Two perspectives on health care reform
EDITOR'S NOTE: Polls show that health care is one of the top isssues among voters. Most Republicans remain wedded to the country's private health care system. At least in principle, most Democrats favor universal health care, though they disasgree on how to achieve it. The Kentucky State AFL-CIO is one of many union organizations nationwide that has endorsed a single payer program, which is advocated by Kentuckians for Single Payer Health Care. Here are two different viewpoints on this important issue.
We don't need private health insurance
New single-payer plans don’t need to worry about carving out roles for health-care profiteers.
By ADAM GAFFNEY
The Nation
Does achieving “Medicare for All” mean mostly eliminating private health insurance? Single-payer proponents say yes: After all, if a public plan provides comprehensive, no-deductible coverage for everyone, nobody would want—much less be willing pay for—duplicative private coverage.
Yet candidates who previously embraced single-payer sometimes seem a bit unsure. For instance, Senator Cory Booker, who co-sponsored Senator Bernie Sanders’s single-payer plan back in 2017, was asked whether he would “do away with private health care” recently, and he responded, “Even countries that have vast access to publicly offered health care still have private health care, so no.”
There are actually two distinct questions wrapped into one here. First is whether we want a universal public plan for everyone, or a hodgepodge of public and private plans that cover different parts of the population according to age, income, workplace, disability, and so forth, but that together cover everyone. Last year in Dissent, I made the case that a nation like ours—with enormous unmet medical needs, an inadequate safety net, and galling inequality—is a poor fit with a multi-payer system that divides the population into a hierarchy of public and private plans with inequitable levels of access, varied copays and deductibles, and unequal benefits and provider networks. This would never achieve the equity, universality, or efficiency of a public plan that provides complete coverage to everyone.
A Better Path to Universal Health Care
The United States should look to Germany, not Canada, for the best model.
By JAMIE DAW
The New York Times
As a Canadian living and studying health policy in the United States, I’ve watched with interest as a growing list of Democratic presidential candidates — Senators Bernie Sanders, Kamala Harris, Elizabeth Warren, Kirsten Gillibrand and Cory Booker — have indicated support for a Canadian-style single-payer plan with little or no role for private insurance. Approval of such a system has become almost a litmus test for the party’s progressive base.
But rather than looking north for inspiration, American health care reformers would be better served looking east, across the Atlantic.
Germany offers a health insurance model that, like Canada’s, results in far less spending than in the United States, while achieving universal, comprehensive coverage. The difference is that Germany’s is a multipayer model, which builds more naturally on the American health insurance system.