by TED S. McGREGOR JR. & r & & r & & lt;span class= "dropcap " & "T & lt;/span & his could hurt a little" is the tagline to Michael Moore's new documentary, Sicko, which opens this week. On the poster, there's Moore with that impish grin, pulling on a rubber glove. The American health care system is a big stinking mess, which makes the image of some scruffy doofus figuring it all out truly hilarious.
But that scruffy doofus has been right about just about everything -- big business, guns, George W. Bush -- so maybe we'll finally feel health care as a moral issue. After all, problems trickle down, and it's the poor who suffer most. But those millions of uninsured Americans drag the system down, too, as they seek help in the emergency rooms, or wait until their illness is advanced and costly to treat.
So I'm glad Moore picked health care for his follow-up, but he's come to the wrong conclusion when he says all private health insurance should be eliminated. I'm sure when Americans see how fellow citizens have been treated by "the system" they may feel the same way and demand reform. And when an issue is boiling over like this one, politicians often don't think much -- they just move the pot to do something.
& lt;span class= "dropcap " & H & lt;/span & ealth care's been boiling away for years, but it's back on the front burner now -- every presidential candidate has some kind of solution. Despite America's ability to deliver the world's best health care, our system of paying for it is barely working -- individuals' coverage shrinks by the year, as costs grow unpredictably for those employers still offering it. Even doctors and hospitals are struggling, as proven by the recent news that Spokane's own Empire Health Services may sell out to a national chain. By all accounts, it's a responsible decision for the financially strapped EHS, but it says a lot that hospitals can only survive under a for-profit, multi-state model.
It's gotten steadily worse ever since 1994, the last time a federal solution was undertaken. It was the early years of the Clinton presidency, and big business was desperate for help on controlling health care costs; the conservative U.S. Chamber of Commerce even got behind the plan. Then, as we all recall, talk radio windbags and ascendant Republicans gleefully drowned the reforms and, even better, humbled Bill Clinton.
Reform wasn't killed, however, it just moved to the private sphere, and insurance companies and large health care corporations offered solutions in the form of managed care and HMOs. Meanwhile, businesses that continued to offer health coverage struggled as growth in expenses outpaced inflation.
CEO Steve Burd watched health care costs overwhelm his bottom line at Safeway, and when Wal-Mart announced it would bring its low prices -- enabled by invisible health benefits -- to California, he knew he was in trouble. The result was a bitter labor fight with his employees, which led to a strike in 2004. Ultimately, Safeway workers backed down and took significant cuts to their health care packages. But instead of declaring victory and counting his profits, Burd set out to fix the system.
To get there, Burd, a conservative Republican, formed an unlikely alliance with Sen. Ron Wyden, Oregon's liberal emissary to Washington, D.C., and together they have crafted the Healthy Americans Act. And Burd has organized the Coalition to Advance Healthcare Reform, made up of businesses big and small -- in all, representing more than 40 corporations with about two million employees.
The Burd/Wyden plan makes a clean break with that tradition (only in place since the 1940s) in which people get their health insurance through their employers. Under their plan, individuals would be required to buy insurance from a wide range of choices, and businesses would be given enough incentives and tax breaks to pay higher wages. The nation gets universal health coverage, businesses get out from under an increasingly unfair system and individuals, for once, will know what their health care is really costing and behave accordingly. Of course success depends on bringing real competition, with lots of insurance companies offering lots of different health plans, from Cadillac plans to Kias.
Wyden claims his plan won't cost anything to implement and that over a span of years, the savings will climb into the trillions.
& lt;span class= "dropcap " & A & lt;/span & bout the time the Burd/Wyden plan could come to a vote -- perhaps in 2009, with a new administration -- some jackass with a microphone may feel compelled to yell "big government" from the back of the room.
But Burd has a message for people like that: If you keep killing common sense reform, beware. If that pot really starts to boil over, and with the right set of Democrat cooks in the kitchen, the country might get something it could truly regret. That's how Michael Moore's dream of government-run health care could become the next big experiment in democracy.
Moore is a great filmmaker, but on policy I have to side with Wyden and Burd. I'm sure some European countries are quite good at running their own health care systems and I agree that "health care" and "for-profit" don't always mix, but I've seen enough. Maybe 10 years ago I could have supported government-run health care, but our country has become almost hopelessly bad at running things. Hurricane Katrina, the Iraq war, the Department of Homeland Security, adding new Medicare benefits when we can't pay for the old ones, head-in-the-sand energy policies -- right now, I'm sorry to say I have zero confidence our government could administer health care effectively.
But at least Congress could stay true to the spirit of our republic and create a level playing field, which is all that Burd and Wyden are proposing. Maybe they need a tagline, too: "Take our pill or this could hurt a lot."