Readers around the world are probably asking themselves why can’t the Americans get their act together and just accept universal healthcare? If one looks to outcomes, the American system is both the most expensive healthcare system and the least effective among all industrialized countries. In fact, in some critical areas of care, the US healthcare system ranks worse than so-called “third” or “second” world countries. For example. American infant mortality rates are higher than Cuba’s or Slovenia’s. Not only this, but the gap in healthcare outcomes is startling to say the least. All of this, despite the fact that, despite myths from politicians, the US healthcare system is far slower than its European counterparts. So, in reference to the title of this blog, what the hell, USA?
Despite the conflation of Affordable Care Act (ACA), commonly known as “Obamacare” with universal healthcare, the ACA was initially a conservative healthcare alternative created by the right-wing Heritage Foundation. If it was given a real name, it would be “Romneycare” after the Massachusetts politician who implemented a private insurance policy in his state before President Barack Obama. Another key distinction is that universal healthcare systems don’t all use an individual mandate, because they as public systems, not private funded systems. Even the most comprehensive national health plans don’t cover all kinds of treatments. They instead relegate certain treatments as electives, which are paid mostly out of pocket. Even more so, most healthcare systems are, in reality, two-tiered, which means that for the wealthy private insurance fan, there are also options. In a sense, it’s not all “free”. So, in fact, the opposition to the individual mandate signals more of a positive than negative to universal healthcare’s support. However, these basic definitions are lost in the noise of American media.
Has there every been a proposed single-payer/universal healthcare bill in the American Congress? Many, in fact, though one would be hard pressed to find any of this in the mainstream press. Just to be clear, healthcare is not an ideological issue. In Britain and Germany, heads of government, Benjamin Disraeli and Otto von Bismarck respectively, passed social insurance policies, despite their conservatism, because they felt that the opportunity would endear them to voters against the socialist-labor parties. In the US, Theodore Roosevelt, the leader of the Republican Party, supported healthcare reforms, carefully considering the German model. However, in an ironic twist, the labor unions opposed healthcare reforms, including the American Federation of Labor (AFL), fearing loss of union strength, and, of course, the private insurance companies. Several other attempts were made by every successive president up to Nixon, whose private market-based Family Assistance Plan is more comprehensive than the ACA.
Yet, despite all of the misinformation, prior to the (ACA), Americans were overwhelmingly dissatisfied with the availability of healthcare insurance, consistently over 70%. While many may not know what the term “single-payer” entails, or the details of every health policy, it is clear that an alternative to the private market needs to be found.