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Private enterprise approach imperils American health care

Melvin B. Miller
Private enterprise approach imperils American health care
“You’d think the biggest economy in the world would be able to figure out affordable health care for the working man!”

Every European nation has some form of universal health care for its citizens. This was not true of the United States until so-called Obamacare was enacted. However, it cannot be said that the ardent critics of the Affordable Care Act are driven simply by a spirit of inhumanity. One wonders what provokes the callous disregard in the United States for the welfare of fellow citizens.

Perhaps the reason is that America was always seen as the land of opportunity that was so expansive that hardworking, ambitious immigrants could homestead and make a life for their families. Neighbors were distant, except in the cities, so people had quite independent lives.

In fact, people were expected to be independent from the government. Not until a constitutional amendment in 1913 (16th Amendment) was Congress empowered to “lay and collect taxes on income.” The provision of tax funds finances the “entitlements” that conservatives abhor.

The American ideal is the thrifty, law-abiding citizen who generates the revenue and assets necessary to finance an affluent lifestyle. The inability to accomplish this is viewed as the fault of the citizen. Conservatives do not believe that the government is obligated to assume any liability for the failure. In fact, stark conservatives even object to assistance that might cause the citizen to be less committed to self-reliance.

Strangely enough, the conservative attitude toward universal health care can be viewed as a distortion of “hard love.” Conservatives believe that the dire consequences of being unable to afford medical care will induce Americans to work harder and to be thriftier. But that is not working. Default on medical bills is now one of the greatest causes of personal bankruptcy.

The nation’s economic philosophy was established at the time of the Industrial Revolution, and there has been resistance to any change since then. Conservatives have had difficulty agreeing to amended policies despite substantial technological changes in America as well as the growth of cities.

The corporate, private enterprise model has been so effective in building America into an economic behemoth that there is a natural tendency to expect it will solve all problems. However, it has not been working in public health care. According to a July 18, 2017 report in the Los Angeles Times, per capita health costs in the U.S. are much higher than in Europe. In 2015, such U.S. costs were $9,024 compared with $5,119 for Germany and $3,971 for Britain. And, according to the Organization for Economic Cooperation and Development, the outcomes in Europe were better.

Now, in order to contain costs, 18 states have refused to expand Medicaid and 10 states, including six that have agreed to Medicaid expansion, are considering a work requirement for Medicaid recipients. There have been no publicized efforts to cut costs by reducing corporate profits in the process.

The American approach to universal medical care sometimes creates the impression that corporate profits are more important than the health of American citizens.