Health care wunderkind Ezra Klein has a fine column on how the landscape for universal health care has changed. Giving some historical context of why we don’t have universal care in this country, unlike just about every other industrialized country, Ezra makes a pro-business case for universality:
[ … H]ealthcare was simpler in the 1940s, and far less expensive. In the 21st century, it’s not simple at all. Once a perk of employment, health insurance is now a necessity, and a structure that dumps such power, complexity and cost in the laps of employers is grotesquely unfair to both businesses and individuals. There’s no logic to an auto manufacturer running a multibillion-dollar health insurance plan on the side; it should stick to making cars. There’s no excuse for pricing the self-employed and entrepreneurial out of the market. And there’s no reason the owner of a three-employee start-up should have to go to bed with a heavy conscience because his coffee shop can’t pay for chemotherapy.
Of course, the cancer-stricken coffee-shop employee should not be made to go bankrupt because the new “universal health care” law somehow didn’t manage to cover him. Goes without saying, right? Hah.
Anyway, I hope Ezra’s right in his optimism that a variety of interests will find a mutually agreeable solution. It does strike me that PhRMA is one of the few industries (along with telco) that seems to get everything it wants. When you’re sitting on a gold mine, you tend to be pretty fierce about protecting it. So, we’ll see how much resistance is mounted in a newly Democratic congress.
If universal means tax payers write a big check to pharma to finance genetic researchers, then I say stick with the system where people go bankrupt. But if universal means medical care is free, then great. People shouldn’t have to worry about paying even ten dollars when they get sick and want to see a doctor. If they can’t be treated with the technology and drugs that we can afford to treat them with, then they can’t be treated. Well, hmmm. I suppose that as long as there are rich people, there will be people that buy themselves better health care than what we can afford to give everyone for free, and then we’ll be right back where we started, with poor people getting crappy health care. Maybe we could tax the extra expenditures that rich people would buy for themselves something like 200%, or something logarithmic, so that rich people will be allowed to buy themselves that crazy million-dollar-a-month treatment, but only if they can afford to pay two million a month in taxes. And the doctors and drug companies would have to pay higher taxes on the expensive rich-person treatments, so that they don’t really make more money by offering more expensive treatments either. That would level the playing field and make the ridiculously expensive treatments so unaffordable and unattractive that doctors and pharma wouldn’t see them as their cash cow. But it could still be done, it just wouldn’t make anyone rich and it wouldn’t divert funds from fighting mundane, unprofitable sicknesses.
It does strike me that PhRMA is one of the few industries (along with telco) that seems to get everything it wants.
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I’d add the banking/mutual fund industry. I went to the State House to see if there might be any relief for the huge fees that banks charge when a debit card is used in a store when there is not enough to cover the transaction. Instead of rejecting the transaction, they accept it, but they hit you with a $35 dollar fee, and then start charging you $5 or $10 a day for every day that your balance remains below zero. You can then make a deposit and think you have a healthy positive balance, but in reality, they are just taking all your deposit and not telling you you still owe them more money. You then use the card many more times, and get hit with a huge bill. Sovereign Bank took something like $500 dollars from a friend of mine, and they wouldn’t give it back. When I talked to the staffers who work on that committee, they give me the same lines that the banks give me, telling me that the banks do it that way because people don’t like being embarrassed at the cash register. Bull! People would rather be embarrassed at the register than find out they have no savings and owe the bank $500 dollars.
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If the State House was on our side, they would not allow banks to do that. They are on the bank’s side.
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Hmm, what industry does NOT get everything it wants?