Thursday, May 11, 2017
To the editor:
Instead of loading into a bus and trekking to the White House Rose Garden for a premature health care victory celebration, it would have been better for the House Republican caucus to board an Airbus, fly to Frankfurt and get a first-hand look at the German health care system as a model for their health care redesign.
Germany is another large industrial democracy with a heterogeneous population. Its system provides universal coverage with a better outcome than ours at two-thirds the per capita cost. Life expectancy at birth in 2013 in Germany was 80.9 years versus 78.8 here, and infant mortality at birth was 3.3 per thousand live births in Germany versus 6.1 here.
The German system also provides choice, something the Republicans profess as their guiding principle.
There is a base public coverage so that no one slips through the cracks and an option to purchase enhanced private-sector insurance if even better coverage is desired.
Private insurance, pharmaceutical sales and medical device sales are regulated by the state to contain costs, a probable necessity in any full-service system.
I attended a town hall meeting held recently by Representative Walden in Burns during which he lamented, as he frequently does, that under the ACA in the U.S. large numbers of counties have only one insurance provider and are likely next year to have no providers.
This is a valid concern; he is right to raise it. A universal federal public option, much derided by the Republicans, but similar to the German base option, would provide a solution to this problem.
The detractors of a public option will say that government involvement will lead to rationing (recall the “death panel” scare tactic). But before the ACA, we had rationing by income level in this country. Any financially-viable system using advanced medical technology cannot afford unrestricted use of expensive devices, procedures and drugs.
This is a fact of life. More vigorous regulation of drug costs, procedures and a burgeoning insurance industry coupled with relief from excessive malpractice litigation can minimize the need for rationing.
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