Montana Viewpoint

November 27, 2006 

Quick, what’s the difference between a national health care system and what we have now? The correct answer is—nothing.

Just because we don’t have a health care system that covers everybody doesn’t mean we don’t have a national health care system. A system is defined by policy decisions, and it’s America’s chosen policy to provide governmental health care insurance to people who can prove they are poor or old, and to let the private sector provide it to everyone else. Let me qualify that last statement: for that part of everyone else that can afford it.

There are lots of people who would argue—and have argued—with me about this. “Why, America has the best health care in the world,” they say. And I agree, but only if you can afford it. It is not the best health care in the world for people who can’t afford to buy health care insurance.

Many people say they don’t want a government run health care system. Their main argument is that the private sector can deliver health care more efficiently and with less cost than a government run system. Maybe so, but why hasn’t it? While America’s national health care system is a failure as far as middle class Americans are concerned, it must be what the health care industry wants. If they didn’t want it, they are certainly powerful enough to have had it changed.

American health care costs more per person than anywhere in the world, and it still only covers the poor, the old, and those who can afford it. It is not just inefficient, it is broke. This is what economists call “market failure” in the sense that a necessity of life is priced beyond the means of many people. If you want an example of market success, take a look at McDonald’s or Wendy’s.

We have been nipping at the heels of this problem for over 50 years, and heel-nipping is about as good as it gets, because the health care industry is happier than a clam at a clambake (they’re always smiling, aren’t they?) with the current system of market failure. That’s because it’s not market failure for them—they’re making boodles of bucks; it’s market failure for the consumer.

While some Americans may believe that government is too inept to provide health care, they don’t seem to be giving up their Medicare; which, by the way, we have because of that market failure I was talking about.

We are told to fear an increase in taxes that would be necessary to cover the cost of a national program. That’s true, but put it in perspective: working Americans who are covered by an employer’s health insurance program are already paying a 14% “tax” on their wages. That’s what health care coverage costs as a factor of real and potential earnings lost to insurance premiums.

According to a study prepared for the state of Vermont, 11% of an employer’s payroll is spent on employee health care coverage, and the employees’ share of 3% comes directly out of wages. That’s not counting money they pay out of pocket to cover deductibles.

For those who pay for their own insurance, any increase in tax would be offset by not having to pay insurance premiums. Those without insurance might see a net increase in their taxes, but they would have health insurance to show for it. The costs would be spread across the tax paying population just as they are now, only now they’re reflected in the cost of health care services instead of taxes.

The question isn’t whether or not we need a national health care program; the question is are we happy with the one we have. And if we aren’t, are we willing to pay for a better one?


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