Left Too Long

Three factors have to be considered in establishing a national health care plan: (1) Who is to be covered; (2) The quality of care; (3) Cost.  Unfortunately, as (1) and (2) increase, so does (3).  The U. S. is now faced with a difficult debate about quality of health care, coverage, and cost, at a time when the percentage of seniors (who consume a majority of services) is rising.  They have left it too long.

Fortunately for Canada, some of the contentious issues were decided forty years ago.  It has universal health care coverage for illness and injury, and participation is mandatory.  It is not faced with the dilemma of having 15% of the population without coverage. The young pay premiums, thereby effectively subsidizing the more expensive costs of seniors; and issues such as pre-existing conditions don't arise.

Extending coverage to previously uninsured in the U. S. increases costs.  For those who choose not to insure until they have a medical problem, the cost can be prohibitive; and to provide them with the same cost coverage as those who have always carried insurance, unfairly increases the cost for the latter.  In an aging population, the outlook is unpleasant.  Therefore, the new health care legislation made private health insurance mandatory.

Of course, people don't like to be told what to do, particularly when it means higher costs.  But you can't have your cake and eat it, too.

It's possible that health care costs might be reduced.  Many of the tasks performed by doctors; e. g., vaccinations, prescription renewals, review of routine medical tests, and physical exams, might be conducted by lesser trained health care practitioners.  However, the number of procedures requiring high-trained specialists will probably grow.

The best choice for the U. S. would be to have a public option to private insurance, with assistance for low-income persons.   The plan should be mandatory and tax-deductible, leveling the burden, making coverage universal, and eliminating the issue of pre-existing conditions.  Unfortunately, it looks like the disagreements will go on and on, given the number of competing interests, and the ability of these interests to promote dissent, rather than to resolve it.