Montana Viewpoint
Why isn’t government health insurance for everyone?

February 6, 2006

We Americans are second to none in helping neighbors in crisis. A house fire, sick child, or natural disaster—all bring forth an outpouring of sympathy and generosity for those affected by a tragedy because we see those folks as truly deserving of help.

Which raises an interesting point; if you don’t deserve help—if you can’t pass some sort of subjective neediness test given by the general public—you’re out of luck. The fact that the test is so subjective leads to an arbitrary awarding of aid, more often depending on perceived need rather than actual.

In fact, we’re pretty rabid about denying help to those who don’t deserve it, and go to great lengths to weed them out and punish them if by some chance they happen to get something they don’t deserve. We are willing to spend more money preventing someone from getting undeserved assistance than it would cost to just give it to them.

Take health insurance, for example. The only people in the United States who are eligible for no-questions-asked government heath insurance are the elderly. OK, so there is one question: “how old are you?” If you pass the test of living long enough, you’re in like Flynn.

The message is, if you are going to have a medical disaster, postpone it until you’re 65. But what about people with serious illness who are under 65? Why are they any less deserving of guaranteed health insurance than their older friends? Because they’re not 65? Come on.

Which leads back to the arbitrary distribution of help to Americans in need; there are wealthy seniors who are quite capable of covering their own medical expenses who are covered by Medicare; and there are middle income non-elderly who aren’t eligible? Who wrote those rules?

On average, Americans spend $5,635 per person a year on health care compared to the average cost in 30  industrialized countries, including America, of $2,307. We have a lower life expectancy, and higher infant mortality rates than average, too.

Of course, all these other nations have some form of nationalized health care coverage, which means that some people we would deem as undeserving get help, too. That help to the undeserving is prevented in America simply by denying help to everyone, a simple solution which happens to penalize the deserving.

I’ve heard two interesting arguments against guaranteed government provided health care insurance which I think carry great weight in the minds of Americans: “Universal government health care does not work out in the long run”; and “Health care is rationed in countries with national health insurance.”

I suppose it’s all a matter of relativity. If by “long run” we mean over, say, a couple of generations—maybe 40 years—we’d be a little off. Germany has had national health insurance since 1883, which is some 123 years by my count, and, given the history of the German economy, they don’t seem to have fared any more poorly than other countries.

But the most potent argument is that health care in all those other countries is rationed. If you need non-emergency surgery you get put on a waiting list and folks have been known to die while waiting for their number to come up (so to speak).

Ever efficient, America has eliminated that concern and the tension and worry that may accompany it. There is no waiting list; you have immediate assurance that you will not get that surgery unless you can pay for it yourself; no waiting list, no surgery, no worry.

I’m not writing about this because of some ambiguous bleeding heart concerns. In my 14 years as a Montana state legislator I’ve had hundreds of people ask me to help them get medical care, or to find ways to pay for things such as cancer treatment. I get lucky about 50% of the time, and find some solution for them.

I’m to the point now where I can’t see the sense in continuing the charade that our health care system works. Do we provide good care? The best, to those who can afford coverage or qualify for government help. But for the large percentage of those who can’t get coverage, we provide the worst kind of health care, which is virtually none.

There are many aspects and arguments around health care that can’t be covered in a long, let alone short, article. It is a complex issue, but at its core is a simple question: Do Americans deserve universal health care coverage?

And if not, why not?

Jim Elliott
Phone: 406-444-1556
Mail: State Senate Helena, MT 59620