My State of the Union Fantasy

Date: 4 Jan 1995 | posted in: From the Desk of David Morris, The Public Good | 0 Facebooktwitterredditmail

My State of the Union Fantasy

by David Morris

January 4, 1995

Bill Clinton has one last shot left before the Grinch steals Washington: the State of the Union Address. What he says on January 24 will either make him a wallflower at someone else’s party or the nation’s bandleader. Here’s the kind of speech I’d like the president to give:

Members of Congress and fellow Americans,

Twelve months ago I stood in this same place and told you that the most important issue facing this country was the escalating cost and shameful inadequacy of our health care system.

I spoke of the 40 milion Americans who lack any health coverage and the insecurity our present health system breeds. I talked of tens of millions of people who cannot leave ther jobs for fear of losing their health coverage and the one million people on welfare because its the only way they can get healthcare for their children

I promised to do my best to give every man, woman and child in this country access to adequate health care. Today I stand before you today to make a confession. I didn’t give it my best. I acted like a politician. Rather than propose a bold plan, I offered a watered down proposal that I thought would be more politically saleable. Instead of offering a simple and proven plan, I ordered my advisors to design an untested system that nobody could understand.

Yet, despite my mistakes and the tens of milions of dollars the opposition spent to convince Americans that the current health system is fine, some 70 percent of Americans still believe in the need for dramatic health care reform. They are right and last year we were wrong.

So tonight I am renewing my pledge. I will lead the battle for universal health care. And this time I promise to do it right. I will propose a plan similar to the simple, remarkably successful and wildly popular helath system that has been operating for 30 years in Canada

My conservative opponents and their insurance industry allies will scream “socialized medicine”. To which I respond,”Whatever works.” The bottom line is that the Canadian health system is cheaper, covers more people and is far more popular than our own. And anyone who doesn’t believe that need only travel a few miles north and check it out.

Canada substitutes a sinigle government insurance company for our hodgepodge of 1,200 private insurers. One health insurance card is good for everything and everywhere. The government doesn’t run the hospitals or employ the doctors. It simply pays the bills.

That kind of system cuts overhead to the bone. Canada covers 25 million residents for medical, hospital, long-term care, mental health services and prescription drugs for people over 65. Yet Canada’s single government insurer employs fewer administrators than does Massachusetts Blue Cross, which covers only 2.7 million people. If we adopt a single-insurer system, the tens of billions of dollars of reduced overhead could pay for extending medical coverage to all Americans.

Both sides of the aisle have a lot to learn about the Canadian health system. My good friend Senator Paul Tsongas announced that he would be dead if he lived in Canada because they were incapable of giving him the kind of medical care needed for his condition. Our Canadian neighbors gently but firmly pointed out that they had in fact invented the surgical procedure that saved the Senator’s life.

Republicans told us that Canadians cannot choose their doctors. Canadians again reminded us that they can and it is this country, not theirs, that is severely curtailing the patient’s right to choose.

Last year I told this distinguished body “If we just let the health care system continue to drift, our country will have people with less care, fewer choices and higher bills.” Today 2 million more people have joined the ranks of the uninsured. And we are witnessing the rapid transformation of our medical system from one driven by compassion to one driven by greed.

As Robert Sherill has incisively noted, “Decisions about life and death matters is shifting away from physician and community leaders into the hands of corporate bureaucrats and medical industry enterprenerurs–most of whom have never seen the inside of a medical school.”

Stock analysts in wall street refer to patients as “revenue bodies” and company owned health insurance subsidiaries as “patient feeder systems”.

Just one health conglomerate, the Columbia/HCA Health Care Corporation generates $15 billion in revenues and controls half of all for-profit hospital capacity. The company seeks to own a fifth of all the nations hospitals within the next decade.

The profitization and corporatization of health care hasn’t reduced spending. This trillion-dollar sector continues to expand at twice the rate of inflation.

Last year I told you that over 60 years four presidents, both Republican and Democrat, have tried and failed to extend health care to all Americans. Last year I became the fifth. I’ve learned from my mistakes. In the coming months I and my Cabinet will be taking our single-insurer plan to the people. Our message is simple. Our health care system has become dangerous to our health. Last year we fumbled the ball. This year we need to get the job done.

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David Morris

David Morris is co-founder of the Institute for Local Self-Reliance and currently ILSR's distinguished fellow. His five non-fiction books range from an analysis of Chilean development to the future of electric power to the transformation of cities and neighborhoods.  For 14 years he was a regular columnist for the Saint Paul Pioneer Press. His essays on public policy have appeared in the New York TimesWall Street Journal, Washington PostSalonAlternetCommon Dreams, and the Huffington Post.