none of these actually impact the daily lives of the vast majority of Americans.  This is not to say that we should ignore issues that don’t affect us directly.  Were that the case, slavery might have lasted into the 20^th century.  But we should not ignore the obvious.

In the recent December Democratic debate Bernie was asked how he planned to pay for a single payer healthcare system. He was actually asked how much specifically in taxes would have to be raised to pay for it.  This was a how much more this month do you expect to be beating your wife kind of question.

He awkwardly (and timidly, in my opinion) attempted to point out that, essentially, every American is already paying a huge healthcare tax in the form of premiums and co-pays (my words), and the elimination of that would offset any tax increase.  He didn’t succeed.

Moreover, he failed to give even the slightest idea on how we get from here to there.  Democrats, in their desire to defend Obamacare, have added nothing significant to the debate on this issue.  The Republicans simply want to eliminate the law (which they invented) and let the chips fall where they may.  Not surprisingly, those chips would be like poker chips going to very few winners.

Saunders and other politicians often ask this question but don’t have the cohunes to give an answer: why do Americans pay multiples more (per capita) in healthcare costs than any other developed nation yet receive outcomes no better or inferior for the society as a whole? The American capitalist approach to healthcare, unique in the world, makes the difference and the reason it doesn’t work has to do with healthcare itself.

General healthcare is not a marketable commodity as Republicans would like you to think.  It is a service which is essentially inelastic, meaning that regardless how much the price goes up the demand for the service does not drop.  It is no more marketable than Police protection, Fire Departments, the Military, food safety, road repair or any one of many public services.

There is no free enterprise pressure to lower cost and no practical way to shop for services based on price. Controlling cost is the real issue and Obamacare doesn’t take us one step closer…but it could have.

Insurance based Universal Healthcare, as they have in Japan, is probably the type of system we could gravitate toward, given the passage of Obamacare.  However, Japan’s system has both central control of pricing and outlaws for-profit hospitals.  These are critical ingredients to controlling healthcare costs and a near impossible goal given the flora and fauna of American politics. Or is it?

In enacting the Affordable Health Care Act Obama caved on the most important aspect of the law, the public option.  He was willing to risk long term failure for short term success. It was a bad deal. It was like negotiating your right to bake bread by giving up the yeast.

The most cost-effective healthcare in the Country today is Medicare.  The public option would have essentially created a “Medicare” for American’s under 65.  It is likely it would have attracted a lot of support and combined with over-65 Medicare could have given the US Government the kind of leverage that is needed to control costs.

Given enough support we might be able to back door into a Japanese type of Universal Health Care, which ironically America created for the Japanese after WWII.

For those brain-dead Conservative Republicans who robotically respond that the Government is incapable of handling such power, I suggest they give a portrait of Lyndon Johnson the finger and turn down their Medicare benefits when they turn 65.

Bernie, Hillary and common sense Americans who know that Obamacare isn’t going away anytime soon need to start to address how to improve it and deal with its overriding fault…cost. It is by reinstating the “public option”. That is what Saunders should have responded with and should have done it with gusto.  Does he even get it?