So, a week or so ago, there was a debate between Ted Cruz and Bernie Sanders on healthcare and the ACA. And I just felt the need to talk about some of the things Cruz said. I'll preface this by saying I largely agree with Sanders on healthcare and support ACA insofar that we don't replace it with something better, like universal healthcare. As such my position is largely identical to Sanders on the debate. That said I'm going to respond to some of Cruz's arguments.
1) Rationing. Cruz's key argument against universal healthcare seems to be that there's rationing of care. I agree with Sanders here...we have rationing here in America too. It's called poor people not getting the treatment they need. America's healthcare is top notch, and arguably better than what is provided in the rest of the world...but only if you can afford it. And it's not affordable. We spend 17% of our GDP on healthcare whereas other advanced countries spend far less. Around 9-12%. I don't know about you, but I'd rather have the entire population get 90% of the care free of charge at point of service for everyone, than to have some people getting 100%, others getting 90%, and others getting 50% (basic emergency room services and nothing more). I'd rather live in a world where everyone has affordable healthcare that's good than one where some have slightly better care and others get bottom tier care.
2) Wait times. Republicans love to bring up horror stories of people waiting for surgeries or hours to get treatment in the emergency room. What they don't tell you is this happens in the US all the time. When I was 19 I had periorbital cellulitis. It's basically an infection that makes the eyelid blow up like a balloon. I went to the emergency room with insurance...and was there for 6 hours. I wasn't given fast care at all. Seems to be common in emergency room visits in my experience. Then there's wait times for surgeries. My dad needed emergency surgery at one point and it took 2 months to get an appointment for it. He had to fight with insurance companies and their stupid in network out of network BS and all that crap just to get an appointment. The surgery went well, but don't get me wrong, you have to wait in the US too.
It seems when talking with people from other countries, a lot of wait times are often for less than necessary surgeries. People might have to wait 6 months for a knee replacement or something. Of course, you can live without one, and considering how healthcare priority is given to those who need it most, they might figure it's better to wait on a knee replacement while someone who needs emergency heart surgery gets it. I've also seen people claim to get stuff like heart surgery less, but I've also seen evidence there's little affect on outcome and we might just be surgery happy in the US. So it's not even clear that more care leads to better outcomes and our system might simply be inefficient. This might seem better for some people, but it's like a placebo in some cases. Immediate care might not impact mortality rates 5-10 years down the road for less than necessary surgeries.
3) Most of Cruz's arguments apply specifically to Obamacare. Obamacare is a flawed program. Yes, it may have had an impact on full time employment and hurt some businesses from growing. That happens when you don't have a government program independent of the employment system for most people. Yes, middle class families might pay more. Before Obamacare, people who were sick simply couldn't afford healthcare because of preexisting conditions. Here's the thing about market based healthcare....profits are the primary concern, not health. Insurance companies don't care if you die. They just want to make money off of you. And if they can't make money off of sick people and have to treat them like everyone else, other peoples' rates go up. It's a flaw with the for profit insurance system. Should've went with universal healthcare.
Another argument Cruz made was to allow people to buy insurance across state lines to lower prices. This might help the middle class who kinda got the short end of the stick with Obamacare and its high rates, but it absolutely won't help the poor or most vulnerable populations who need care most.
4) Government being the problem. In Cruz's mind, government is the problem. He's a typical conservative, and seems to believe if government got out of healthcare it would be more affordable. While there is certainly a lot wrong with how our government approaches healthcare (quite frankly medicare is a typical overly complicated mess that likely inflates prices since it combines the worst of both government and market based healthcare) , government acts to respond to market failures. The default approach to any good or service in our capitalist society is to have it run by the market. When that fails, we use government. Government responds to market failures and does things the market doesn't do a good job of themselves. Every government program is a response to a market failure. Medicare was a response to older people not being able to afford care. Medicaid was basically the welfare form of medicare. The ACA was intended to fix a lot of problems aimed at people who were poor or had preexisting conditions and couldn't afford care. It had some bad side effects, but that's because it didn't go far enough and still keeps the underlying market system. Cruz mentioned a Saturday Night Live skit about how the answer to everything for some people was "more cowbell." The cowbell was what was making the song in the analogy bad, but the answer was always to add more to it. The lesson was intended to be a stab at government. That the more government tries to run healthcare, the more it will mess it up. I see the problem as the opposite. The more market based we make healthcare, the more messed up it is, because let's be honest, businesses are there to make a profit and don't give a darn how affordable their care is. They'll take you for everything you got, and because you can't say no, you're left paying exorbitant rates for something you need to continue living. It's screwed up and immoral, period.
Healthcare should be a human right, and the market should at best play a peripheral function in the system. Rather than the government responding to market failures, the healthcare system should be based on government care, with the market possibly offering extra services the government doesn't provide (this happens in some countries). The problem isn't too much government, it's not enough, with the government implementing band aids rather than full scale systemic solutions. The problem with ACA isn't that it went too far, it's that it didn't go far enough. So MOAR COWBELL I SAY, Mr. Cruz.
And yeah, that's my opinion on the debate and Cruz's positions in it. I don't agree with republicans on healthcare, and believe that while their ideas might be better for the middle class relative to ACA, it would be a raw deal for the most vulnerable populations in society who need help most. Repealing Obamacare would reintroduce the problems Obamacare was intended to solve and leave many people worse off. As a supporter of diminishing marginal utility being a deciding factor in who bears the costs of things in society, those who need stuff the most and are most unable to afford it should get it, and those who can afford it should pay a little extra. It's only fair and just in my opinion. And while ACA isn't perfect, I'll only settle for removing it if we're going to be serious about implementing REAL universal care.
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