Best of the Web
- Obama health czar led companies in trouble - Health care- msnbc.com (7/2/09)
- Most profitable drugmaker? Not a Big Pharma - FiercePharma (7/1/09)
- Cancer Chief Fires Back at Times Story on NCI -- ScienceInsider (7/1/09)
- Is Waxman-Markey Worth It? -- Kevin Drum at Mother Jones blog (7/1/09)
- Ezra Klein - Does Medicare Pay Below "Cost?" (Wonky!) (7/2/09)
- EXCLUSIVE: The *Real* HELP Bill. And It's Much Better. - The Treatment (7/1/09)
- CRP, other biomarkers, not clinically useful to predict CVD risk -- heartwire (6/30/09)
- FDA Panel Backs 'Black Box' Warning for Acetaminophen Prescription Combos -- MedPage Today (6/30/09)
- Why Wal-Mart Is Now Supporting An Employer Mandate - Wonk Room (6/30/09)
- Congress Mulling Elimination of Tax Deductibility of Drug Promotion Expenses -- RPM Report (6/28/09)
Comments
- Dan Carpenter commented on Priorities for Comparative Effectiveness Research
- gpawelski commented on On the High Price of Cancer Drugs
- gpawelski commented on The Morning Papers, June 25, 2009
- JPB commented on Never Let the Story Get in the Way of a Good Headline
- gpawelski commented on The Morning Papers, June 23, 2009
Recent Articles
Health Care: Right or Responsibility?
It's unlikely last night's debate will change many minds. Both John McCain and Barack Obama spent most of the evening reciting well rehearsed campaign themes. But there was one exchange that elucidated a fundamental difference between the two men over core values, triggered by Tom Brokaw's intriguing question: "Is health care a right or a privilege?"
The Republican nominee hesitated briefly before changing the terms of the question. McCain called health care an individual responsibility. This fits well with his plan to tax benefits and offer tax credits that would send tens of millions of people into the individual insurance market. It also embraces the philosophy behind what Jared Bernstein of the Economic Policy Institute has called the YOYO (You're On Your Own) economy, because individuals would be on their own to buy plans from a deregulated private health insurance industry.
I found myself leaning toward the television as Obama rose to speak. Surely he would find it politically expedient to avoid uttering the "right" word, which risked branding himself as just another big-spending liberal who supports unfunded entitlement programs. But with little hesitation he embraced the idea that health care is a right, and then launched into the anecdotes about people struggling to pay their health care bills, including his mom as she lay dying.
I could be wrong about this, but I suspect that this may be the first time that a presidential candidate has embraced the idea that health care is a right for every citizen. Medicare and Medicaid, the health care programs for seniors and the poor, were seen as necessary to cover populations left out of the 1960s prosperity.
But they were never considered a legal right. The U.S. constitution is silent on the issue. The while the right to an education is built into every state constitution, no state has found the political will to give health care similar status.
In that sense, the U.S. is unlike every other advanced industrial country in the world. A recent PBS special narrated by Washington Post correspondent T.R. Reid hammered that point home over and over again. When he asked public officials, physicians, and individual citizens in Switzerland, France, England, Taiwan and Japan whether a person could be denied health care in their countries, or whether they would be pursued to pay he bill if they couldn't afford it, the instantaneous and universal response was no. It was unimaginable, because health care was a right in their countries.
The Obama health care plan does not actually embrace the idea that health care is a right. He promises to cover every child. He would increase the number of insured through various incentive schemes and stepped up efforts to hold down costs. His political advertising on his health care plan stresses his plan's middle-of-the-road nature. It's neither deregulated insurance companies denying coverage nor government-run health care requiring higher taxes, the ad claims.
But he raised the bar for coming health care debate by calling health care a right. If Americans agree, then the issue he's put on the table is how best to deliver that promise to every citizen.
- gooznews's blog
- Login or register to post comments
- Printer-friendly version
Comments
Since "hope" spring eternal, I can only hope that Obama is constrained by the political race . . . he can do NOTHING as a mere candidate. As President, with a supportive legislature, perhaps he can expand his definition of "right" so that --despite our own perceived 'national exceptionalism--we may consider and endorse a universal system.
Some basic level of affordable quality health care for ALL its citizens is a moral and ethical obligation of any great nation.
HEALTH CARE IS NOT A LEGAL CONSTITUTIONAL RIGHT
The amount of $ spent on health care should be driven by the values of the electorate
We need a values discussion in this nation
My bias is for both individual(health behaviors) and institutional (public health)prevention.And compassionate rationing at the end of life.
Dr. Rick Lippin
I'm not sure that the question framed as a legal issue is applicable to the views of past US Presidents. I think that FDR believed that Health Care Insurance for everyone either paid for fully or subsidized by the Federal government and other governmental units was the correct policy for the country at large (1935 Wagner Act; speeches in New York City in September 1936). So did Harry Truman in the 1948 campaign and proposals to Congress in 1949; LBJ in 1965 before passage of Medicare and Medicaid; Jimmy Carter in 1977 introducing his health care cost containment bills; and Bill Clinton in early 1993.
I'm with FDR, Obama, etc. But then . . . an earlier email this evening came from an Illinois electrical inspector. An (urban) family had called him in to authorize the restoration of their electric service, which had been turned off in 2007, now that they had amassed the money.
He could not.
Her agonized to me and another friend that the house's wiring is just too dangerous for him to give the family's utility the go-ahead.
Where do we set the limits to entitlement? Please don't take this as a rhetorical or dismissive question.
The list of Presidents who believed in and wanted to implement some sort of universal health care includes Richard Nixon, who would probably have acted and perhaps succeeded, but for...well, we all know.
Health care SHOULD be a right but it's much too complicated for a quick fix in this country. Medical school is so very expensive that medical students have to take out huge loans that preclude their ability to charge reasonable fees or practice in smaller communities where they cannot make enough money to pay their loans. Other countries (for example Cuba) offer medical school funded by the government. And there is a serious nurse shortage in large part because not enough potential nursing students can get addmitted to school. This is because nursing schools cannot pay enough to lure qualified nurse teachers - the folks who are qualified can get higher paying jobs practicing nursing or doing utilization review at insurance companies.
Then there is the greed factor. Hospitals and their executives are some of the highest paid people around. The fundamental problem is that health care providers and pharmaceutical companies in this country either think they need to get rich, or need to make a bunch of money to even get into health care (to pay for education, research, etc.) or both. In other countries, doctors are not living in mansions. People may not expect as much as Americans do from health care providers, and may be satisifed with fewer and less expensive diagnostic tests and simpler care, and this is often discussed as the reason why care in other countries is so much cheaper. But what I don't hear much about here in America is what we can do to bring down the cost of medical education, and why medical providers and executives expect to get rich and what we might do about that. I think we should each pay a small federal tax which would go into a fund to pay for med/nursing school scholarships. The recipients should be required to serve in smaller communities and/or have a salary cap for at least 4 years. After a couple of decades, we might have some qualified medical providers who don't need to charge exhorbitant fees to pay for med school, and might decide they like the job enough to stay in smaller communities and/or charge reasonable fees to practice medicine. We need to change the culture in medicine somehow, get it back to an altruistic calling, not a way to become a millionaire.