Thursday, January 10, 2008

How to Get Universal Health Insurance

I'm not an advocate for government provided health insurance, but I can see that it might be beneficial on some levels. It would make employees less dependent on their employers and more able to change jobs or to go into business for themselves. I know lots of folks who feel constrained in their choices by a fear of being without health insurance for their families. Also, many people who don't get health care now would be able to get it. I have known many folks whose only visits to the doctor were in emergency rooms.

I reckon that advocates for universal health insurance are going about it the wrong way. A gradual approach might win over more voters and assuage fears of socialized medicine. How about adding pregnant women to the Medicare rolls? That would have potentially huge societal payoffs with all women having access to prenatal care, and it would be politically difficult for opponents to come out against pregnant women ("Damn those mooching Preggos!"). Many of the probable opponents of the program are anti-choice and advocates for the "unborn" (this always makes me think of the "undead"), so program advocates ccould ask how folks who profess to love fetuses so much could deny them health care just because their vehicles are poor.

Once this is in place, you could start talking about expanding the program to cover nursing mothers and suckling children. What kind of monster would deny a suckling child a check up?

Another way of selling this program to probable opponents is to point out that it is pro-natal. It's a subsidy for Americans who reproduce. Don't a lot of right wingers constantly whine about how we aren't reproducing enough and how pretty soon the third worlders will take over by the force of demographics? This is cultural insurance! If you're going to subsidize ethanol, why wouldn't you subsidize reproduction? Get your priorities straight, wingnut.

This program may encourage women to nurse longer, and I don't reckon that any harm would come of such an outcome. The program could be expanded to cover the live-in fathers of the unborn and the sucklings in an effort to promote intact families and to make sure that the unborn and suckling beneficiaries continue to have the economic and emotional support of their fathers. Keeping these fathers healthy is critical to the program. Don't wingnuts complain about the collapse of the family and fatherlessness all the time? Here's a chance for them to do something about it.

To keep adminsitrative costs down, we might as well presume that all children up to a year old are suckling and eligible for benefits together with their parents. That would eliminate the need to send out lactation police to check up on who might be getting benefits without actually giving milk. Also, some women can't nurse, and it would be unfair to penalize them and their children.

If the program works and it can be shown that improvements in overall health have resulted, it would be a shame to cut the kids off just when they were doing so well. It would be time to expand the program to continue to cover them during those critical first six years. It would be hard to justify denying benefits to kids who were born before the start of the program, so they'd have to be added as well. If things go as planned, then we will see improved performance in first graders and even more improvements in health, and it would be irresponsible to squander the investment we have made in children's health by cutting them off at this point. We might as well keep them on the rolls until they reach the age of majority.

In this manner, you might win over the most authoritarian wingnuts by playing to their concerns and issues, and you will ultimatley win over big business because the costs of children's health insurance will have become socialized rather than falling on business as part of compensation packages.

I have left folks 18 to 65 on their own, but you can see how this range could be closed gradually until everyone is covered.

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